What is IBS?

IBS - Irritable Bowel Syndrome, or irritable bowel as it is also called in English. This functional disorder has many names and is not a new phenomenon, IBS has been known for almost 200 years under many different denominations and is a disease that affects more and more young people.

IBS affects about 10-20% of the population and usually debuts before the age of 40. Women are greatly overrepresented, but there is likely to be a large percentage of darkness in men as well. The disease causes great suffering for those affected and accounts for 20-50% of visits to a gastrointestinal specialist and is today the second most common cause of absence from work or school.

Diagnosis

Diagnosing IBS is difficult as the symptoms are rarely constant and vary widely from individual to individual over time. Diagnosis is established partly through the exclusion of another disease and, on the other hand, by established criteria, the so-called Rome IV criteria, in order to be able to call in the symptoms more easily and find connections:

Recurrent abdominal pain at least once a week for an average of the last three months is associated with at least two of these:

• related to defecation
• change in stool frequency;
• change in the shape (appearance) of feces;

Triggering factors to IBS

Several factors play a role in the physiological consequences of developing IBS.

• Psychosocial circumstances - stress and life crises often precede an onset of IBS.
• Inflammation/Infection - onset after gastrointestinal infection.
• Cognitive factors - how we deal with problems and adversities.
• Pharmaceuticals.
• SIBO - bacterial overgrowth in the small intestine of bacteria normally found in the large intestine.
  In studies, it has been observed that SIBO occurs in about 60 - 80% of IBS sufferers.

Physiological consequences

In the past, IBS was thought to have psychosomatic causes as the symptoms varied so much between sufferers. Modern research instead provides insights and understanding of physiological causes:

The Interaction between intestinal flora and brain changes. The communication of the intestinal flora with the brain plays a central role in the symptomatology of IBS.

Permeability of the intestine deteriorates and leads to increased ingress of harmful substances

Inflammatory changes in the nervous system of the intestine

Dysbiosis - imbalance in the intestinal flora resulting, among other things, from the overgrowth of pro-inflammatory bacteria in combination with a low presence of protective, beneficial bacteria and low species richness (diversity).

IBS Categories

The variety of symptoms for IBS sufferers is large and divided into different subcategories.

IBS-C (constipation)

IBS-D (diarrhoea)

IBS-M (varying stool)

IBS-I (triggered by previous infection/inflammation)

IBS-U (undefined)

Symptom picture

Visceral hypersensitivity means an increased sensitivity to pain in the abdomen and is the predominant symptom in IBS. The work of the intestine is controlled by an interaction of hormones and nerve signals. IBS sufferers have an increased sensitivity in these nerves and experience about 10 times more pain when stimulated in the gastrointestinal tract than healthy individuals.

Abdominal pain affects more than half of IBS profiles with constipation and 80% of IBS profiles with diarrhea. Visceral hypersensitivity can be likened to a vicious circle of interacting factors and is difficult to break.

Stool disorders

Altered and varying frequency and consistency.

Dyspepsia

Disorders from the upper part of the stomach that may include early feeling of satiety and a burning sensation in the upper stomach pit.

Abdominal distension/flatulence

In IBS, an increased amount of gases accumulate in the stomach which causes stomach pinching, swelling and bloating and often worsens with meals.

Fatigue/Depressed mood

IBS affects everyday life for many, with psychological symptoms such as anxiety and depressed mood and is today the second biggest cause of absenteeism from work or school.

Treatment

IBS has a complex and varied symptomatology and it is therefore difficult to find a treatment that is suitable for everyone in the long term. Treating IBS is about understanding what is causing the trouble and what you can add and subtract from to reduce its discomfort. Often a combination of different treatments is needed to achieve the best result.

Common medicines

• Bulking agent
• Medications for diarrhea
• Laxatives
• Antidepressant drugs
• Proton pump inhibitors - stomach acid lowering agents

Fodmap - dietary therapy

• Developed in 2005 by scientists and nutritionists in Australia.
• Studies show that 75% are helped by FODMAP.
• It is about eliminating fermentable carbohydrates from the diet and keeping those that do not cause symptoms.

Probiotics

High-dose, documented probiotics have shown good efficacy in IBS in studies and are today an established supplement for gastrointestinal specialists in IBS treatment.

Psycho/Physiological Treatment

• Relaxation
• CBT (Cognitive Behavioral Therapy)
• Hypnosis - studies show a great improvement in the picture of symptoms
• TNS, acupuncture

Summing up

IBS is a complex and often life-affecting disease that requires an individual and holistic treatment approach. By understanding their triggers, working on diet, and possibly combining medical treatment with psychological interventions, many can find relief and improve their quality of life. Remember, there is no one-size-fits-all solution — what works for one person may not work for another. It is important to work closely with a doctor or specialist to develop a treatment plan that suits your particular needs.