Most people who are given a diagnosis of irritable bowel syndrome - or IBS - eventually become frustrated. Given enough time, their doctors usually become frustrated too. That is because IBS is not really a disease at all. It is a label given to people who don't feel well but don't seem to have anything wrong with them.
What is IBS anyway?
There are specific criteria used to diagnose IBS. Because they were adopted at an international conference held in Rome in 1988, they are called the Rome criteria. According to the Rome criteria, IBS patients must have a change in stool consistency or frequency and abdominal pain that is relieved by bowel movements - for at least three days per month for three months. There are other details but these are the most important.
Most people who get a diagnosis of IBS have tests done first to rule out serious pathology, and this often includes a colonoscopy. During this procedure, a gastroenterologist examines the large intestine using a camera inserted into the rectum. If everything looks normal and your symptoms don't improve, you have IBS.
The problem is that the term IBS does not mean anything. It does not reveal anything about what is actually wrong with you. More importantly, it does not lead to any really useful treatment that conventional medicine has to offer.
Your doctor may have tried acid-suppressing pills, antidepressants, so-called prokinetic drugs that keep things moving or antidiarrheals that slow them down. These therapies are designed to relieve symptoms - which they do, in some cases - but they do nothing about the underlying problem. This is not surprising, considering that no problem has actually been identified.
What can be done?
There are many different things that can go wrong and lead to the symptoms of IBS, and the diagnosis is really an umbrella term for all of them. Fortunately, there is no reason to fear: with specialized testing, it is usually possible to figure out exactly what the problem is. Some examples include:
- Lack of stomach acid, which can make it more difficult to digest your food and lead to acid reflux or heartburn
- Food allergies or sensitivities that trigger changes in gut function - the most common problems caused by dairy, corn, wheat and soy.
- Intestinal dysbiosis or bacterial overgrowth - meaning abnormal bacteria in your intestines that can produce toxins and unwanted gases and change the environment in your gut
- Sensitivity to gluten - also called celiac disease. This is an allergy to a part of wheat that can be triggered by many, many foods and cause a wide variety of symptoms.
- Infection with Helicobacter pylori - a bacterium that can take up residence in your stomach for years without causing major problems but which is linked to IBS
- Damage to the lining of the intestines caused by a previous or ongoing infection. The typical stomach flu, or viral gastroenteritis, leads to chronic IBS symptoms in 10% of patients.
- Hormone imbalances between progesterone and estrogen that may help explain why IBS is more common in women than men
If you have been told that your problem is in your head, don't be upset. An additional factor that is very important but often overlooked how stress affects the nervous system. The gut is often called the second brain because it has so many nerves and neurotransmitter chemicals controlling its function. There is an undeniable link between your brain and the nerves controlling digestion. This is why preliminary clinical trials have shown that IBS can be treated with hypnosis, meditation and acupuncture.
Our approach to irritable bowel syndrome involves identifying potential problems that can be treated in a step-by-step manner. While some therapies are supported by good quality clinical trials, others are based on clinical experience. Digestive problems are very satisfying to treat because with a regular program of supplements and some modification of diet, most patients get much better.