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. A bowel movement may temporarily relieve these symptoms. The disorder is also known as spastic colon, irritable colon, and nervous stomach.
You should see your family physician if you have experienced any of these symptoms and have not yet had them medically investigated.
What Causes IBS?
The cause of IBS is unclear. Sometimes IBS occurs after an intestinal infection. Other times it occurs after a stressful experience. Most of the time there is no clear cause. Some people with IBS experience 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, or motility, of smooth muscles within the intestines and increased pain sensitivity in the gastrointestinal system. Some people with IBS obtain relief 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.
When we experience stress our response causes neurological and chemical changes in 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 the rest of the 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 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 because of the impact their symptoms are having on 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.
Besides psychological treatment, some people find that other changes are helpful. These may include avoiding foods and drinks with caffeine which stimulates the stomach and intestines, eating smaller amounts at each meal, increasing fibre, and taking medications. These medications may 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 any of these treatment approaches if you have not already done so.
For more information:
- Canadian Digestive Health Foundation: www.cdhf.ca
- Irritable Bowel Syndrome: www.ncbi.nlm.nih.gov
- Irritable Bowel Syndrome Association: www.ibsgroup.org
- Irritable Bowel Syndrome (IBS) – Badgut: www.badgut.org
- Irritable Bowel Syndrome – Canadian Psychological Association: www.cpa.ca/psychologyfactsheets/irritablebowelsyndrome
