Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS)

Irritable Bowel Syndrome, known commonly as IBS, is a gastrointestinal disorder affecting bowel function. It is truly unknown how many people suffer from the condition, as it is widely under-reported, but experts estimate between 10% and 21% of the world's population is affected.

IBS is generally characterised by symptoms of chronic, recurrent abdominal pain or discomfort, bloating, altered bowel habits (including frequency, urgency and/or consistency of stools). Symptoms associated with IBS can change frequently and flare ups can occur suddenly and unexpectedly.

IBS can remain undiagnosed, as the symptoms vary by individual and diagnosis relies on personal reporting of symptoms and ongoing medical history as there is no specific test to diagnose irritable bowel syndrome. It is diagnosed when all structural and biochemical abnormalities have been explored and ruled out.
While IBS isn't life-threatening in itself, those living with the condition are impacted daily and their quality of life is often diminished.

IBS Subtypes

IBS-C - Constipation predominant IBS (characterised by Bristol stool Types 1 and 2), is associated with symptoms of constipation, abdominal pain and often bloating. The pain is alleviated upon passing the stool.

IBS-D - Diarrhoea predominant IBS (characterised by Bristol stool Types 6 and 7), is associated with bloating, abdominal pain and loose, watery stools, sometimes with mucous present.

IBS-M - Mixed type IBS (characterised by fluctuations in Bristol stool Types 1 to 6), is associated with alternating diarrhoea and constipation.This is often reported as the most painful subtype and people who suffer with it may experience the change between stool types very rapidly.

There is not one single-known cause for IBS, although several pathophysiologies have been proposed as potential contributing factors in the development of IBS

Disbyosis and imbalances in microbial colonisation
It is well documented that gastrointestinal function is reliant on bacterial populations being balanced in the gut, commonly referred to as the "microbiome". Imbalances in this complex structure of bacterial systems can play a part in the development of IBS. Pathogenic infections or imbalances in beneficial bacteria (particularly imbalances in E.coli, Bifidobacteria and Lactobacilli sp.) have been shown to increase the risk of developing IBS.

Small Intestinal Bacterial Overgrowth (SIBO)
SIBO is a condition characterised by imbalances of bacterial overgrowth in the small intestine. Symptoms of SIBO are often very similar to those of IBS including abdominal pain, bloating and changes in bowel habits. While there isn't enough research to show that SIBO has a direct effect on the development of IBS, some studies have shown that the presence of SIBO is substantially more prevalent in patients suffering from IBS, indicating a potential correlation between the two conditions.

Gut-Brain Axis
Low-grade inflammation is another factor associated with most people suffering the condition. IBS sufferers often have increased levels of pro-inflammatory cytokines (such as TNF-alpha, interleukin (IL)-6 and IL-8. These cytokines have been found to activate the hypothalmic-pituitaryadrenal axis (HPA) by stimulating the hypothalamus to produce coricotropin-releasing hormone (CRH). Elevated CRH can result in increased digestive symptoms, as well as perception of pain, known as visceral hypersensitivity, commonly reported in IBS patients.

Diet
Dietary intake has long been proven to have a direct effect on overall digestive function and symptoms associated with overall gut health. Certain foods have been shown to have increased effects on the development and severity of IBS symptoms. Diets rich in poorly absorbed short-chain carbohydrates (FODMAPs) and heavily processed or refined foods as well as alcohol are more likely to enhance IBS symptoms.

Many aspects have been considered as causitive factors for onset and development of symptoms associated with IBS and while there is no singular contributing factor, it is though that this complex, multi-faceted disease is under reported. IBS Awareness Month is held in April every year and the hope is to reduce the stigma behind IBS and for people who are suffering in silence to be able to talk more openly about it with their healthcare provider. If you suspect you may be suffering from IBS, engage with your medical practitioner and start the conversation.

Our food sensitivity testing and stool analyses can assist sufferers of IBS in managing their symptoms. If you need any further information or assistance, please call 1300 55 44 80 Monday to Friday AEST.