People with Irritable Bowel Syndrome (IBS) experience abdominal pain and cramps, and usually diarrhea alternating with constipation. Sometimes they experience frequent diarrhea or constipation rather than one alternating with the other. Other common symptoms include a feeling of gas, bloating, fullness in the abdomen, and a poor appetite. Often a bowel movement temporarily relieves these symptoms. The disorder is also known as spastic colon, irritable colon and nervous stomach. Many people experience IBS symptoms as life-altering.

You should see your family physician if you have experienced any of these symptoms and have not yet discussed them with him or her.

What Causes IBS?

The cause of IBS is unclear. Sometimes IBS occurs after an intestinal infection. Other times it occurs after a stressful experience. But most of the time IBS occurs without any clear cause. Some people with IBS have symptoms most days. Others may have long periods with few or no symptoms between episodes.

Some research studies have found that people with IBS have abnormal levels of the neurotransmitter serotonin in their gastrointestinal system. Neurotransmitters are chemicals that enable nerve cells to communicate with each other. The abnormal levels of serotonin cause problems with the movement of smooth muscles within the intestines (motility) and increased pain sensitivity in the gastrointestinal system. Some people with IBS obtain relief from their symptoms when they take antidepressants that focus on restoring a more normal neurotransmitter level.

There is some evidence that people with IBS may have low-grade chronic inflammation in the cells in the gastrointestinal system. Researchers think that this is the case when the person has experienced stomach flu, or gastroenteritis prior to the onset of their IBS symptoms. The fact that this sometimes occurs has suggested that IBS may be caused by a bacterial infection. Other research suggests that IBS patients have abnormal levels of bacteria in their small intestines.

Diagnosis: Clearing up Important Misconceptions

The diagnosis of IBS is done by looking at your symptoms and excluding other possible physical diseases or disorders that might be causing them. The diagnosis is made when the symptoms occur for at least three days each month within the previous three months.

IBS is often referred to as “functional” which means that there is no known physical cause. This is an unfortunate and misleading term because it suggests that the disorder is purely psychological. It used to be thought that if a physical problem could not be found to explain physical symptoms including pain, the symptoms must be “all in the head.” Most clinicians and researchers now understand that this makes no sense at all for any type of health problem including IBS. All perception depends on the neurological and chemical activity in the brain. As such, all health problems including IBS, must have underlying physical factors whether current medical tests can measure and identify them or not. For example, let’s say that we are experiencing stress because we perceive some problem. This perception in the brain changes the chemical and neurological activity of the brain, which in turn causes stress-related hormones to be made by our body. These hormones cause our stomach and intestines to become more sensitive and to contract more. If we experience abdominal pain as a result, we may react with more distress, which in turn may cause more abdominal pain. This example gives us only a glimpse of the very complicated two-way street between brain and body that is always occurring every moment we are alive. The mind and body are always both responsible for our experiences. One cannot be separated from the other.

Changing our thoughts, feelings, and perceptions directly alters the body and vice versa. This explains the effectiveness of psychological treatments for IBS and other health problems. Coping better with physical symptoms leads to real physical changes in the brain which, in turn, can lead to healing within the body. If we learn how to employ our inner resources to cope better, we can help ourselves decrease physical symptoms, including pain, regardless of the underlying physical causes. This is the main goal of psychological treatment.

Treatment Approaches

Most people with IBS feel anxious, depressed and frustrated with their symptoms because they interfere with their day-to-day lives. Psychological treatment helps people regain control of their lives by learning to cope with their symptoms more effectively. As they cope better, the symptoms often decrease in both frequency and intensity.

Some people find that by making dietary changes, they can also obtain relief. However, everyone is different so no one type of diet is recommended. Some people with IBS find that it helps to avoid foods and drinks with caffeine that stimulate the stomach and intestines. Some experience improvement when they eat smaller amounts at each meal. Those with constipation sometimes experience improvement when they increase their fiber intake.

Some people with IBS benefit from taking medication. These medications include anti-spasmodic drugs, drugs to combat constipation or diarrhea, antidepressants to help reduce abdominal pain, and antibiotics. You should consult with your physician about this treatment approach if you have not already done so.

Call for a free telephone consultation or to arrange an appointment.

For more information:
1. Canadian Digestive Health Foundation: www.cdhf.ca
2. Irritable Bowel Syndrome: www.ncbi.nlm.nih.gov
3. Irritable Bowel Syndrome Association: www.ibsgroup.org
4. Irritable Bowel Syndrome (IBS) – Badgut: www.badgut.org
5. Irritable Bowel Syndrome – Canadian Psychological Association: www.cpa.ca/psychologyfactsheets/irritablebowelsyndrome

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