Causes

The specific causes of IBS are unknown, and there are many things that can create IBS symptoms. Those with IBS often develop heightened sensitivity in their intestines and altered motility. Gas can cause distention of the intestine that can produce symptoms such as bloating or pain. The altered motility can cause constipation or diarrhea.
Small intestinal bacterial overgrowth (SIBO) can be a disruptive contributor in causing the GI tract to behave in an abnormal manner. SIBO is an overgrowth of bacteria in the small intestine, which is an area that should be relatively sterile. SIBO can be triggered by stress, certain foods, antibiotics, or different medications. Once the excess bacteria build up in the small intestine, they feed off the foods we eat and use the carbohydrates as fuel. The bacteria in the small bowel can create excess gas that leads to painful bloating, and possibly a change in bowel habits as well.

Symptoms

The symptoms of IBS can occur frequently or on an occasional basis. The most common symptoms are:

• Abdominal pain
• Bloating and gas
• Cramping
• Constipation
• Diarrhea

How is IBS diagnosed?

Diagnosis depends on a detailed medical history and physical exam. Other, more serious conditions such as Crohn’s disease, Ulcerative colitis, colon cancer, peptic ulcer disease, or celiac disease have to be excluded. Additional testing and procedures may be needed in order to ensure the correct diagnosis. These may include blood tests, imaging studies such as ultrasound or Computerized Tomography (CT) Scans, EGD, or colonoscopy. Once a diagnosis is made, your Gastroenterologist will be able to treat with the correct medication or treatment regimen in order for you to live an active, healthy lifestyle.

Treatment

While IBS symptoms can be frustrating, the good news is that IBS does not cause permanent harm to the intestines, and does not lead to intestinal bleeding or to a life-threatening disease such as cancer.
Since those with IBS tend to have different reactions to certain types of foods, it is often recommended to try various dietary & lifestyle regimens to counteract IBS symptoms. Your Gastroenterologist may provide an overview of the most common food and beverage triggers that should be considered when developing dietary changes, along with lifestyle choices to consider changing. Keeping a diary is a good way to track how your body reacts to different foods and beverages.

Foods and beverages that commonly trigger IBS symptoms:

• Alcohol
• Caffeine
• Milk products
• High-fat foods
• Gas producing foods (e.g. beans)
• Spicy foods

Going gluten-free is a popular choice now, but if you are not gluten intolerant, it may not be beneficial to eliminate gluten from your diet. Talk with your Gastroenterologist before deciding that a gluten-free diet is a good option.

Lifestyle changes to help manage IBS symptoms:

• Reduce stress
• Relaxation techniques (e.g. deep breathing exercises, yoga)
• Keep hydrated
• Stay active
• Get enough sleep

What are the medications for IBS?

In the past, prescription medication options for IBS have been limited, but this is rapidly changing with new medications getting FDA approval, with several more drugs in various stages of development. The most common medications available are Amitiza, Linzess, Xifaxan, Hyoscyamine, Dicyclomine, Donnatol, Glycolax, Viberzi, Atrantil, IBGard, and Align. Some of these drug options treat specific types of IBS (e.g. IBS-C), so they are not typically a universal solution for all IBS patients. Your Gastroenterologist will discuss the medication options that are best suited for your specific IBS symptoms.
It is important to remember that just because natural treatment options are available over the counter, does not mean that they are always safe. It is essential that you speak with your Gastroenterologist before trying any herbal supplement to make sure that the herb in question will not negatively affect any medication you are taking or any other health problem that you may have.