Irritable bowel syndrome or IBS is a common disorder that affects the digestive system. Symptoms of IBS include abdominal cramps, diarrhea, constipation, bloating, etc. Almost all symptoms of IBS are gastrointestinal.

Irritable bowel syndrome has a significant negative impact on the quality of life. IBS can persist for years and may be interspersed with periods of no symptoms.

Disorders such as anxiety, depression, and chronic fatigue syndrome, are common in people with irritable bowel syndrome.

Irritable bowel syndrome is characterized by changes in bowel movements without apparent cause. Based on this, irritable bowel syndrome is classified into four types depending on the type of bowel dysfunction, constipation dominant, diarrhea-dominant, both constipation and diarrhea, and neither constipation nor diarrhea.

It is estimated that 10-15% of the global population is affected by irritable bowel syndrome.

Signs and symptoms of IBS
The signs and symptoms of IBS can vary from person to person.

The primary symptoms of IBS are abdominal pain and changes in bowel movements. Symptoms of IBS tend to be acute with attacks that are experienced for a few days or weeks. These attacks eventually subside and may be recurrent.

Other symptoms of IBS are bloating, gas, cramps, nausea, constipation, and diarrhea. Along with this, there may be a sense of urgency in bowel movements and a feeling of incomplete bowel evacuation. Abdominal distension may also be seen.

People with irritable bowel syndrome also tend to suffer from gastric reflux, a loss of appetite, lowered libido, lower abdominal pain, fatigue, and headache.

Since these symptoms are rather vague, irritable bowel syndrome is a diagnosis of exclusion. This means that there are more serious conditions that must be excluded before a diagnosis of irritable bowel syndrome can be made.

Signs and symptoms that point to a more serious disorder include blood in the stool, rapid weight loss, abdominal pain persisting at night, etc.

The symptoms of IBS are uncomfortable, and even cause some people to miss work or school.

Irritable bowel syndrome cannot be cured, but the symptoms can be treated. Treatment of the symptoms of IBS can be done mainly through lifestyle changes and stress management. In severe cases, medication may be prescribed to manage the symptoms of IBS.

Classification of irritable bowel syndrome
Irritable bowel syndrome is classified based on the primary type of bowel dysfunction.

Irritable bowel syndrome is of four types:

• IBS-C which is predominantly constipation
• IBS-D which is predominantly diarrheal
• IBS-A which has alternating bouts of constipation and diarrhea
• IBS-U which is neither constipation nor diarrhea but pain predominant

Management of the symptoms of IBS
Since there is no specific cause of irritable bowel syndrome, treatment is focused on management of the symptoms of IBS. Treatment of irritable bowel syndrome has a multidimensional approach—medication, dietary changes, and stress management.

Medication for irritable bowel syndrome
The medication that is prescribed for irritable bowel syndrome largely depends on the predominant symptoms.

For constipation-predominant irritable bowel syndrome, medication for increasing the bowel movements can be used, such as laxatives and stool softeners.

For diarrhea, anti-diarrheal medicines provide great relief. These medicines include loperamide and codeine.

Drugs affecting the neurotransmitter serotonin are useful in the management of irritable bowel syndrome. Serotonin is commonly associated with brain functions, but 90% of all serotonin in the body is found in the gut. Serotonin is responsible for gut motility and intestinal movements.

Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and tricyclics can be used to treat the symptoms of IBS. Additionally, since anxiety and depression are common in people with irritable bowel syndrome and so antidepressants are a great way to handle these conditions.

SSRIs and other antidepressants are better suited for people with constipation-predominant irritable bowel syndrome since it increases intestinal movements. People with diarrheal IBS may experience increased cramping and pain.

Dietary and lifestyle changes
Some people with irritable bowel syndrome reported a reduction in the symptoms of IBS when they eliminated gluten from their diet. Other changes like removing high gas foods like beans, may also help.

Certain foods contain compounds called FODMAPs have been linked to an aggravation of the symptoms of IBS. These FODMAPs are found in some vegetables, fruits, and dairy.

Adding fiber and probiotics to your diet is beneficial in treating irritable bowel syndrome.

An important step in reducing the symptoms of IBS is to reduce stress in everyday life. Counselling and practicing relaxation techniques like yoga and meditation can help to manage stress levels and ease the severity of irritable bowel syndrome.

Regular mealtimes and getting adequate physical exercise, are good ways to control the symptoms of IBS, and also for managing your overall health.

Irritable bowel syndrome can be a painful, disabling, and sometimes embarrassing condition. If the symptoms of IBS are disrupting your life, consult a doctor to get proper treatment.