The Most Frequently Asked Questions On IBS

Irritable Bowel Syndrome (IBS) is a real pain in the gut—especially for the estimated 13 to 20 percent of Canadians who suffer its hallmark symptoms of cramps, bloating, gas, constipation and diarrhea. Additionally, this gastrointestinal (GI) disorder also appears to affect more women than men at a more than  2:1 ratio and is more prevalent in Canada than in any other country. 

Here, find expert answers to some of the most commonly asked questions about the chronic condition, including what steps you should take if you suspect you have it. 

What is IBS? 

IBS is a “syndrome” that affects the gastrointestinal (GI) tract, says Talia Zenlea, a gastroenterologist at Women’s College Hospital in Toronto, along with the Tummy Clinic, a multidisciplinary clinic that specializes in treating IBS. 

“Syndrome is a catch-all term to encompass a group of symptoms that tend to occur in a characteristic pattern in a group of patients,” adds Zenlea. 

While it’s not deadly or degenerative, 70 percent of sufferers have said it interferes with their everyday life and these chronic symptoms can negatively impact your quality of life. 

There are three different kinds of IBS:

IBS-C: Constipation (women are more susceptible to this type)

IBS-D: Diarrhea 

IBS-M: Sufferers experience a mix of constipation and diarrhea  

What are the most common symptoms of IBS? 

There are a number of GI symptoms (simultaneous or separate) that can suggest a person may have IBS, including altered bowel habits (chronic constipation or diarrhea), cramps, mucus in stool and abdominal pain, among others. 

What’s the difference between a bout of constipation or diarrhea and IBS?

Time. A brief bout of constipation or diarrhea doesn’t mean you have IBS. Prolonged or chronic GI symptoms over several months or even years, however, may indicate it. What distinguishes a bout of GI distress from IBS is the duration in which you’ve dealt with the symptoms, what your doctor would call “chronicity,” explains Zenlea.

How do you get a diagnosis?

Your first stop would be your General Practitioner where they would discuss your symptoms and medical history, and perform a physical exam. In most cases, physicians are able to diagnose IBS by discussing the length and severity of symptoms. However, depending on your particular situation, they may run a few tests to rule out any other digestive organic illnesses or conditions, such as celiac or Crohn’s disease.

How do you treat IBS?

You have to tackle the problem from a few sides, says Zenlea. Once your IBS diagnosis is confirmed, your doctor can prescribe you a variety of medications to treat your chronic abdominal pain, constipation or diarrhea. When specifically treating IBS-D, there are available prescription medications that are able to slow down your bowel contractions to help control chronic diarrhea and belly cramps. There are also medications that act more locally and reduce the bacteria in your gut. Over-the-counter remedies such as psyllium fibre supplements, enteric-coated peppermint oil, calcium (IBS-D), magnesium (IBS-C), and probiotics can also help regulate your bowel movements, relieve cramping or abdominal pain, and stabilize your gut bacteria. As IBS is different from one person to the other, the best way to ensure you best manage your condition is to consult your GP.

Zenlea says there isn’t one single way to deal with symptoms of IBS, but rather several different ways. In her view, the best approach is to marry prescription treatment and over-the-counter remedies with certain helpful lifestyle interventions, including minimizing daily stress and/or making dietary changes. Many patients also turn to cognitive behavioural therapy (CBT), a form of talk therapy that challenges habitual responses to stress and negative patterns of thought, to help with symptom management.

Can dietary changes help?

While your GP is your first stop when it comes to dealing with IBS, it may also be beneficial to look to a dietitian for further help, especially if you suspect some of your symptoms are exacerbated by dietary triggers. A dietitian with experience in IBS may introduce you to the low FODMAP diet, which stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. It’s essentially a way to eliminate a number of short-chain carbohydrates that are harder for the small intestine to absorb and have a tendency to hang around and ferment, which results in the trademark symptoms of gas, bloating, abdominal pain and bowel movement changes. These carbohydrates are found in dairy, some vegetables and fruits, sweeteners and grains. This diet consists of a three-step approach. You start by eliminating these foods for a period of time (usually two to six weeks). Secondly, you slowly reintroduce them in order to pinpoint which ingredients cause the most irritation in your gut. Finally, you come up with a long-term and sustainable IBS-friendly diet. It's best to work through this diet with your GP or a specialized dietician.

What about exercise? 

Exercise is not part of the usual range of treatments usually deployed in treating IBS, but Zenlea says there’s some evidence to suggest that certain types of exercises can help alleviate certain symptoms. For example, core-strengthening exercises may help reduce bloating, and pelvic floor exercise may help alleviate discomfort caused by constipation, she says, adding that exercise “never hurts” and is always a good way to facilitate overall wellbeing.