It’s normal to occasionally have stomach aches or have trouble going to the bathroom, but people with irritable bowel syndrome (IBS) are disabled by chronic pain and discomfort. IBS effects the large intestine and will often cause painful and intolerable symptoms such as bloating, abdominal pain, and inconsistent bowel movements.
Patients with IBS experience some harsh symptoms that can impact their quality of life. It is important to treat IBS, so people with IBS can have healthier bowel habits. Symptoms include:
In order to be diagnosed with IBS, through the diagnostic criteria set forth by Rome IV, you must have these symptoms for a least one day per week over the last 3 months with symptoms begin over 6 months ago. Most doctors do not follow the requirements too closely, according to Philip Schoenfeld, MD, MSEd, MSc, co-author of the American College of Gastroenterology’s IBS treatment guidelines.
According to Schoenfeld, it is tough for patients to remember the exact number of weeks they have had symptoms. He suggests people not wait and, to instead, see a doctor as soon as you have recurrent symptoms.
Linda A. Lee, M.D., states that there’s no effective blood test or marker to diagnose irritable bowel syndrome. Rather, most doctors will search for symptoms to ensure that they fit the diagnosis check-list. Symptoms usually appear in childhood and, normally, before the age of 40. According to Dr Lee:
It’s very unusual for someone who is 80 to present with IBS [for the first time]
IBS is commonly confused with other illnesses, so your doctor will ask you questions and perform tests to diagnosis the right illness. Other ailments can cause diarrhea and constipation. Blood in the stool, fever, weight loss, and constant pain are not symptoms of IBS. If you have these symptoms, see a medical professional right away.
IBS is not the same as inflammatory bowel disease (IBD). According to Christine Frissora, M.D., gastroenterologist at Weill Cornell Medicine and New York-Presbyterian,
IBD is characterized by an immune-mediated inflammatory process that results in ulceration and actual inflammation in the intestine.
Irritibale bowel disease may also be known or progress into ulcerative colitits or Crohn’s disease.
Dr. Lee extrapolates,
people with IBS do not have the kind of inflammation that we typically associate with IBD, though some people can have both.
IBS does not cause changes in the bowel tissue or increase the risk of colorectal cancer. Dr. Frissora adds to these differences by explaining, beyond gastrointestinal (GI) distress, IBD may cause “alarm signs,” like “fever, bleeding, weight loss, joint pain, and eye problems.”
People with IBS commonly have triggers to bring on their spout of symptoms. Most commonly, foods like garlic, onions, sweeteners, smoking and drinks that contain alcohol. Greasy foods can encourage unwanted colonic contractions, so it is advised by doctors that you avoid any of the above. Many foods can trigger IBS. Also, food known to cause gas can cause IBS symptoms.
Stress is known to bring forth symptoms of IBS. There is also a vicious cycle as the symptoms of IBS induce stress and stress leads to IBS symptoms. It can be stressful if you are unsure if you will be able to make it to the restroom or not.
Though there is no scientifically agreed upon root causes, but some factors seem to cause IBS. Intestinal contractions that are either too strong–causing diarrhea–or too weak–causing constipation–may be to blame, though the exact cause of this muscle problem is not known. GI tract abnormalities can throw off your digestive process, including poorly coordinated signals between your brain and intestines.
IBS is chronic but, fear not, there are ways to manage and often do entirely away with symptoms. IBS can be managed through better, tapered dietary choices. If your IBS leads to diarrhea, you will ususally be advised to try out alow-FODMAP diet by your doctor, to determine what your dietary triggers are. Dr. Lee explains exactly what this is:
FODMAPs are carbs that all of us eat every day, but humans do not have the enzymes to break them down very well. They’re not absorbed in the small intestine, so they’re passed into the colon where bacteria begin to ferment them and produce gas…For those with [gut] hypersensitivity, any kind of gas distention triggers discomfort, a sense of bloating, and it sometimes can trigger hypermotility and diarrhea with that
One the other hand, if your IBS causes constipation, adding more fiber to your diet and taking stool softeners can help. Dr. Lee says some patients also take certain supplements, probiotics, or other medications to target certain symptoms. Some antidepressants can be used to control the nerve activity within the stomach to ensure it is less sensitive to stress. These meds come with high negatives, it has been advised to avoid this particular type of treatment by Dr.Frissora.
IBS in Women
IBS is more popularly found in women than in men in the United States. Dr. Lee believes the reason is likely biological, though experts do not have an agreed upon verdict. There are studies that have indicated that there could be a correlation with prgesterone and estrogen with irritable bowel syndrome symptoms in women. Many women, both with and without IBS, report GI problems during their menstruation cycle. Those that have IBS will experience symptoms to worsen when menstruation occurs.
Symptoms of IBS can at times become worse when experiencing menstruation, though the reason is not yet medically known. It is common with menstruation to see shifts in digestive tract functions, but those with IBS experience elevated indigestion issues.
IBS in Men
As IBS would be more popular with women in comparison to men, as IBS hasn’t been as thoroughly studied in men. The difference in diagnosis rate may merely be social, however. Dr. Lee states that IBS can vary from person to person:
If you go to India, for example, you’ll find that prevalence of IBS is equal. The thought is that it’s because men who have GI symptoms in India are more likely to go to a doctor to seek help than men in the United States,”
One study showed that diarrhea in IBS is very common with men. A study was conducted on the differences between the genders that had irritable bowel syndrome, it was discovered after discomfort and pain, more men were experiencing movements of the bowel in comparison to women. Furthermore, women experience more correlated sickness/vomiting than men.
More research suggested that there were no differences between women and men when it came to stool frequency, pain, depression or affecting their lives on a day-to-day basis.
It has been noted that women will experience intense bloating and harder stools. Women will also go through anxiety with IBS. Although, women will report their symptoms, men hardly do because of the stigma surrounding it. As a result, it is suspected that more often than not, men will leave IBS untreated.
IBS and the job of hormones is a critical point of study, as IBS is most common in females. Androgens (sex hormones), may help ward off IBS. Androgens are much stronger in men than women.
It’s quite plausible that androgens are able to fight against the beginning stages of chronic pain diseases, such as IBS. A particular class of androgen, Testosterone, might offer a numbing impact when it comes to pain. High degrees in androgens, specifically testosterone, can at times reduce pain in women and men.
Medical Cannabis and IBS
We have an internal regulation system called the endocannabinoid system. Cannabinoids, able to interact with the system, are also found in the cannabis plant. The endocannabinoid system is not fully researched, but we know it consists of cannabinoid receptors. The receptors are found throughout our central and peripheral nervous systems and a large number of them are found within our digestive system.
The very first researcher to connect marijuana and IBS was Ethan B. Russo. In 2003, Russo theorized IBS and other health conditions were the result of deficiency in the body’s cannabinoid chemicals. Novel research has given hard support to Russo’s theories. In animals, cannabinoids are shown to affect gut motility and visceral hypersensitivity, both of which have been highlight as contributing factors of IBS. In a 2017 review on the topic, writers claim, “additional high-quality method studies are needed before a clinical recommendation is indicated.”
One theory, from the few studies that do exist, is that medical marijuana provides improvement for IBS symptoms because cannabinoids affect acetylcholine and opioid receptors in addition to cannabis receptors. Other studies have shown those with IBS-D may benefit from dronabinol. Dronabinol is chemically engineered to math the properties of cannabis. It is able to decrease gut transit and increase colon compliance. It is currently used in cancer patients for lessening the side effects of chemotherapy.