IBS myths and facts

IBS myths and facts

Irritable Bowel Syndrome (IBS): Busting Myths and Finding Solutions

Design by Andrew Nguyen

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder that affects around 11% of adults worldwide. It is characterized by symptoms such as abdominal pain, excess gas, bloating, a sudden urgent need to use the bathroom, and changing bowel habits. Despite its prevalence, there are many misconceptions surrounding IBS that need to be addressed. To shed light on this condition, we spoke with Dr. Ashkan Farhadi, a gastroenterologist at MemorialCare Orange Coast Medical Center, and Dr. Mollie J. Jackson, a gastroenterologist at the University of Kansas Health System.

Myth 1: We know what causes IBS

Dr. Farhadi emphasizes that while research is uncovering more about IBS, we still do not know the exact cause. Although certain foods like dairy products or spicy foods may trigger symptoms, they do not cause the condition itself. However, post-infectious IBS can be caused by bacteria such as Campylobacter jejuni.

Myth 2: Stress causes IBS

Research suggests that stress can influence gut bacteria composition and play a role in IBS via the gut-brain axis. However, Dr. Farhadi points out that people with and without IBS generally face similar amounts of stress. It may be how people manage stress — rather than stress alone — that determines whether they experience IBS symptoms. Stress not only increases hormone release in the gut but also changes the gut’s anatomy, making it more sensitive to stress. This means that even after the stressful period is over, IBS symptoms triggered by stress can persist. Dr. Farhadi also mentions a study he conducted which found a link between subjective well-being and fewer symptoms of IBS. Psychological, social, and genetic factors may also contribute to the development of IBS symptoms.

Myth 3: Doctors only diagnose IBS through fancy tests

Contrary to popular belief, IBS can be diagnosed without relying on fancy tests. Dr. Farhadi explains that with the right clinical criteria, doctors can diagnose IBS with 97% accuracy within 5 years. The diagnosis is based on the Rome IV criteria, which includes symptoms of abdominal pain, a change in stool frequency, a change in stool form, and relief or worsening of abdominal pain related to defecation. Subtypes of IBS exist, such as predominantly diarrhea, constipation, or a mixed pattern. Bloating is a common symptom but is not necessary for diagnosis.

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Myth 4: IBS is curable

Effective management of IBS involves a combination of prescription medication and tailored lifestyle changes. Dr. Farhadi emphasizes that in the majority of cases, management is simple and affordable, including fiber, probiotics, reassurance, and exercise. However, finding the right medication can be a trial and error experience. Medication can help relieve symptoms, but there is currently no cure for IBS.

Myth 5: IBS is uncommon and does not affect quality of life

Dr. Jackson highlights that IBS is a common disorder that affects the gut-brain interaction. Its prevalence in North America is 10-15% and is associated with increased healthcare costs. IBS can significantly impact the quality of life for patients. In fact, a study found that patients with IBS reported that they would give up 10-15 years of life expectancy for an instant cure to their condition.

Myth 6: All types of exercise help IBS

While exercise can be beneficial for managing IBS, Dr. Farhadi clarifies that not all types of exercise are the same. Competitive exercise and weightlifting can actually increase stress rather than relieve it. Long-distance running, in particular, can trigger IBS symptoms such as diarrhea. It is essential to find exercise routines that suit individual needs and minimize symptom flare-ups.

Myth 7: Meditation helps

Although research is ongoing, some studies suggest that meditation may help alleviate IBS symptoms. The brain-gut-microbiome axis plays a role in IBS, and gut-directed psychotherapies have shown promise in improving symptoms. Meditation and mindfulness can positively affect how we process thoughts, sensations, and emotional responses, potentially improving IBS symptoms. Dr. Farhadi recommends “mindless meditation,” which involves walking for 30 minutes daily on the same route until it becomes so monotonous that one stops paying attention to their surroundings.

Myth 8: Cutting out lactose helps

While many patients with IBS report milk intolerance, there is no conclusive link between IBS and lactose intolerance. However, cutting out dairy products may help relieve gastrointestinal symptoms, as lactose intolerance is common in a significant portion of the population. An elimination diet can help identify trigger foods, with the low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet being the most studied for IBS.

Myth 9: Natural treatments work for IBS

Natural remedies like peppermint oil and cardamom have shown promise in relieving IBS symptoms, but limited research exists on their efficacy. Dr. Farhadi suggests trying these natural remedies, as long as they are not strong chemicals. Herbal remedies have been used for centuries with minimal adverse effects. However, it is always important to consult with a doctor before starting any new treatment.

Myth 10: Fasting relieves IBS

Reducing the frequency of meals from three to two times per day may reduce the number of symptoms experienced daily. However, Dr. Farhadi explains that fasting may not necessarily be the best approach, as it merely turns off the engine temporarily. Although fasting has benefits such as weight loss and memory improvement, it is not a long-term solution for IBS.

Myth 11: Fiber helps IBS

Fiber may help manage chronic constipation in patients with IBS. However, excessive fiber intake can lead to bloating due to excess gas in the gut. To avoid this, Dr. Farhadi recommends consuming a pinch of water-soluble fiber psyllium, a prebiotic, with a spoonful of Greek yogurt, which is a probiotic.

Myth 12: There is an IBS diet

Dr. Farhadi emphasizes that there is no specific diet for IBS. Diets are individualized and dynamic, meaning they can vary depending on the person and the circumstances. Food triggers can change over time, and what works well for one individual may not work for another. It’s important to listen to your body and consult with a healthcare professional to develop a personalized approach to managing IBS.

In conclusion, debunking myths about IBS is crucial in providing accurate information and understanding this chronic condition. While the exact cause of IBS remains elusive, managing symptoms through various approaches such as medication, lifestyle changes, stress management, and targeted diets can significantly improve quality of life for individuals with IBS. Remember to consult with healthcare professionals for personalized guidance and support in managing this condition.