Irritable bowel syndrome is a digestive disorder that plagues about 10 percent of the population, but is rarely talked about openly. That is partly because symptoms come and go, making it somewhat difficult to diagnose; as well, IBS doesn’t show up in any visible disease process or tissue damage, but rather is described as a malfunction in how the intestinal system works. However, it is very real for those who feel its effects, and this month – designated as IBS Awareness Month – it may be time to assure those who suffer from the syndrome that their symptoms are not a figment of their imagination, and there are solutions to alleviate them.

The most common symptoms of IBS are bouts of urgent diarrhea (three or more a day), episodes of chronic constipation (three or fewer bowel movements a week) or a pattern that alternates between the two. Along with erratic bowel movements, or apart from them, may be abdominal pain or discomfort (often reported as “cramping”), bloating and gas or a frequent feeling of incomplete evacuation.

In years past, people with these symptoms might have been diagnosed as having colitis, or a spastic or nervous colon. Today, there is a separate name for the condition which falls under the general category of functional gastrointestinal disorders with the understanding that it may have both physical and mental causes.

Absorbing nutrients

When one examines the intricacies of the gastrointestinal (GI) tract, and realizes how hard it works each day to digest the food constantly being ingested, absorbing the nutrients that keep the body functioning and eliminating the waste, it is remarkable that there aren’t more problems. All the food and drink we put into our mouth moves through the esophagus, stomach, small intestine and large intestine (the lower part is called the colon). The large intestine absorbs water and any remaining nutrients overlooked by the small intestine and turns what is left into the stool which passes into the rectum where it is stored until a bowel movement occurs and the waste is eliminated.

The causes of irritable bowel syndrome are not well understood – but it is somehow related to the passage of food through the intestines. It might be that normal motility of muscles are impaired so contractions to move the food are erratic, or it may have something to do with signals between the brain and nerves in one of the intestines. Mental health or psychological problems such as anxiety, panic disorder, depression and post-traumatic stress disorder are common in people with IBS, although the exact link between these disorders and development of IBS is unclear.

Some people have trouble digesting sugars and soluble fibre in certain foods and if they are not digested early on, moving further into the intestine, bacteria breaks them down and the end result is bloating and release of gas. So-called “gassy foods” are certain fruits and vegetables such as bananas, members of the cabbage family and legumes, milk, cheese, grains such as barley and oat bran, nuts, artificial sweeteners, caffeine and alcohol. It should be noted that many of these foods have significant nutritional benefit and belong in the diet unless your GI tract has a sensitivity. Thus it is important for you to pinpoint which foods are problematic for you – a good way is to keep a food diary – to avoid placing yourself on a restricted diet unnecessarily. It might also be helpful to eat smaller meals more frequently to help your system better digest foods.

Imbalance of bacteria

There is also some evidence to suggest that IBS and other gastrointestinal ailments may be caused at least in part by an imbalance in “normal” or good bacteria that live naturally in the digestive tract and have functions such as supporting the immune system and producing several essential vitamins, and harmful or pathogenic bacteria that produce gas (and diarrhea) and cause infection. It is thought certain probiotics – living microorganisms, usually bacteria which also live in the gut – will help maintain a healthy balance by interfering with disease-causing bacteria. Common probiotics (such as species of Lactobacillus and Bifidobacterium) are found in the yogurt and kefir which contain live cultures (look for the phrase “contains active cultures” on the label). Probiotics can regulate bowel function including motility which has to do with diarrhea and constipation.

If you are having trouble with gas, bloating or bowel movements, it wouldn’t hurt to give yogurt and kefir a try before taking more drastic measures. For some people, changing the kind and balance of gut bacteria with probiotics may relieve the symptoms of IBS. Probiotics are also available in liquid, powder and pill form if larger concentrations are desired.

It should be noted that while antibiotics have a place in medicine to kill certain pathogens, they should be used with discretion since the drugs kill not only the “bad” bacteria that cause illness but also the good microbes that regulate the intestines.