Are you suffering from digestive issues that have been going on for some time and you can't seem to find out what causes them or why they occur when they occur? Then, Dr. Google might have confronted you with the term IBS. What is it? What causes it? How do you cure it? The answer to all of those questions is complicated and I will try to approach them as comprehensively as possible. If you have not been diagnosed with IBS but are suffering from digestive issues I strongly advise you to go see your doctor.
What is IBS?
In short, Irritable Bowel Syndrome (IBS) is a chronic Functional Gastrointestinal Disorder (FGID) of the large intestine (colon). It is a chronic illness because it's symptoms occur over longer periods such as months or even years.
Common IBS symptoms
The symptoms of IBS vary and how they affect people is different for everyone. Most commonly IBS is characterized by chronic and often relapsing symptoms of abdominal discomfort and pain stemming from cramping, bloating and gas, as well as, diarrhea, constipation or both.
IBS might also cause symptoms that do not manifest in the intestine such as heartburn, fatigue, headaches, poor sleep, and muscle pain.
What causes IBS?
The precise cause of IBS isn't known. Here are some of the underlying causes that are assumed to be responsible for the development of IBS.
- Frequency and strength of muscle contraction in the intestine: The walls of our intestine are made of layers of muscles that are designed to contract to move the food through the digestive system. If these contractions are stronger and last longer than is the normal case it can cause gas, bloating and diarrhea. On the opposite, if these contractions are weaker than they normally should be it can slow down
- Infection: Sever bacterial or viral infections of the digestive system such as gastroenteritis have been found to trigger IBS. Also, bacterial overgrowth (SIBO) in the intestine can be the reason for IBS to develop.
- Changes in the microflora: The microflora, the good bacteria in the gut, plays a key role in the health of our intestines. Research has shown that there seems to be a difference in the microflora of people with IBS to those of healthy people.
- other triggers of IBS are believed to be: inflammation fo the intestine, malfunction of the nervous system connecting the digestive system and the brain, hormonal changes and stress.
Is there a cure for IBS?
Sadly, there is no cure for IBS to this day. As IBS symptoms are caused by the behavior of the gut and its muscles there is no physical damage or other measurable indicators to explain your symptoms. This is why there is currently still no test to confirm IBS and doctors can only make a diagnosis based on your symptoms.
This is also the reason why many self-diagnose IBS. I strongly advise against doing so. Many serious illnesses such as colon cancer, chrons and celiac disease begin with IBS-like symptoms. Go see your doctor if your digestive issues have been plaguing you for more than two to three weeks.
Are you suffering from IBS?
If your answer is yes, don’t be discouraged! You are not alone in this. It’s estimated that 1 in 7 people is affected by IBS worldwide. Thankfully, science has come far in understanding how nutrition and lifestyle affect IBS symptoms. At Monash University research done on IBS has found that many people suffering from IBS struggle with similar issues: Their digestive system reacts sensitively to all or some FODMAPS. The Low FODMAP diet which has been developed as a result of these findings thankfully has scientifically been proven to reduce IBS symptoms in 75% of people suffering from IBS.
What are FODMAPS?
FODMAP is an acronym for:
- Fermentable: describing the process through which gut bacteria ferment undigested carbohydrates to produce gases.
- Oligosaccharides: fructans and galacto-oligosaccharides (GOS) as found in wheat, onion, garlic, beans
- Disaccharides: lactose as found in dairy products such as milk, soft cheese, ice cream, yogurt
- Monosaccharides: fructose as found in apples, honey, high fructose corn syrup
- Polyols: sugar alcohols sorbitol and mannitol as found in certain vegetables(mushrooms) and fruits (apricots) or used for artificial sweetening (chewing gum).
In short, FODMAPs are short-chained carbohydrates, also known as sugars, that can't be completely digested and absorbed in the intestine. As a result, they can trigger IBS symptoms in people with sensitive guts. Head over to my post about FODMAPs to understand what they are.
Why do FODMAPs trigger IBS symptoms?
Most people eat foods that are high in FODMAPs every day and do not experience any issues. So why do people with IBS experience symptoms from foods high in FODMAPs? When food is eaten the FODMAPs in it move slowly through the small intestine while attracting water. As they reach the large intestine, the gut bacteria feasts on the FODMAPs as their source of fuel and rapidly ferment them which results in the production of gas.
This process happens in everyone. The difference is that people who suffer from IBS often have problems with the intestine motility (the speed at which the intestine processes its content) and have a highly sensitive gut wall. The extra water the FODMAPs attracted into the intestine combined with the gas causes the intestinal walls to stretch. This results in IBS symptoms such as pain, excess wind, bloating and altered bowel habits (diarrhea and constipation). For a comprehensive and illustrative video on IBS and FODMAPs head over to Monash.
FODMAPs are found in a wide range of foods including vegetables, fruits, breads, nuts, legumes and additives. It’s impossible to know the FODMAP content of food which can only be revealed through laboratory analysis. Happily, the team at Monash University and Fodmapfriendly have specialized in measuring the FODMAP content of a huge array of foods. The information they obtain is distributed via their respective mobile apps, the Monash University FODMAP Diet App and the FodmapFriendly app. They are lifesaving tools when starting on the FODMAP diet.
So what's this so-called Low FODMAP diet? Head over this post for a short explanation of how the diet works.
To note: The information and advice on foodfrenemylove.com are not intended to replace the services of trained health professionals or be a substitute for medical advice. Have a chat with your doctor or GP if you suffer from digestive issues!