Understanding IBS Symptoms

Irritable bowel syndrome (IBS) is a common digestive disorder impacting the intestine and is a huge burden on people who live with this condition. Characterised as a long-term condition, IBS can lead to a wide range of unpleasant symptoms, including abdominal pain, bloating, and alterations in bowel habits, that can take the form of either constipation or diarrhoea, adding to its complexity.

Despite its widespread incidence, ranging from an estimated 10-15% of the global population, IBS remains a condition that can often go undiagnosed and untreated, which in turn can cause considerable discomfort and disruption to daily life. By shedding light on the symptoms, causes, diagnosis, and treatment options associated with IBS, people can take the necessary steps to manage their symptoms better and improve their quality of life.

Common IBS Symptoms

The symptoms of IBS are highly individualised, can be caused by numerous factors, and can manifest in a wide range of symptoms. However, several symptoms are commonly experienced by individuals with IBS.

  • Abdominal pain is a main symptom of IBS and can range in severity from mild discomfort to excruciating cramps frequently localised to the lower abdomen. The pain is often intermittent and can often be alleviated by opening the bowels, although the intensity and distribution of pain vary widely between individuals and over time.
  • Bloating is characterised by a sensation of abdominal distension and fullness, whereas gas is the expulsion of air from the rectum. Bloating and gas are frequently observed in individuals with IBS, leading to substantial discomfort and social awkwardness. Various factors, such as certain food and drink, stress, or hormonal imbalances, may exacerbate these symptoms.
  • Constipation, infrequent or hard-to-pass bowel movements, is another common symptom of IBS that can provoke abdominal pain, bloating, and flatulence. Some individuals with IBS may suffer from chronic constipation (IBS-C), while others may oscillate between constipation and diarrhoea (IBS-Mixed).
  • Chronic diarrhoea: some individuals with IBS may experience chronic diarrhoea (IBS-D). Diarrhoea is characterised by loose and watery stools and increased frequency. If left untreated, diarrhoea may lead to dehydration and electrolyte imbalances.
  • Alternating constipation and diarrhoea (IBS-M) is a distinctive feature of IBS that can render bowel movements unpredictable and disruptive to daily life, compounding the challenges associated with this condition.
  • Urgency to pass stools is a symptom that can significantly impact the quality of life and people’s social life, as they always need to be near a toilet. This symptom can be precipitated by stress or certain food or drinks. Individuals with IBS may experience urgency which can leave them feeling anxious, embarrassed and often prevents them from leaving the house.
  • Feeling an incomplete bowel movement is a sensation that can lead to significant discomfort and may trigger the urge to pass stool again, even when such action is not necessary. This symptom may arise due to muscle spasms in the rectum or colon and can exacerbate other symptoms of IBS.

IBS symptoms can be truly distressing, but researchers still do not fully understand the root causes of this digestive dysfunction. It is crucial to recognise that the symptoms of IBS do not usually correspond to any apparent structural disorders or disease in the gastrointestinal tract. Patients often undergo physical examinations or diagnostic evaluations. However, doctors may not be able to diagnose any visible abnormalities in the digestive system. 

IBS has been classified as a functional disorder, which indicates that the digestive system is not functioning properly. More recent evidence suggests that it is in fact a disorder of gut-brain interaction rather than a functional gastrointestinal disorder. IBS is thought to stem from a multifactorial interplay of underlying issues, such as problems arising in the communication between the gut and the brain, abnormalities in the nerves and muscles of the digestive tract, changes in gut microbiota, and emotional stress.

The cause of IBS points to many factors, including genetic predisposition, lifestyle factors such as dietary habits and physical exercise, and psychological factors such as anxiety and depression. Furthermore, certain foods containing high-fat levels, caffeine, or artificial sweeteners can potentially exacerbate IBS symptoms in some individuals. In many cases, IBS is thought to start after an episode of acute gastroenteritis and is termed post-infectious IBS (PI-IBS).

Since no apparent structural damage or disease is associated with IBS, the condition is often diagnosed solely based on symptoms, as there is currently no specific diagnostic test for IBS. Given the considerable heterogeneity in symptom presentation and the diverse range of potential contributing factors, this diagnostic approach can pose challenges to accurately diagnosing and effectively managing IBS.

Nonetheless, various treatment options are available for IBS, including dietary modifications, medications, and lifestyle adjustments. Collaborating with a healthcare professional can be instrumental in formulating an individualised management plan that effectively addresses the unique symptoms and circumstances of each person with IBS. New therapies are also being researched; oral intestinal adsorbents such as Enterosgel, an over-the-counter treatment, in a recent UK-based trial have been shown to be effective in relieving the main symptoms of IBS with diarrhoea.

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