Originally appeared in the article, "Home Remedies for IBS," by Leoni Jesner, ACE-CPT on December 6, 2021.
Irritable Bowel Syndrome (IBS) is a chronic disorder that comes with a list of unpleasant symptoms including abdominal pain, bloating, cramping, and fluctuations between constipation and diarrhea. In Western countries, IBS affects 10 to 20% of the adult population and is twice as common for women.1
"Worldwide, it affects almost 1 billion people, although there are varying degrees in the severity of IBS and a variation in symptoms," explains Mark Pimentel, MD a gastroenterologist and associate professor of gastroenterology at Cedars-Sinai in Los Angeles, California.
Catherine McQueen / Getty Images
It may not come as a surprise then that IBS is one of the most common functional gastrointestinal (GI) disorders seen by physicians within the U.S. and worldwide, says Melanie Keller, ND, a naturopathic doctor and epigenetic intuitive. However, there are many who do not seek medical care for their symptoms.
"Functional disorders are conditions when there is an absence of structural or biochemical abnormalities on common diagnostic tests that could explain symptoms," says Dr. Keller. "Among the patients who do seek care, about 40% have mild IBS, 35% moderate IBS, and 25% severe IBS."
Symptoms of IBS
Not everyone experiences IBS in the same ways. Here are some common signs and symptoms of IBS.2
- Experiencing pain in the abdomen especially with regard to bowel movements
- Noticing changes in bowel habits including diarrhea, constipation, or sometimes both
- Feeling that you have not completed a bowel movement
- Having whitish mucous in your stool
- Noticing an increase in symptoms around your menstrual cycle if you have one
To diagnose IBS, a healthcare provider will look for a pattern in your symptoms over time. Because IBS is a chronic disorder, it lasts a long time with symptoms often coming and going.
What Causes IBS?
A magnitude of factors can contribute to IBS, some of which are more prevalent than others. In many cases, pinpointing the exact cause can be a challenge. Here is a closer look at some of the things that can contribute to IBS symptoms.
One of the most common causes of IBS is food poisoning. A second-generation antibody blood test called IBSsmart can confirm this. In fact, one in nine people who experience food poisoning develop IBS, says Dr. Keller.
"Post-infectious irritable bowel syndrome (PI-IBS) is a form of IBS caused by food poisoning and almost always has a diarrheal component," she adds.
The IBSsmart blood test measures anti-CdtB and anti-vinculin antibodies, biomarkers that can distinguish IBS from inflammatory bowel disease, such as Crohn’s Disease. Crohn's disease has been found to cause ongoing severe inflammation of the gut, according to Dr. Pimentel.4
A systematic review and meta-analysis of over 21,400 patients with enteritis (caused by bacteria or virus-contaminated food or drinks) found that the risk of IBS was four times higher compared to those without infectious enteritis.3
By definition, IBS does not present with visible inflammation. However, though it may not be seen during routine diagnostic testing, it may still be involved.
Evidence of low-grade chronic inflammation on a cellular level in some individuals who suffer from IBS is beginning to build. This inflammation is thought to be associated with cases in which IBS was preceded by a bout of gastroenteritis, the condition classified as IBS-PI.
Small Intestinal Bacterial Overgrowth
Small intestine bacterial overgrowth (SIBO) occurs when bacteria usually found in the large intestine overgrows in the small intestine. It is sometimes considered a potential cause of IBS.
"The most common symptoms of SIBO are persistent abdominal pain, cramping, gas, bloating, and diarrhea, with those experiencing constipation possibly due to intestinal methanogenic overgrowth (IMO)," says Dr. Keller.
The latter is caused by microorganisms with methane (methanogens) which can also overgrow in the small bowel or colon and lead to constipation.5 In short, more focus is being placed on the role of gut bacteria and the bacterial makeup of IBS patients who do not have the disorder to understand if bacteria in the small intestine contributes to IBS.
"Both conditions [SIBO and IMO] can be diagnosed with a simple breath test and there are options available for treatment," she says.
Although most studies on the effects of food additives have yet to be performed on humans, evidence suggests that artificial sweeteners can exasperate IBS. First polyols, which are found within FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), are short-chain carbohydrates and are closely linked with symptoms of IBS.
The development of IBS is linked to changes in the gut bacteria and therefore foods that are poorly digested only make things worse.