Ask a Nurse - Irritable Bowel Syndrome (IBS)

Hi, I'm Cathy with Level Up RN. In this episode of Ask a Nurse, I'll be answering your questions about irritable bowel syndrome or IBS, such as what is IBS, what are the symptoms of IBS, and how is irritable bowel syndrome diagnosed and treated? Irritable bowel syndrome or IBS is one of the most commonly diagnosed gastrointestinal disorders. IBS causes stomach pain, bloating, as well as a change in bowel habits that cannot be explained by another underlying cause. Symptoms of irritable bowel syndrome include abdominal pain, bloating and cramping, a change in the appearance of your bowel movements such as having mucus in the stool, and changes in the frequency of your bowel movements. For some individuals, having a bowel movement will help to decrease their pain and discomfort with IBS, but for other individuals, having a bowel movement will increase pain. Some people will have diarrhea with their IBS, which is referred to as IBSD, other people will have constipation with their irritable bowel syndrome, which is referred to as IBSC, and then others will have bouts of both diarrhea and constipation, and this is considered mixed bowel patterns, and we refer to this as IBSM.

The exact cause of irritable bowel syndrome is not known, but there are a number of contributing factors. This includes issues with brain-gut interactions, meaning the signals between the brain and intestines is not well coordinated. Altered bowel motility is another contributing factor. This means that the muscles in the intestines either contract too strongly or maybe don't contract strongly enough. And then changes in the gut microbiome is another factor. This means we have changes in the number or type of bacteria and other microbes that reside in the intestines. IBS can also develop after an intestinal infection such as gastroenteritis, and food sensitivities play a role as well. So some people will have worse symptoms after they eat certain foods. And then finally, individuals who experienced early life stressors such as abuse, and individuals with mental health disorders such as anxiety or depression will have an increased risk for having irritable bowel syndrome. In order to diagnose IBS, your provider will review your symptoms as well as your medical history and family history, and they will likely order tests as well such as blood test and stool test to help rule out other causes of your symptoms, which could include lactose intolerance, celiac disease, as well as inflammatory bowel disease.

Treatment of IBS includes diet changes, lifestyle changes, as well as medications. Diet changes that can be helpful include increasing your fiber intake as well as avoiding gluten. Your provider may also recommend that you follow a low FODMAP diet, so this is a diet that restricts certain carbohydrates that are difficult to digest. This includes certain fruits, certain vegetables, dairy products, wheat, rye, among other products. So your provider may recommend that you follow this diet for a couple weeks to see if your symptoms improve, and then you can try adding some of these foods back into your diet to see how well you tolerate them. Recommended lifestyle changes for IBS include increasing your physical activity, decreasing your stress, and getting enough sleep. In terms of medications, probiotics are frequently recommended in the treatment of IBS. For IBS with diarrhea, your provider may recommend an over-the-counter antidiarrheal agent such as loperamide or a prescription medication such as alosetron. For individuals with IBS with constipation, fiber supplements, laxatives, or a prescription medication such as lubiprostone may be recommended. Other medications that are used in the treatment of IBS include antidepressants such as tricyclic antidepressants and SSRIs, as well as antispasmodics which help to decrease bowel spasms.

All right. That's it for this episode of Ask a Nurse. I hope you found this information to be helpful. If so, be sure to hit that Like button. And if you have a health topic that you would like me to cover in a future episode of Ask a Nurse, definitely leave that in the comments. Stay informed and stay well.