Irritable bowel syndrome is distressingly commonEmma Kapotes/Rd.com, iStock/BrianAJackson
Most of us have experienced gastro-intestinal (GI) discomfort such as gas, bloating, pain in the lower belly, diarrhea, and constipation. But when does this occasional distress cross over into irritable bowel syndrome (IBS), a chronic condition that is treatable (but not curable)? Here are signs you have an unpleasant syndrome that afflicts up to 20 percent of the adult U.S. population.
IBS symptom: You regularly feel discomfort in your bellyEmma Kapotes/Rd.com, iStock/BrianAJackson
The key tip-off to an IBS diagnosis: lower abdominal pain occurring on and off for a few months—but only if it is accompanied by bowel changes such as diarrhea or constipation or both, says Eamonn M. M. Quigley, MD, co-director of the Lynda K. and David M. Underwood Center for Digestive Disorders at Houston Methodist Hospital. IBS sufferers with constipation often find relief from bloating when they have a bowel movement. The condition can have a strong effect on sufferers’ lives. For instance, in severe cases, those with diarrhea may become reluctant to leave the house for fear of having “accidents.” Here are other possible causes of your abdominal pain.
IBS risk factor: You’re a woman under age 50Emma Kapotes/Rd.com, iStock/BrianAJackson
For unknown reasons, women sufferers outnumber men by two to one, a ratio that holds not just in the U.S. but across a wide range of countries. The form of IBS tends to differ by sex. “Women are more likely to experience constipation and bloating, while men are more likely to have diarrhea,” Dr. Quigley says. IBS becomes less common after people reach their 50s. “Whether that’s due to the hormonal changes of menopause, or alterations in the gut bacteria that come with age, or something else connected to aging, no one knows,” says Dr. Quigley.
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IBS symptom: You experience gastric distress when you eat avocados, lentils, bread, milk, garlic, or soda sweetened with high fructose corn syrupEmma Kapotes/Rd.com, iStock/BrianAJackson
These foods contain carbohydrates known as FODMAPs, which can trigger G.I. symptoms in people with IBS (and others, as well). “FODMAPs are osmotic—they pull water into the intestinal tract. They may not be digested or absorbed well and could be fermented upon by bacteria in the intestinal tract when eaten in excess,” according to the Digestive Health Center Nutrition Services of Stanford University Medical Center. “When bacteria ferment these carbohydrates, they produce gas, which is irritating to sensitive people,” Dr. Quigley notes. There are five categories of FODMAPs and you can have a problem with one but not another. Diets that restrict FODMAPs have been successful in relieving IBS symptoms, but they are complicated. Stanford offers a well-studied plan. Note that some IBS sufferers experience distress after eating any food, not just FODMAPs. Learn the high-FODMAP foods that are the worst for your sensitive belly!
IBS symptom: You had unexplained abdominal pain when you were youngEmma Kapotes/Rd.com, iStock/BrianAJackson
A subset of IBS sufferers—one study says 30 to 40 percent—react strongly to stimulation (such as bloating due to excess gas) inside the large intestine. This hypersensitivity might be due to a number of factors, including a previous infection in the GI tract. If you had what is known as “functional abdominal pain” during childhood, you may have developed sensitivity in that region of your body. Functional abdominal pain is “abdominal pain that cannot be explained by any visible or detectable abnormality, after a thorough physical examination and appropriate further testing if needed,” says the American College of Gastroenterology (ACG). It is quite common among children. Among pediatric gastroenterologists, “almost a quarter of all children seen for stomach or intestinal complaints have functional abdominal pain,” the ACG adds.
IBS symptom: You’re often tiredEmma Kapotes/Rd.com, iStock/BrianAJackson
“Fatigue is a common symptom of irritable bowel syndrome,” says Dr. Quigley. While doctors don’t know the exact reason, some patients with IBS show signs of body-wide inflammation, which can wear them out. “People who don’t suffer from IBS often underestimate how the condition impairs quality of life,” Dr. Quigley notes.
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IBS risk factor: You took a lot of antibiotics when you were a kidEmma Kapotes/Rd.com, iStock/BrianAJackson
The GI tract is host to trillions of bacteria that perform important functions, such as digesting otherwise indigestible carbohydrates (including FODMAPs) and aiding in the production of vitamins K and B. Recent studies have indicated that a balance of these bacteria is crucial for the optimal functioning of the immune system. According to Dr. Quigley, epidemiological evidence suggests that antibiotic use in childhood is connected to the later development of IBS. “The theory is that the antibiotics caused changes in the gut microbiome that are relevant to IBS,” he says. To avoid unnecessary antibiotics, ask your doctor or pediatrician these key questions about antibiotics.
IBS risk factor: You’re stressed outEmma Kapotes/Rd.com, iStock/BrianAJackson
Your stomach fills with butterflies before you have to give a speech. Or your intestine clogs up when you’re under the gun at work. The connection between your brain and your digestive system is known as the brain-gut axis and it affects all of us. Mediated by the gut microbiome, the nerve pathways along the axis are especially consequential for IBS sufferers: Stress is a major trigger for symptoms, Dr. Quigley says. For a small segment of people, past stress may also play a role. “A higher than expected percent of people with IBS have a history of childhood trauma such as the death of a parent or sexual abuse,” notes Dr. Quigley. Childhood trauma, in effect, rewired their brain-gut axes.
IBS risk factor: You suffer from fibromyalgiaEmma Kapotes/Rd.com, iStock/BrianAJackson
“Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals,” notes the Mayo Clinic. According to Dr. Quigley, 50 to 60 percent of fibromyalgia patients also have IBS. However, only 5 percent of IBS patients also suffer from fibromyalgia.
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IBS risk factor: Some members of your family have irritable bowel syndromeEmma Kapotes/Rd.com, iStock/BrianAJackson
“It’s very common to see familial trends in IBS. If your mother, sister, and aunt have IBS, you might have it, too,” Dr. Quigley says. “But a clear genetic pattern hasn’t been found. Is there a genetic pattern we can’t detect yet or are environmental factors at work?”