Irritable Bowel Syndrome (IBS) & Incontinence

What is Irritable Bowel Syndrome?

Irritable bowel syndrome (IBS) is one of the most common problems of the digestive system. IBS is what’s referred to as a functional disorder and is a long-term condition that causes recurring pain or discomfort in the abdomen and altered bowel habits.

About 10-20% of people will experience the unpleasant symptoms of irritable bowel syndrome (IBS) at some time. It can develop at any age, but for most people, the first symptoms tend to show up in early adulthood. Women are more likely than men to get IBS and to have more severe symptoms.

Types of IBS

Irritable bowel syndrome can present in three basic forms. It can be predominantly:

• Constipation based – Bowel movements alternate between constipation and normal stools with symptoms of abdominal cramping or aching commonly triggered by eating
• Diarrhea based – Diarrhea is a major problem first thing in the morning or after eating with an urgent need to go to the toilet. Sometimes fecal incontinence may be an issue
• Alternating constipation and diarrhea

IBS risk factors

You’re more likely to have IBS if you:

• Are a woman — around twice as many women have the condition than men
• Are young — IBS tends to affect people under age 45 with the first signs showing up in early adulthood
• Have a family history of IBS — people who have a family member with IBS may be at increased risk
• Have mental health problems — anxiety, depression, personality disorders and a history of childhood sexual abuse are all risk factors. Additionally, women who have suffered domestic abuse may be at risk also.

Symptoms of IBS

Although symptoms vary from one person to the next, some of the more common indicators of IBS include:

• abdominal pain or cramping (often relieved by-passing wind or feces)
• diarrhea, constipation, or a combination of both
• a sensation that the bowels are not fully emptied (especially just after having a bowel movement)
• abdominal bloating
• mucus in the stools
• excess wind
• nausea
• indigestion
• backache
• tiredness
• bladder problems

To some people, IBS symptoms don’t tend to warrant a visit to their doctor, however, if you find these symptoms seriously affect your lifestyle, or you find it quite difficult to cope with these symptoms, talk to your doctor.

Important! These symptoms are not specific to IBS. They may be attributed to conditions other than IBS, including Coeliac Disease which can damage the lining of the intestine. If you have any of the above symptoms, let your doctor determine if Coeliac Disease is present or if the symptoms point to other conditions.

When should you see your doctor?

If you have any of the symptoms of IBS, a persistent and noticeable change in your bowel habits, or if you have any of the more serious signs listed below, see your doctor as soon as possible

• Rectal bleeding
• Abdominal pain that progresses or occurs at night
• Sudden weight loss

Your doctor can help you find ways to relieve your IBS symptoms as well as rule out any conditions of the colon, such as inflammatory Bowel Disease and Colon Cancer. Your doctor can also help you avoid possible complications from problems such as chronic diarrhea.

Causes of IBS

The walls of the intestines are lined with layers of muscle that rhythmically contract and relax as food moves from your stomach through your intestinal tract to your rectum. If you have irritable bowel syndrome, the contractions may be stronger and last longer than normal, causing gas, bloating, and diarrhea.

But sometimes the opposite is also true. Weak intestinal contractions slow the passage of food and lead to hard, dry stools.

Abnormalities in your gastrointestinal nervous system also may play a role in causing you to experience greater than normal discomfort when your abdomen stretches from gas or stool.

And it could also be poor coordination between the brain and the intestines that make your body overreact to the changes that normally occur inside the digestive process — which in turn causes pain, diarrhea, or constipation.

Irritable bowel syndrome is just another one of those conditions where there doesn’t seem to be a definitive cause. That said, there are some things that trigger attacks including:

• Infection — persistent bowel symptoms can linger after a bout of gastroenteritis — sometimes long after the offending bacteria or virus has been eliminated. It was reported that 5 to 32% of IBS may be due to this problem.
• Food intolerance — Sugars, particularly lactose (found in dairy and many processed foods) are the most common dietary trigger for IBS. Fructose and sorbitol are also believed to trigger IBS.
• General diet — low fiber diets can lead to constipation-predominant IBS. Some people find foods such as chocolate, spices, fats, fruits, beans, cabbage, cauliflower, broccoli, milk, carbonated beverages, and alcohol all cause problems.
• Emotional stress — stress or anxiety, can affect the nerves of the bowel.
• Medications — such as antibiotics, antacids, and painkillers can bring about constipation or diarrhea.
• Hormones —women are twice as likely to have IBS which leads researchers to suggest that hormonal changes can play a role in bringing about symptoms of IBS. Many women find that IBS symptoms are worse around and during their menstrual cycles.

Diagnosis and testing for IBS

Your doctor may also refer you for a sigmoidoscopy or a colonoscopy. This involves using an endoscope (a flexible, tube-like instrument to look inside your bowel). A bowel biopsy may also be taken for examination in a laboratory to help rule out more serious conditions.

However, if you’re under 50 and have typical symptoms of IBS, you may not need any further tests. Where your doctor may be concerned, is if you have any of the following other symptoms which could point to other more serious conditions.

• sudden weight loss
• blood in the stool
• symptoms developing after age 60
• Family history of bowel problems
• diarrhea without other symptoms
• anemia

Treatment of IBS

IBS cannot be cured with medications or special diets. A good doctor is one who will work with you to create a plan based on treating, alleviating, or even eliminating the symptoms of IBS. These may include:

• a modest increase in dietary fiber, together with plenty of clear fluids
• reducing or eliminating common gas-producing foods, such as beans and cabbage
• reducing or eliminating dairy foods, if lactose intolerance is a trigger
• establishing eating routines and avoiding sudden changes in routine
• stress management, if stress seems to be triggering the attacks

Some medications may also help to ease the symptoms of IBS if and when they flare up. These may include:

• To treat IBS with diarrhea, your doctor may recommend medications, such asloperamide, rifaximin (Xifaxan), eluxadoline (Viberzi), or alosetron (Lotronex), which is prescribed only to women and is prescribed with special warnings and precautions.
• To treat IBS with constipation, your doctor may recommend fiber supplements, when increasing fiber in your diet doesn’t help, laxatives, lubiprostone (Amitiza), linaclotide (Linzess) or plecanatide (Trulance).
• Pain relief medication to ease abdominal pain including antispasmodics (to ease cramping); low dose of antidepressants and selective serotonin reuptake inhibitors
• Your doctor may also recommend probiotics. Probiotics are live bacteria, that are similar to microorganisms you normally have in your digestive tract. Researchers are actively studying the use of probiotics to treat IBS.
• Additionally, mental health therapies and relaxation training which can help you relax your muscles or reduce stress. If you suffer from psychological issues like anxiety, depression, and stress, we recommend seeing a psychologist or counselor who can help you to deal with these issues and for coping with IBS.

"This content should not substitute medical advice from your personal healthcare provider. Please consult your healthcare provider for recommendations/diagnosis or treatment.”

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