Trust your gut: Learn more about IBS

April 9, 2019 Sabrina Yin, RN – Swedish Digestive Health Institute

IBS symptoms are commonly present in other health issues, and IBS often can go undiagnosed.

Treatment of IBS focuses on symptom relief.

IBS can be managed with diet, medication, cognitive therapy and stress relief.

Irritable bowel syndrome (IBS) is a common digestive tract condition with symptoms that affect around 10-15 percent of American adults. Sabrina Yin, RN, a nurse navigator at the Swedish Digestive Health Institute in Seattle, WA, shares some IBS facts that can give you a better understanding of this issue.

IBS can be challenging to diagnose.

Because IBS is a collection of common symptoms, sometimes it can be frustrating for both patients and physicians to determine what is going on.

 “Many people in the general population experience the symptoms of IBS but only a small percentage of those people will seek medical attention,” Yin says. “Many people are going undiagnosed. It’s important to know that if you have IBS you are not alone.”

There are many IBS symptoms.

“The main symptom of IBS is abdominal pain or discomfort associated with a change in bowel habits,” Yin says. “A patient may describe it as cramping, bloating, sharp pain or even burning, and the pain may be triggered by eating specific foods or emotional distress.” 

People can also experience constipation or diarrhea, or an urgent need to go to the bathroom. There are also symptoms not related to the bowel, such as anxiety, depression, migraine headaches, and pelvic pain.

“Some people with IBS symptoms can tolerate them well, while others may have symptoms that prevent them from experiencing a full quality of life,” Yin says.

There are actually different kinds of IBS.

Yin says the condition has four IBS subcategories: predominant diarrhea (classified as IBS-D), constipation (IBS-C), mixed bowel habits (IBS- Mixed) and unclassified symptoms (IBS-U).

There is no specific cause of IBS, but there are some risk factors.

People are more likely to experience IBS symptoms if they are younger than 50, female or have a family history of IBS. There are several triggers that can play a role in IBS: problems with muscle contraction in the intestine; hypersensitive intestine caused by altered central nervous system; intestinal inflammation; impaired immune function caused by bacteria or a virus; microbial imbalance in the gut; food sensitivity or intolerance; and hormones and stress. 

Women do have it worse than men when it comes to IBS.

Hormonal changes is one reason why IBS is twice as common for women than it is for men. For instance, women tend to notice more symptoms such as gas, bloating and diarrhea during their menstrual cycle, when their hormones are in flux. And women with IBS tend to experience these problems more intensely during menstruation than women who don’t have IBS.

Women are also more likely to meet the criteria for IBS than men and have a higher prevalence of symptoms. In addition to hormone changes, this could also be attributed to bio-behavioral stress response, gender roles and psychosocial symptoms that women experience differently than men, Yin says. 

“Women in general have more functional pain syndromes such as fibromyalgia, chronic fatigue, TMJ and migraines compared to men,” she says. “I want women with IBS symptoms to know that they are not imagining things.” 

Treatment depends on the type of IBS someone has.

The focus of treatment is on relieving symptoms, Yin says. In addition to the type of IBS, treatment can also be influenced by the severity of symptoms. Common tools include diet modification, medication, cognitive therapy and alternative therapy, such as massage or acupuncture. 

Physicians may recommend keeping a food diary for a few months and working with a registered dietitian to make sure they are getting enough nutrients while eliminating any trigger foods. Potential medications can include smooth muscle relaxants, anti-diarrhea drugs, laxatives, antibiotics, and low-dose antidepressants. And because there is a strong connection between the nervous system and gut function, cognitive therapy has become an important method of treating IBS. 

IBS patients need to relax and reduce stress.

Stress is often associated with the onset of symptoms—and those symptoms can improve when the stress is gone. That means for some patients bouts of IBS may seem random and appear to come and go without reason, which can also make a diagnosis difficult. 

“Curbing stress is so important because it can have such a profound effect on symptoms,” Yin says. “Find a way to relieve stress such as exercise, relaxation techniques including meditation, yoga or prayer, or reading. Counseling is another valuable tool—cognitive behavior is the most popular method, and others include psychotherapy and hypnotherapy.” 

In fact, new understanding of the connection between the gut and the brain, and the effect they have on each other, has reinforced the importance of mental health in treating IBS symptoms. 

“Think about our gut as a second brain and the brains talk to each other—therapy helps improve the communication between our two brains,” Yin says. “It really explains a lot of things we are currently offering as treatment. For instance, a gastroenterologist may prescribe an antidepressant to some patients with IBS, not because the problem is all in their head, but because the medication helps to calm the nerve cells in the gut.”

Learn how to manage IBS symptoms.

Yin has five tips to help manage symptoms:

  1. Don’t spend time worrying about what symptoms may or may not be. 
  2. Try to locate conflicts in personal relationships and reduce stress there.
  3. Take an active role in your own heath and educate yourself.
  4. Try to identify the things that make symptoms worse and then try to reduce their impact one at a time. Focusing on too many of them at once may cause more stress.
  5. Don’t let IBS overwhelm personal relationships—don’t make it the primary focus.

“Many people worry about their symptoms. IBS is troubling and uncomfortable, but the condition doesn’t increase the risk of any future health problem,” Yin says. “IBS isn’t life-threatening, and people with it are not more likely to develop other colon conditions, such as colitis, Crohn’s disease or colon cancer.”

“It can be frustrating to live with IBS because it comes and goes throughout your entire life, so patience is key to dealing with this condition,” she continues. “Achieving relief of IBS symptoms can be a slow process that can take six months or longer. But be patient and listen to your body, it can help improve the quality of your life.”

IBS patients need to work closely with their physician.

Successful management of IBS often requires a good understanding of what it is and how it is treated. “So, ask your doctor lots of questions and help your doctor get to know what is important to you,” Yin says. “Patients with a good clinician-patient relationship and continuity of care tend to report better symptom control and relief.”

Now that you know what IBS is, make sure that you know what it isn’t.

Anyone experiencing symptoms other than those associated with IBS should seek medical care as soon as possible. Yin notes that these “alarming features,” as she calls them, including rectal bleeding, unexplained weight loss, fever, lab abnormalities such as anemia or elevated inflammatory markers, family history of colon cancer and symptom onset after age 50. These could be signs of a more serious issue and should be checked out earlier rather than later.

Trust your gut: If you are experiencing IBS symptoms, don’t let them go unexamined. Make an appointment with a physician today; if you need to find a physician, locate one near you in our physician directory. You can also book an appointment online at Swedish Primary Care.

Sabrina Yin, RN, is a nurse navigator for Swedish Digestive Health Institute. She is a specially trained registered nurse who serves as a bridge between patients, physicians and specialists. Sabrina provides patients with clinical resources, answers questions and ensures patients receive the highest level of care.

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