Last Updated on 17 June 2024
IBS or Irritable Bowel Syndrome is the common name that clinicians gave to a strange and still unknown intestinal disorder. It is strange because none has ever found its cause. By the way, even this disorder belongs to the impressive collection of diseases I have endured in my lifetime. I started suffering from Irritable Bowel Syndrome when I was 12 years old and continued suffering until my adulthood.
Fortunately, with patience (little) and perseverance, I managed to keep my IBS under control. That is why, I decided to share my experience with you. In this article, indeed, I explained, step by step, what IBS is and how to prevent it from ruining your life.
What is IBS and What Are its Symptoms?
IBS is an undefined intestinal disorder consisting of stomach pain, diarrhea, or constipation. These are the main symptoms of Irritable Bowel Syndrome. Further symptoms are the straight consequence of these three, such as, bloating, nausea, gastritis, escalating and excruciating pain. The pain is, sometimes, so sharp that patients may be hospitalized. It happened to me several times.
I remember that one day, one of my IBS attacks has been so painful that I ended up hospitalized with intravenous injections. Doctors even believed that my stomach pain could have damaged my kidneys, and to avoid me further efforts, they put me on a wheelchair.
Fortunately, I recovered after a couple of days and left the wheelchair transportation to resume my usual life. However, ever since, I decided to better deepen the causes of my severe IBS. Yes, because the pain that accompanies this disorder may be from mild to severe. I have had every pain intensity: from the bearable to the most unbearable one. Why? I wondered so many times in my life.
Why I suffered so much from Irritable Bowel Syndrome? Yes, Why? And why this intestinal disorder is so widespread nowadays? I suggest that you don’t leave this article because as a patient and health blogger I discovered so many details that are worthy to be read in the following paragraphs.
Is IBS a True Disease?
Here is the first appalling reply: maybe IBS does not exist! It is only a name used by doctors to diagnose a disorder that it is hard to diagnose. Most of the time, in fact, every test you’ll be undergone will be negative! Negative feces tests, negative urine test, negative colonoscopy. It happened to me and I think it happened to many patients with IBS. In this case, doctors will define your stomach pain as irritable bowel syndrome or idiopathic intestinal disorder.
A disease is idiopathic when no cause is detected. I am sure that your doctor also said to you that there is no cure for IBS, although it is an annoying malaise. This is one of the main reasons of the bad mood of people who have IBS.
Yes, there is a closely relationship between Irritable Bowel Syndrome and mood disorders. People with IBS are often irritable and nervous. They are right, especially if they are left alone to struggle with their stomach pain. The most evident symptoms of IBS are, indeed, sudden diarrhea attacks followed by constipation or vice versa. In this condition, patients find hard to live a normal social life or eat at the restaurant. I remember what happened to me after a party with relatives and friends.
One night, I said to my husband to stop the car amid the woods, because I was in need to go to the bathroom! I used the woods as a toilet! Every occasion was for me a humiliating frustration. Christmas, Eve, and other sacred holidays were for me a source of depression and fear to have a new IBS attack. These are the main emotions of those who have IBS.
With the fear of an attack, you develop eating fear and even the fear of living! The emotional and social implications of Irritable Syndrome Bowel are many. When you have IBS you don’t know what to eat and what to avoid!
Every food may be the IBS trigger! There is only an evidence: the constant presence of stomach pain, diarrhea and constipation that forms the so-called altered bowel, namely a disorder in the defecation mechanism.
This, in turn, may alter your digestive and psychological functions and after many years of IBS you end up to develop gastritis, bloating, digestion difficulty, emptying difficulty and a strange pain in the left or right flank. If untreated, you can also develop anal fissures and hemorrhoids. Often, these disorders bleeding, but the latter is not a symptom of IBS, but of the anal scratches caused of constipation.
If you note bleeding after defecation, ask your doctor for a careful examination, because this may be a symptom of another intestinal disease.
In short, this complex frame of symptoms forces doctors to discover if that is true IBS or if it is, instead, IBD, namely a chronic inflammatory intestine disease such as Crohn’s disease or ulcerative colitis. Many clinicians think that the term IBS has been overused. Among patients with altered bowel habits, clinicians distinguish, in fact, between younger and 50-year-old ones. The latter category is more likely to have a life-threatening intestinal disease. The IBS detection is, hence, an exclusion diagnosis.
If the tests for inflammatory intestine diseases are negative, the only possible diagnosis is the one of IBS, which, in turn, may not be irritable bowel syndrome, but another intestinal disease with its own causes.
What is the Main Cause of Irritable Bowel Syndrome?
The main cause of IBS is an alteration of Gut microbiota. Gut microbiota is the set of bacteria which populate our intestine. These bacteria can be good or bad. Intestinal bacteria have the function to digest fibers and produce digestive enzymes. That is why with IBS, sufferers develop digestive disorders, also.
If the Gut microbiota is mostly made of bad bacteria, patients may develop a gastrointestinal alteration. Bad gut bacteria such as Escherichia Coli can make it even worse. If they overgrow, they may also affect brain and cause meningitis.
The gut microbiota alteration is common in IBD and IBS, but with relevant differences. The discovery has been published on Science Translation Medicine, where is reported the result of a clinical trial conducted on 2000 patients. Scientists have examined the Gut microbiota extracted by the DNA of their stool and seen that people with IBS and IBD have bad bacteria in their Gut microbiota. The composition of these bacterial is anyway different in the two diseases.
The altered Gut microbiota causes inflammation in IBD and no inflammation in IBS. However, the IBS bad bacteria are quite virulent and able to damage the functions of bowel. The level of this damage is unclear, yet. Clinical trials demonstrated that IBS is not a dangerous disease and don’t lead to severe medical bowel diseases such as cancer or ulcerative colitis. However, frequent, and persistent attacks cause a serious discomfort to sufferers with a likewise severe impairment in their life and job. If your IBS preventing you from doing your full-time job, for example, you may get disability benefits.
Another cause of IBS is stress. It seems, indeed, that this intestinal disorder is closely linked to psychological causes, such as anxiety, depression, and stressful life conditions. As usual, it is still unclear if these conditions may alone trigger IBS or if they are a consequence of the Gut microbiota alteration.
Several clinical trials confirmed the connection between brain and bowel and the ability of some intestinal bacteria to produce neurotransmitters. such as serotonin, and inflammatory cytokines. This activity may explain why IBS sufferers experience a high level of anxiety and depression and a low stress resistance. If bad intestinal bacteria prevail, even mood will be impaired.
Irritable Bowel Syndrome becomes, hence, a disorder which affects the entire person, in the body and in the mind. A healthy Gut microbiota is, in turn, the key to keep IBS under control. It would be interesting to know more about the cause of the Gut microbiota alteration. The alteration may be caused by genetical causes, food allergy, poor diet, autoimmune diseases. Gut microbiota alteration has also been diagnosed in patients with diabetes and neurodegenerative diseases such as Parkinson and Alzheimer, but even in patients with depression.
It is still unclear if depression destroys Gut microbiota or if the Gut microbiota alteration causes depression. The only evidence is that the two disorders are closely linked. The common element is always the alteration of Gut microbiota. Hence, IBS is only a common name of a disorder which may have different causes and an origin that is not in bowel. That is why I said that IBS may also not exist. It exists a frame of symptoms already described in this post.
As regards my experience with IBS, I think that my Gut microbiota has been destroyed when I was a baby. My mother couldn’t breastfeed and decided to give me the milk for adults, namely the hardest to digest for a suckling! Obviously, I got sicked and developed a severe enteritis. Doctors cured my enteritis, but I have always grown with intestinal issues. Stomach pain always accompanied my life, until I decided to stop it! By the way: technically, Gut microbiota alteration is called intestinal dysbiosis o dysbacteriosis.
How to Cure IBS
If you cure dysbiosis, you may make Irritable Bowel Syndrome curable. But, first, you must discover the cause of dysbiosis. Every person, indeed, is different and even the causes of the Gut microbiota alteration are different. Some sufferers may have an autoimmune disease, others may be a food allergy, other IBS sufferers may be susceptible to severe forms of depression.
To relieve IBS, hence, you must first discover the cause. I suffer from Hashimoto’s thyroiditis, for example, an autoimmune disease involved in depression and intestinal disorders. Even my mother has this autoimmune disease.
Hence, it is not IBS to be hereditary, but often it is hereditary the disease which caused irritable bowel syndrome! Sometimes, IBS is caused by Gluten Sensitivity, an intolerance to the protein of cereals such as wheat, barley, and oat. In this case, IBS symptoms may be accompanied by bloating, nausea, gastritis, and digestive disorders. I discovered to be gluten intolerant. Indeed, when I intake high quantities of bread, I have nausea and gastritis.
Digestive problems in IBS may be the sign of another ailment you must further investigate. If you cure the underlying disease, you’ll cure your IBS. If autoimmune diseases and food intolerance have been excluded, the other IBS causative agents remain all the ones that alter your Gut microbiota: depression, stress, poor diet, and an individual food sensitivity. There are foods, in fact, which may alter your own Gut microbiota. They are called IBS triggers.
Most of the time, the main triggers are dairy. They foster fermentative processes of intestinal bacterial. When several years ago I went to a gastroenterologist in Catania to treat my IBS, he said to me two important things: Forget dairy and reduce stress! Today, after many years, I can say this doctor was fully right. Milk, yogurt, cheese, ricotta, and other dairy is still food causing me intestinal disorders, especially cow milk. I have had less problems with goat and sheep milk.
I discovered why. We IBS sufferers are, indeed, very sensitive to saturated fats. With aging, this sensitivity stretches to other fat food, such as red meat and processed food. Cow milk is full of saturated fats, but even goat milk has them! The difference is that cow milk has long chain fats (molecular structure), which are hard to digest, while goat milk has short chain fats which are easier to digest. However, goat and sheep milk have lactose, another possible IBS trigger when you are also lactose intolerant.
Hence, to keep your IBS under control, you must avoid processed food, dairy, and saturated fats. Dairy are very important for calcium in menopausal women. To avoid stomach pain and calcium deficiency, menopausal women with IBS should eat low fat and lactose free goat yogurt. Moreover, yogurt is rich in probiotics which help restore the Gut microbiota. If the IBS attacks continue with yogurt, also, consider using probiotic supplements.
They may have healthy effects, but if they contain chemical excipients, they may have also side effects. Hence, it is better they are prescribed by your gastroenterologist. The best probiotics are in food. Aside yogurt, there are many other foods rich in probiotics, such as miso and tempeh (I bought these alternative foods, but never eaten them).
The best probiotics are in the traditional bread leavened with mother yeast, also called sourdough, or crescente in Italian. Modern bread is leavened with brewer yeast, instead, but this yeast is dangerous for our Gut microbiota, because it fosters fermentative processes and helps the growth of bad bacteria. Sourdough is a piece of the bread dough kept in the fridge until it gets acid. In this piece of yeast, there are tons of good intestinal bacteria which can restore the missing Gut microbiota.
The main cure of IBS is, indeed, dietary.
Diet for Irritable Bowel Syndrome
The diet for Irritable Bowel Syndrome is not the same for all sufferers. It is, in fact, an exclusion diet to detect and finally remove the food which triggers the disorder. The exclusion diet proceeds with several dietary trials, where, every day or very week, you include the food your bowel tolerates and exclude the one your intestine does not tolerate. Obviously, the diet for IBS must be done with the help of your nutritionist or gastroenterologist.
Usually, the diet which works for every patient with IBS is the one tending removing foods that cause intestinal inflammation or irritation. They are:
- Processed food
- Food full of saturated fats
- Cured meat
- Spicy meals
- Chocolate
- Milk and dairy
- Citrus and overall acid fruits
If you suffer from gluten sensitivity, you should remove all cereals containing gluten from your diet.
Also avoid hot and cold drinks, they have an irritating effect on the intestinal tissue.
As regards the consumption of Fodmap, namely foods containing sugars and carbohydrates fermented by intestinal bacteria, you should avoid only the ones that give you a true discomfort. Hence, all foods containing lactose and legumes containing insoluble fibers, such as peas, beans, broccoli, cauliflowers, and eggplants, for example. However, Fodmap (lactose aside) must not be completely removed from your diet. You should avoid it only when your IBS is in the active phase.
For my IBS diet, I tried to eat legumes without bread and I have had no IBS symptoms (because I have gluten sensitivity, also). I discovered that after several dietary trials!
When IBS relieves, you can try to include some forbidden food, I fully excluded gluten and lactose, for example, but when I don’t have stomach pain, I try to eat beans and broccoli in order to make my diet more complete and nutrient.
The dietary rule for IBS with diarrhea is to reduce insoluble fibers, hence don’t eat whole grains and legumes and other vegetables with insoluble fibers when you have diarrhea. During those annoying days, I follow the so-called blank diet, with boiled rice, a boiled egg or white meat and an apple. The latter contains pectin, a soluble fiber that has the effect to reduce bowel inflammation.
The dietary rule for constipation is instead opposite; increase the intake of insoluble fibers to stimulate the intestinal motility. Since IBS occurs with an alternance of diarrhea and constipation, you must also alternate your diet. It is important the cooking way, as well. There are cooking methods which cause inflammation, such as frying, while others which reduce fats and maintain the nutritional properties of food, such as steam cooking.
I eat baked ham, for example, and I don’t have IBS symptoms, because this meat is cooked with steam. Anyway, it is better to prefer food containing omega3 fats because these fats reduce inflammation and improve Gut microbiota. To have a normal life even with IBS, your doctor may suggest that you take a pill to prevent diarrhea. I received this advice, too, but I prefer to use probiotics. I take them when I go out and they prevent perfectly my IBS attacks.
Severity of Irritable Bowel Syndrome
Even though the discomfort of IBS has a bad impact on your life, this disorder is not deadly. I know you think that your stomach pain and the IBS attacks are killing you, but it is not so! I was 12 years old when I started suffering from IBS and today that I am 50, I haven’t died for IBS. I assure that I endured violent pain and unstoppable IBS attacks which ruined my nights, working days and sleep, leading me to the hospital, also. I know about what I am talking, believe me! This disorder is closely linked, as said, with an intestinal vulnerability (for autoimmune diseases, for example) and stress.
These two conditions communicate among them to trigger Irritable Bowel Syndrome. In your journey to defeat or manage your IBS, you must start a journey to manage your stress and change your lifestyle. I learned to do that! The stress – intestine mechanism is perverse. If you don’t’ tolerate stressful life conditions, you may get irritable and depressed. This “irritation “also irritates your bowel and triggers the disorder. We can’t avoid stress, we live in it, but we can learn to manage it.
To get rid of it, exercise is a good solution. Through physical exercise, you strengthen your intestine, improve your mood, and increase the good bacteria of your Gut microbiota. For sever stressful conditions, you can also follow a cognitive psychotherapy, where you learn relaxation techniques. Sometimes, it is enough only to change some details, such as regulate your sleeping hours or avoid to spend many hours on the Internet, for example.
Conclusion
I believe that the term IBS is unappropriated. Irritable Bowel Syndrome is the result of a complex frame of disorders coming from other causes. They may be internal and external. We live in a very competitive world, where worries and anxiety are in their fullest. Our intestine is our second brain, where our immune system resides. Stress is killing our immune system and the result are massive and widespread cases of IBS. I also think that the main cause of the disorder is just an alteration of gut microbiota.
It is this alteration that must be treated, not the simple IBS. In an age of processed food, pollution, genetically modified food, pesticides and plastic ingested with fish, the minimum we can have is IBS. It is the scream of our soul. To defeat it, we must listen to it and intervene before it is too late!
References and Bibliography
- KEITH B. HOLTEN, M.D., and ANTHONY WETHERINGTON, M.D., University of Cincinnati College of Medicine, Cincinnati, Ohio – LAURIE BANKSTON, M.D., Clinton Memorial Hospital, Wilmington, Ohio – Am Fam Physician. 2003 May 15;67(10):2157-2162 – Diagnosing the Patient with Abdominal Pain and Altered Bowel Habits: Is It Irritable Bowel Syndrome? May, 15, 2003 – www.aafp.org/afp/2003/0515/p2157.html
- IRCCS Humanitas Research Hospital – Meningite – www.humanitas.it/malattie/meningite/
- By Arnau Vich Vila, Floris Imhann, Valerie Collij, Soesma A. Jankipersadsing, Thomas Gurry, Zlatan Mujagic, Alexander Kurilshikov, Marc Jan Bonder, Xiaofang Jiang, Ettje F. Tigchelaar, Jackie Dekens, Vera Peters, Michiel D. Voskuil, Marijn C. Visschedijk, Hendrik M. van Dullemen, Daniel Keszthelyi, Morris A. Swertz, Lude Franke, Rudi Alberts, Eleonora A. M. Festen, Gerard Dijkstra, Ad A. M. Masclee, Marten H. Hofker, Ramnik J. Xavier, Eric J. Alm, Jingyuan Fu, Cisca Wijmenga, Daisy M. A. E. Jonkers, Alexandra Zhernakova, Rinse K. Weersma – Gut microbiota composition and functional changes in inflammatory bowel disease and irritable bowel syndrome – Science Translational Medicine19 Dec 2018 – https://stm.sciencemag.org/content/10/472/eaap8914
- Irritable Bowel Syndrome (IBS) – Kirsten Tillisch, MDAssistant Clinical Professor Division of Digestive Diseases University of California Los Angeles –www.healthywomen.org/condition/irritable-bowel-syndrome
- Silvia Radrezza – Pharmacist – Disbiosi intestinale: che cos’è, quali sono le cause e come si può trattare – Microbioma.it – February 1, 2019 – https://microbioma.it/gastroenterologia/disbiosi-intestinale-che-cos-e-quali-sono-le-cause-e-come-si-puo-trattare/
