About 15% of the adult population suffers from symptoms of irritable bowel syndrome
By Ernst Lamothe Jr.
It’s a condition that often is difficult to talk about and experience. However, both aspects are the reasons why it is too often in the shadows and why people need to understand its impact.
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that affects the large intestine. Signs and symptoms include cramping, abdominal pain and bloating along with diarrhea or constipation.
While the cause of IBS is not clear, symptoms arise from a variety of factors, including a sensitive digestive tract and changes in muscle contractions in the gut. IBS may also be known by other names such as irritable bowel, irritable colon or also a nervous stomach, because strong emotions can aggravate its symptoms although they do not cause them.
In the United States, approximately 10% to 15% of the adult population suffers from IBS symptoms, according to the American College of Gastroenterology.
“This is an important health problem because IBS is the most common gastrointestinal issue and has no simple cure,” said Jeffrey Lackner, professor and chief of the division of behavioral medicine in the department of medicine at the University at Buffalo Jacobs School of Medicine. “For patients, it is a significant source of abdominal pain, distress and a significant quality of life issue penetrates different aspects of their everyday life from work productivity to relationships and intimacy.”
Lackner, who holds a Doctor of Psychology degree, discusses five aspects of IBS that people should understand.
1. Difficult to talk about
Irritable bowel syndrome can have many symptoms; the cardinal symptom is abdominal pain felt in the lower abdomen. Pain and bowel problems vary in severity from person to person. Like other chronic pain disorders, IBS is very burdensome when symptoms are more severe. Yet the mental strain of having a disorder no one fully understands and wants to talk about can be just as difficult as the physical effect.
“People don’t like to talk about their bowels,” said Lackner. “It is easier to talk about chronic pain problems like headaches or back pain.”
2. Stigma
Those who battle the condition also must overcome stigma and stereotypes along the way of getting the help they need. Everything from people saying it is 100% mental and “all you need to do is deal with it” to making light of the condition in real life or movies and television.
“There have been times when disorders like IBS are seen as a person being weak or it being just a physical manifestation of psychological problems,” said Lackner. “This is especially the cause when it becomes difficult to find an exact diagnosis and then the pain is considered all in a person’s head. There are still some well-intentioned physicians who carry old-fashioned views of IBS. Luckily, we have come a long way in understanding IBS as a problem in how the brain and gut communicate with one another.”
3. IBS is complicated
The exact cause of IBS is unknown. Possible causes include problems with bowel muscles contraction and movement of food through the digestive tract, overly sensitive colon or issues with the immune system of the nerves in the digestive tract which dysregulates communications between nerves in the brain and gut.
Several studies have assessed the prevalence of mental health problems among treatment seeking IBS patients. About 40% to 60% of people with IBS had met formal diagnosis for mental problems particularly anxiety and depression. But that also means a large percentage do not have a mental health problem, meaning it cannot be dismissed as a psychiatric problem.
“We know that IBS is a complex issue that is influenced by a variety of environmental, biological and behavioral factors that can aggravate the symptoms,” said Lackner. “Stress is definitely something that patients can identify as a common trigger.”
He cautions anyone against making a blanket statement about the condition.
“We need to get out of the habit of just seeing IBS as a psychiatric problem. It’s not helpful and gets away from the critical question which is what factors flare symptoms for which patients in what situations,” he added.
4. Hope without a cure
Despite all the scientific developments, there is still no cure for the disease. Doctors recommend a change in the lifestyle and eating habits. Home remedies or lifestyle changes include dietary changes such as avoiding food triggers like spicy or fatty foods, and a specific psychological treatment called cognitive behavior therapy.
Doctors may suggest gut-directed medications if the symptoms do not improve through simple lifestyle change and cognitive behavior therapy treatment if symptoms remain refractory to first-line medications.
“If someone has IBS, there is no single treatment, food or medication that works across the board for everyone’s gastrointestinal system,” said Lackner. “There are foods that could trigger it, but people have a full range of symptoms that they develop with IBS. There are several nutrition and behavioral self-management processes that can help people lessen their IBS.”
5. Family history
Often occurrence of this condition is seen in people in their late teens to early 40s. It is also said that it may affect multiple people in a family.
Women can be twice as likely than men to suffer IBS.
“It is difficult to know what a positive family history means. It is not clear whether symptoms are due to a genetic predisposition that renders patients vulnerable to symptoms. It is also possible that what is passed on is not biological vulnerability but a psychological one that influences how they interpret and cope with symptoms. The research is compelling that family history has some influence,” said Lackner. “The good news is that just as people can learn bad habits for managing symptoms they can learn good ones and when this happens symptoms can often improve as well if not better than with medications.”
Featured image: Jeffrey Lackner, professor and chief of the division of behavioral medicine in the department of medicine at the University at Buffalo Jacobs School of Medicine: “Luckily, we have come a long way in understanding IBS as a problem in how the brain and gut communicate with one another.”