What is IBS? How is it Diagnosed? What is the prevalence? An overview on IBS
This April is the IBS Awareness Month, a month which encourages people who experience symptoms of IBS to seek medical advice. I thought this might be a good time to refresh some basic knowledge about IBS so you can help spread the message to your family and friends who need to know about this!
Around 1 in 7 people worldwide develop IBS (Irritable Bowel Syndrome) at some stage. It is a disorder in which a person experiences chronic, relapsing abdominal pain or discomfort. Symptoms may include; constipation, diarrhoea, bloating, excessive wind, cramping or a combination of these and can vary within and between individuals. In some people, it can also cause stress and fatigue. These symptoms are unpredictable and can often vastly impact quality of life. At this point in time, the exact cause of IBS is still unclear, however symptoms can potentially be related to heightened pain sensitivity of the bowel, altered gut-brain connections as well as multiple other factors.
Diagnosis of IBS can be difficult because its symptoms are very similar to that of some other bowel disorders. People with IBS symptoms are strongly advised to seek medical advice to rule out the possibilities of having inflammatory bowel disease, coeliac disease and lactose intolerance, cancer, bowel infections and other conditions. Currently, IBS is diagnosed via the ROME IV Criteria, which takes the duration, frequency and types of symptoms into consideration, after other medical causes have been excluded. A person will be diagnosed with IBS if he/she has experienced recurrent abdominal pain from 6 months before diagnosis, on average at least 1 day per week in the last 3 months, associated with 2 or more of the following criteria:
- Related to defecation
- Associated with a change in frequency of stool
- Associated with a change in form (appearance) of stool
There are three main subtypes of IBS. These are: IBS-C (predominant constipation- type 1-2 stools), IBS-D (predominant diarrhea – type 6-7 stools), and IBS-M (IBS with mixed bowel habits). Type of stool can be evaluated via the bristol stool chart below. People whose symptoms do not fit into any category are considered to have IBS unclassified.
Although the cure of IBS is still yet to be discovered, a Low FODMAP Diet has been well researched to provide an effective management of symptoms. FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols. FODMAPs are groups of poorly absorbed short-chain carbohydrates, which are fermented in the large bowel causing gas production. This gas production can then cause bowel distention, bloating, flatulence and constipation but can also draw water into the bowel resulting in loose stools. By lowering one’s intake of high FODMAP foods i.e. onion, garlic, honey, wheat, stone fruits, apples etc. IBS symptoms can be reduced in up to 70% of patients.
So the next step is to consult an Accredited Practising Dietitian who specialises in the management of IBS and implementing the Low FODMAP Diet. There are 3 phases of the Low FODMAP Diet including 1. Elimination, 2. Challenge & Reintroduction and 3. Maintenance. This diet will require restriction of certain foods but it can still be personalised and enjoyable!
If you are experiencing these types of symptoms or know someone who is, advise them to seek medical advise, please don’t suffer in silence!
Interested to know more? We will have weekly blog posts this IBS Awareness Month so stay tuned! We will talk more about the low FODMAP Diet including what you can and can’t eat, food substitutes, simple low FODMAP meal ideas and much more!
Written by: Flora Cheung (APD, AN)
Edited by: Atlanta Miall-Shorten, (APD, AN, AccSD)