Think You May Have Irritable Bowel Syndrome (IBS)?
Abdominal pain, bloating, cramps, constipation, diarrhea… we all experience these not-so-pleasant tummy troubles from time to time. But when these symptoms present themselves on a regular basis and negatively affecting your quality of life, it can leave you wondering if there is a bigger problem at hand. Never fear, CDHF is here! Below we have outlined the common symptoms associated with IBS, and how it is typically diagnosed. Please note: this information should not be used as a substitute for the medical care and advice of your physician.
So.. what is IBS and what are the common symptoms?
Irritable bowel syndrome (IBS) is a disorder affecting the intestine. IBS involves problems with motility (movement of digested food through the intestines) and sensitivity (how the brain interprets signals from the intestinal nerves), leading to abdominal pain, changes in bowel patterns and other symptoms. Although often disruptive, debilitating and embarrassing, it may be some comfort to know that IBS is NOT life-threatening, nor does it lead to cancer or other more serious illnesses.
IBS is very common. In fact, Canada has one of the highest rates of IBS in the world, estimated 18% vs. 11% globally. (Lovell et al. 2012) The exact cause of IBS is unknown, however, it is believed that IBS may be caused by one of several factors. In some, it may be linked to a prior infection or event which disrupts the normal functioning of the intestines.
It is common for people to develop IBS following a gastrointestinal infection, food poisoning, traveller’s diarrhea, surgery, a change in diet or the use of medications. In others, an imbalance of intestinal bacteria or a change in the body’s level of hormones, immune signaling in the bowel wall or neurotransmitters (brain chemicals) may also lead to the development of IBS. Currently, there is a great deal of interest in possible alterations in the number or type of bacteria within the intestine, but the exact role this may play in IBS is not yet known.
IBS is not a single entity. It’s a collection of abdominal and bowel-related symptoms. Symptoms common in IBS that support a diagnosis are:
- Abdominal pain
- Abnormal stool form (hard and/or loose)
- Abnormal stool frequency (less than three times per week or over three times per day)
- Straining at defecation
- Feeling like you haven’t completely emptied your bowels when you do go
- Mucus in stool
To distinguish IBS from temporary tummy troubles, experts have emphasized the chronic (long-lasting) and relapsing nature of IBS and use a criteria based on the occurrence rate of symptoms and their duration to diagnose it (Quigley, et al, 2016).
Rome IV Criteria
In May 2016, the Rome Foundation released the new Rome IV criteria for diagnosing IBS. All around the world, physicians follow this organization’s lead when diagnosing IBS.
According to the Rome IV diagnostic criteria, IBS is characterised by recurrent abdominal pain for, on average, at least one day per week in the last three months, associated with two or more of the following:
- Symptoms related to defecation
- Symptoms associated with a change in stool frequency
- Symptoms associated with a change in form (appearance) of stool
Everyone is different. So are your poops. It’s important to note that the change in your stool could be constipation for some people, diarrhea for others, or alternate between the two. Subtypes of IBS are recognized by the Rome IV criteria based on the person’s reported predominant bowel habit, when not on medications, as follows:
IBS is no joke. People with IBS frequently report feeling depressed, embarrassed and self-conscious. Not being able to predict symptoms places a large burden on daily living. It can limit productivity and performance at work, has a negative effect on the quality of relationships, and limits participation in routine social activity (IBS Impact Report, 2018).
Do the above symptoms and stool patterns sound like you?
You should see your physician. The American Gastroenterology Association (AGA) recommends to patients three steps to improve communication with their physician:
- Speak up early: Talk to a doctor as soon as possible after the onset of symptoms, not just with a friend or family.
- Speak up completely: Detail the symptoms to your HCP, including how the symptoms impact your life, mental health, work, and social interactions. A great way you can do this is by downloading our app. It helps you track symptoms daily and organizes them into easy to understand charts and graphs for your doctor.
- Speak up Often: Inform the doctor on the evolution of your symptoms after any new treatment efforts so that alternative treatment approaches can begin.
You are Not Alone!
It’s so important to remember you are not alone with IBS. Millions of people just like you may also struggle to find the best ways to manage their symptoms. While working with your healthcare professional, you may also want to join an IBS support group to see how others are living with IBS – such as FlushingOutIBS. Having the opportunity to discuss symptoms and coping strategies with others who are experiencing similar issues is another helpful tool in your tool kit for dealing with IBS.
April is IBS Awareness Month! Stay tuned for more articles on IBS including how your microbiome plays a role, evidence based ways to manage IBS, and more tools for living with this condition on a day to day basis.
Quigley EM, Fried M, Gwee KA, et al. World Gastroenterology Organisation (WGO) global guidelines irritable bowel syndrome: a global perspective update. J Clin Gastroenterol. 2016;50(9):704-13.
American Gastroenterological Association (AGA). IBS in America. Summary Survey Findings 2015.
IBS Global Impact Report (2018, accessed March 2019). https://www.badgut.org/wp-content/uploads/IBS-Global-Impact-Report.pdf
Lovell RM and Ford AC. Global prevalence of and risk factors for irritable bowel syndrome: A meta-analysis. Clin Gastroenterol Hepatol. 2012 Jul;10(7):712-21.e4.