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From the time we’re little kids, any mention of bowel habits can trigger giggling embarrassment. We’re not sure why that is, because the intestine is simply another organ in the body. Nevertheless, our concierge primary care doctors in Jupiter know that talking about bowel disorders can be uncomfortable for our patients.

This is unfortunate because changes in bowel habits can sometimes signal potentially deadly diseases. On the other hand, some 45 million Americans endure the disruptive and often debilitating—though not life-threatening—symptoms of irritable bowel syndrome (IBS) because they’re embarrassed to discuss them with us.

April is IBS Awareness Month, sponsored by the non-profit International Foundation for Functional Gastrointestinal Disorders (IFFGD), to encourage people to seek medical advice for this condition. This year’s theme is “Reducing the Stigma.”

What is IBS?

Although there is no cure yet, IBS is a chronic disorder that can be managed. There are no specific medical tests for IBS. Diagnosis is made by testing to eliminate other, more severe conditions. One reason it’s difficult to diagnose IBS is that the symptoms can vary from person to person.

Centered on the large intestine, symptoms can include:

• cramping
• abdominal pain
• bloating
• mucus in the stool
• gas
• diarrhea
• constipation

These symptoms are typical of IBS and, while distressing, they are usually not cause for concern.

Once other similar conditions such as celiac disease or more severe illnesses such as cancer have been ruled out, IBS symptoms are divided into one of three types: constipation-predominant, diarrhea-predominant, or mixed/combination. Treatment depends on which type you have.

What causes IBS?

IBS tends to be a chronic condition, meaning it doesn’t go away, although the symptoms seem to come and go from mild to worse and back again. Often, symptoms will disappear completely for a period of time and then recur.

No one knows the exact causes of IBS, but research suggests certain factors might contribute to it. For example, some women find their symptoms increasing during their periods. Others experience worsening symptoms when they’re in a stressful period in their lives.

Other causes may include stressful or difficult early life events, such as physical or sexual abuse. Bacterial infections, including small intestinal bacterial overgrowth (SIBO), appear prevalent in those with IBS. Food intolerances may play a role, and research also suggests that some people may have a genetic predisposition toward developing IBS.

How common is IBS?

Irritable bowel syndrome is the most common functional gastrointestinal (GI) disorder in the world, experienced by an estimated 10-15 percent of the population. “Functional” means it’s not a condition that is detectable through common diagnostic tests, and in which no apparent structural or biochemical abnormalities account for the symptoms.

According to the IFFGD, even though many people with IBS don’t seek medical care for their symptoms, there are still between 2.4 million and 3.5 million doctor visits for the condition each year in the United States alone. Among those who do mention it to their doctors, about 40 percent have mild symptoms, 35 percent have moderate symptoms, and 25 percent have severe symptoms.

More women than men report IBS symptoms, about 60 percent for women vs. 40 percent for men. This prevalence in women is concerning because IBS symptoms can lead to unnecessary surgery for them. The IFFGD reports that hysterectomy or ovarian surgery has been reported in female patients with IBS as high as 47 percent to 55 percent, due to misdiagnosis of their condition.

How is it treated?

Once a diagnosis of IBS is made, it can be managed through a combination of diet or lifestyle modifications, some type of counseling, and medication for severe cases.

Some people find relief through:

• increasing fiber intake
• adding probiotics to the diet
• getting enough sleep
• enteric-coated peppermint oil capsules
• acupuncture

While adding more fiber may help some who are constipation-predominant, that can be the wrong approach for others. A high fiber intake may only increase diarrhea, cramping, and gas in certain people. Or it could be just certain foods that they react to. Some foods that may trigger IBS in sensitive individuals include:

• gluten
• sorbitol
• lactose
• fructose
• caffeine
• beans
• onions
• cruciferous vegetables
• alcohol
• tomatoes and tomato products

Other approaches

Johns Hopkins Medicine reports that “There is a strong connection between the nervous system and colonic function. Stress plays an important role in the frequency and severity of symptoms in IBS patients.”

Therefore, the following approaches can be helpful in reducing symptoms:

• increasing physical activity
• reducing stressful life situations
• cognitive behavioral therapy
• relaxation training
• counseling
• biofeedback
• mindfulness training
• progressive relaxation exercises
• hypnotherapy
• therapeutic massage

In addition, various medications can help to treat IBS, or at least reduce symptoms. These include drugs to treat diarrhea or different ones to relieve constipation. Anti-spasmodics can help calm the associated intestinal spasms in the colon, and some patients will even respond favorably to certain types of antidepressants.

Because IBS can interfere with daily activities, and in severe cases even reduce your overall quality of life, it’s important to know that it can be managed. So if you are experiencing any of the symptoms described here, please let us know. We can help you manage this chronic condition.