Management of Irritable Bowel Syndrome

Ty Johnston, PharmD Student

Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder that affects 10-25% of Canadians.¹ The symptoms can be very burdensome and disruptive to a person’s everyday life. Despite the condition being poorly understood, there are some simple measures that can reduce symptoms.

What is IBS?

IBS is a disorder that causes severe discomfort but doesn’t cause structural damage to the gut (bowel); in contrast to inflammatory bowel disease (IBD), which causes structural damage and includes conditions such as Crohn’s disease and ulcerative colitis. IBS is poorly understood, and there is not a single cause for the symptoms that it produces; therefore, the disorder is difficult to treat.

What are the Symptoms?^1,2,4

The symptoms of IBS vary from person to person, but the most common symptoms include:  

• Abdominal pain, discomfort, and cramping
• Bloating and excess gas
• Changes in bowel movements, where some people may experience periods of diarrhea while others experience periods of constipation or a combination of both.

Other symptoms may include nausea, headache, and heartburn.

When to Seek Medical Attention?

There isn’t a single test to diagnose IBS. Diagnosis is mainly made through symptoms and their duration, as well as ruling out more serious conditions like IBD. The following symptoms indicate that something other than IBS may be the cause and medical attention should be obtained.^1,2

• Blood or mucus in your stool
• Significant colour change in your stool (such as pale whitish, black, or tar-like)
• Unexplained weight loss
• Severe symptoms
• Symptoms that occur at night
• Persistent vomiting
• Fever

Self-Management

There isn’t a one-size-fits-all approach to deal with IBS symptoms. However, there are some things that can be tried such as: ^1-4

• Exercise! Increased physical activity is associated with decreased IBS symptom severity.
• Drink a lot of water (at least 8 cups per day).
• Limit alcohol and caffeine intake.
• Limit stress as it can act as a trigger.
• Keep a diary of your symptoms and/or diet. Not only will it help a physician with the diagnosis, but it’ll help identify triggers as well. Once triggers are identified, you can work towards avoiding them to manage your symptoms.
• Avoid foods that may trigger symptoms. Here are some common foods that contribute to symptoms:
  • Dairy
  • Cereals (e.g. wheat, oats, corn)
  • Citrus fruit
  • Caffeinated drinks
  • High-fat foods
  • Alcohol
  • Sugar alternatives (e.g. fructose, lactose, sorbitol)
  • Beans, lentils
• Eat smaller and more frequent meals, rather than larger meals.
• If flatulence is the major symptom you are experiencing, avoid:
  • Chewing gum
  • Carbonated beverages
  • Drinking through a straw
• Change in fibre intake. This is particularly important if you’re primarily experiencing constipation, which is often caused by a lack of dietary fibre. If this is the case, then increasing soluble fibre in your diet may help your symptoms.
  • Here is a resource that can be used to increase soluble fibre intake: https://familydoctor.org/fiber-how-to-increase-the-amount-in-your-diet/
  • Avoid bran (insoluble fibre) because it can cause bloating and actually worsen symptoms for some people
• Using antidiarrheals and laxatives may help with diarrhea and constipation respectively, and can be obtained at a pharmacy.

In addition to what was mentioned above, you may seek alternative treatments involving medications, specialized diets or counselling by talking to your healthcare providers, such as a physician or dietician.

The Bottom Line

IBS is a common disorder that causes very burdensome symptoms. Despite the lack of a cure or a one-size-fits-all approach, there are many things that can be tried to manage symptoms.

We hope you took away something valuable from this piece. If you have any questions or concerns regarding this article or others, feel free to reach out to us on Instagram, Facebook, or at ask@orbishealth.ca with your feedback. We’d love to hear from you.

RESOURCES

1. RxTx: CTMA. Irritable Bowel Syndrome
2. RxTx: CTC. Irritable Bowel Syndrome
3. Dynamed Plus: Irritable Bowel Syndrome
4. C. T. (2017, July 2). Irritable Bowel Syndrome | Symptoms and Treatment. Retrieved August 26, 2018, from https://patient.info/health/irritable-bowel-syndrome-leaflet