By Riva Preil
April marks Irritable Bowel Syndrome (IBS) Awareness Month. IBS is a condition characterized by abdominal pain, discomfort, and bloating as well as abnormal bowel habits. There are four main subcategories of IBS: IBS-D (predominantly diarrhea), IBS-C (predominantly constipation), IBS-A (alternates between diarrhea and constipation), and IBS-PI (post-infectious). It is unclear to date what causes IBS. IBS is associated with chronic pain, fatigue, a feeling of urgency prior to passing bowel movements, and tenesmus (a feeling of incomplete emptying of the rectum after passing a bowel movement). Due to the extreme pain and its effects on the suffering individual, IBS is also associated with psychological disorders, such as anxiety and depression. In fact, one study indicates that up to 60% of individuals with IBS also present with a psychological disorder.
Testing for IBS includes performing a stool culture (to rule out any infectious disease), blood work (to rule out celiac disease), an abdominal ultrasound (to rule out biliary tract diseases, such as gallstones), and endoscopy. Unfortunately, there is no current cure for IBS; however there are many treatment options available for symptom management. One important factor to consider is diet, especially because lactose and fructose tend to exacerbate the symptoms of IBS. Therefore, the FODMAP diet (which restricts lactose, fructose, and other carbohydrates which the small intestine has difficulty absorbing) is recommended. In addition, it is important for people with IBS to eat soluble fiber (which can be supplemented through the use of psyllium husks) as opposed to insoluble fiber (ex. bran), which can make symptoms worse. Some medications (such as tricyclic antidepressants) have been shown to alleviate IBS related pain, and one should speak with their primary care physician regarding medications. Furthermore, stress relief strategies such as yoga, tai chi, medication, and exercise may reduce the intensity of the pain. Finally, individuals with IBS often benefit from pelvic floor physical therapy to help manage musculoskeletal related changes that occur in the abdomen and pelvic floor in response to the assault on their system created by IBS.