Irritable Bowel Syndrome

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Irritable Bowel Syndrome (IBS) - What it is and what you can do about it

Some people often suffer from abdominal pain, bloating/distention, diarrhoea or constipation and do not even know the reason. After a visit to the doctor’s office they may be confronted with the diagnosis "irritable bowel syndrome". But what exactly is IBS, which treatment methods are there and what can you do to ease the symptoms – find the answers here.

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IBS: Overview of possible symptoms

  • Abdominal pain
  • Pressing sensation in the area of the lower abdomen, also described as bloating
  • Increased diameter of belly, also referred to as distension
  • Irregular defecation / irregular stool consistency:
    • Diarrhoea
    • Constipation

If you think you might have IBS you should consult with your doctor as soon as possible. While IBS can be painful, it does not damage the colon or other parts of the digestive system. For this reason, IBS belongs to the so-called functional gastrointestinal disorders. These are disorders that have no organic cause. Risk factors for IBS include being a women, being over 50 years of age and having a family history of IBS. Amongst others, typical symptoms are bloatedness, diarrhoea and constipation.

IBS can be quite different in different people. Some people will suffer different symptoms than others, and the characteristics and intensity of symptoms may change over time. For those suffering multiple symptoms one solution for these multiple symptoms is handy to have.

There are four types of irritable bowel:

  • IBS-D (Diarrhoea dominant): The predominant symptom of these IBS patients is diarrhoea.
  • IBS-C (Constipation dominant): The predominant symptom of these IBS patients is constipation.
  • IBS-M (Mix) (Alternating diarrhoea and constipation): IBS patients have alternating episodes of diarrhoea and constipation.
  • IBS-U (Unspecified): This type of irritable bowel does not meet the criteria for either IBS-C, IBS-D or IBS-M but patients present with common IBS symptoms.

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Suspected triggers for IBS

The exact cause of IBS isn’t yet known. People with diagnosed IBS were shown to be more sensitive to pain (e.g. the colon).

Gender, age, genetics, hormonal changes, medications, gastrointestinal infections, allergies and certain foods have been linked to the development of IBS. Doctors and researchers also believe that psychological factors like stress play a large part.

If you have been diagnosed with IBS, certain factors can ‘trigger’ symptoms or ‘attacks’, including:

  • Stress: Strong emotions, such as anxiety or stress, can affect the nerves of the bowel in people with IBS, triggering symptoms.
  • General diet: Low fibre diets can make constipation worse in some people with IBS.
  • Food intolerance as a co-morbidity: people with IBS may experience impaired absorption of lactose (a sugar found in dairy and many processed foods), fructose or sorbitol (an artificial sweetener), triggering IBS symptoms.
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Relief from IBS

There is no universal treatment method for irritable bowel syndrome due to the highly individual nature of the symptoms. In addition to an appropriate drug therapy, sufferers themselves can do something to alleviate the symptoms in the long term.

Drug treatment for IBS

The herbal oral liquid Iberogast® showed effectiveness in the treatment of irritable bowel syndrome. It targets the different IBS symptoms by targeting different underlying causes and has a good safety profile.

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In general, the therapy used for treating IBS should always be tailored to the predominant symptom. Here are some examples for different treatment options.
Diarrhoea can be treated with so-called antidiarrheals; these inhibit bowel activity, stool consistency can be thickened and frequency reduced.
In cases of constipation one possible therapy is the intake of soluble fibre like psyllium, which can ease bowel movements, if combined with enough liquid intake.
Spasmolytics can deliver relief from abdominal (cramping) pains.

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Self-care for irritable bowel symptoms 

People with irritable bowel syndrome should take special care of their daily lives and their eating habits. Some general tips to keep in mind: 

  • Avoid stress: Of course it is impossible to avoid all stressful situations. Nevertheless, you should try to integrate relaxed moments into your daily routine. This can be a lavender herbal bath in the evening, a long walk during lunch or a cosy meeting with friends over the weekend. Think about what tasks you can delegate. For example, a housekeeper could take care of cleaning, and a babysitter can be the key to a romantic evening for two. 
  • Move more: Sports and exercises can promote your general well-being. Light jogging, swimming or cycling can also stimulate digestion and may be tried by people with constipation caused by irritable bowel syndrome.  
  • Eat right: There is no special diet for IBS sufferers. Nevertheless, one's own eating habits should be reflected on order to not unnecessarily burden the gastrointestinal tract. Avoid nutrition triggers you are aware of.
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Possible diets for IBS patients 

Like we said, there is no special diet that can help all IBS sufferers, because everyone is different. But there are some diets that may help you. Try them out after consulting with your doctor.

    Gluten is a protein contained in wheat, barley, rye, spelt and kamut and products from these grains (bread, pasta and similar). Whether gluten really affects IBS or not is not yet totally clear; however, it is a fact that IBS symptoms improve in some patients who are on a gluten-free diet, despite them not having proven coeliac disease. If you wish to try whether a gluten-free diet is suitable or not, the recommendation is to follow a gluten-free diet for some weeks. If the symptoms improve, an attempt should be made to introduce gluten back into the diet and if symptoms recur, you should remain on a gluten-free diet. In both cases, please follow up with your physician. However, it must be emphasised that gluten-containing grains are an excellent source of various nutrients, which must be supplemented with appropriate gluten-free food such as corn, buckwheat, millet, potatoes, rice and oats.

    The human body is not able to degrade and digest dietary fibre. But it is easily digested (fermented) by intestinal bacteria, which may result in the development of gases that cause bloating and abdominal pain.

    The soluble form of dietary fibre is found primarily in legumes (beans, peas, soya, lentils), fruit (citrus, apricots, blackberries, blueberries, raisins, prunes), vegetables (artichokes, cabbage, cauliflower, broccoli, Brussels sprouts, onions), oat bran and barley. Soluble fibre dissolves in water and forms a gel-like structure. The insoluble form of dietary fibre is found primarily in wholemeal or black bread, wholemeal rolls, wholemeal pasta, brown rice, vegetables (carrots, tomatoes, peppers, potatoes, courgettes, cucumbers), fruit (apples, pears, figs, kiwi fruit, bananas, wild strawberries), nuts and seeds. Insoluble dietary fibre helps to reduce diarrhoea, while in the case of constipation it is desirable to increase the amount of soluble fibre in order to loosen the faeces and facilitate bowel movements.

    Dietary fibre plays an important role in human nutrition; therefore, it should not be eliminated from the diet, in contrary it is recommended to increase the quantity of dietary fibre slowly and gradually to a total quantity of 20 to 30 grams of dietary fibre per day. Begin by eating foods that are rich in the soluble form of dietary fibre, and then add foods that contain the insoluble form of dietary fibre. If you do not feel well after eating a particular food, eliminate it from your diet or replace it with another food.

    Fatty foods can also make IBS symptoms much worse. Symptoms can already get worse while eating or shortly afterwards. Fat affects intestinal motility and the occurrence of cramps, increases fluid retention, bloating and abdominal pain.

    Despite this, fat is essential for normal body function. Fats should make up 30–35% of the daily energy intake for adults. The recommended daily intake of fats for IBS patients, in whom fat causes problems, ranges from 40 to 50 grams per day, which is the equivalent of four tablespoons of oil per day.

    Low what? The acronym stands for “Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols” – carbohydrates that are difficult for the intestines to digest. Since these carbs pull more water into the bowel, people with IBS may experience more gas, bloating and diarrhoea after consuming them.
    A Low FODMAP diet is performed exclusively under the supervision of a doctor and a clinical dietitian!
    Patients usually go on the diet for six weeks, but certainly not longer than six weeks as it can seriously compromise health. A lack of essential vitamins and minerals, especially B-complex vitamins, calcium, zinc and iron could occur when following a Low FODMAP diet. This becomes clear if you look at the FODMAP foods you should avoid: it contains many healthy foods like melons, pears, peaches, mangoes, apples and plums, legumes, cashews and certain vegetables like artichoke, asparagus, broccoli, onions, cauliflower and mushrooms. Also excluded are wheat-based bread, cereals, pasta and all products containing lactose.
    After six weeks, you can begin to gradually introduce certain foods containing higher FODMAP contents back into your diet. You can increase the amount of each food and determine the threshold at which a food causes a problem and follow up with your physician. If the food does not cause the problems, it is included in the diet, otherwise it should be excluded.

    Learning to deal with irritable bowel syndrome 

    The first thing to do is to choose a medical professional whom you trust and who has certifiable experience with IBS. They can support you and give you valuable tips along the way. The better you are informed about your condition, the better you can deal with it. 

    Think about informing your closest family and friends about your IBS – this often makes dealing with irritable bowel syndrome easier. Even if this is an issue that many people are uncomfortable talking about, an open discussion is worthwhile. It can be liberating and positively influence the personal relationship. If you have to cancel an appointment because you are not feeling well for example, no one will blame you, or even label it an excuse.

    You can take some precautions to avoid unpleasant situations. Special underwear inserts might help in your moment of need. A hypersensitive reaction to certain ingredients in food can be avoided by simply asking your server about known allergens and additives. 

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    IBS – Psychological tips  

     IBS sufferers could feel quite betrayed by their bodies as you suffer from digestive issues and you can’t do most of the things that you want to do. This makes you angry and you might even hate your body from time to time. Although these feelings are quite normal, it is important to learn to forgive your body for being so symptomatic. It is only reacting to a set of circumstances that it has found itself in. And hate or anger won’t help anyway. Most of the time these feelings could even make your IBS worse. 

    That’s why you should start treating your body more as a sick friend. Stop fighting it and stop trying to control it but start listening to what it needs and take care of it. Your digestive system isn’t your enemy – it is your partner. 

    Due to the nature of its symptoms, IBS can be isolating. And isolation can make your IBS worse as well. Like any other health condition, social support is a key component to feel better. Look for an IBS support group in your area. The more people with IBS you talk to the better. The internet is also a good way to unite with people who share the same disorder. In online discussion forums you can find help, support and empathy for your situation. Just be wary of the validity of information posted and be careful to not be caught up in others whose symptoms are more severe than your own. And always discuss new findings with your doctor. 

    Your Digestive Symptoms 

    From stomach cramps to nausea and vomiting: If your digestive system out of balance, this can manifest itself in various complaints. The search for the triggers is often difficult - because sometimes there are several causes behind the unpleasant symptoms.

    Digestive Complaints 

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    All about Iberogast®

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