Understanding Irritable Bowel Syndrome (IBS)

What is IBS?

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder defined by recurrent abdominal pain associated with defecation or changes in bowel habits [1]. It is estimated to affect 10-15% of the global population [2].

The hallmark symptoms of IBS – abdominal pain or discomfort, bloating, and changes in stool consistency or bowel movement patterns – arise from communication issues between the gut and brain [3]. Specifically, the delicate communication between the gut, central nervous system, and the brain-gut axis is disturbed in IBS patients.

IBS does not cause permanent damage but can have a major influence on quality of life. While not medically serious, its unpredictable symptoms like severe cramps can take a major toll emotionally and physically. Treatment focuses on symptom relief rather than cure [4].

Causes of IBS

The underlying pathogenesis of IBS is complex and multifactorial. Potential contributing factors include: [5]

• Gut microbiota imbalance – Changes in the balance of healthy gut bacteria (dysbiosis) may play a role by altering gut-brain signaling and immune function.
• Genetics – Family history correlates with higher IBS risk, likely involving genes impacting the gut-brain axis, serotonin signaling and transport.
• Infections – Gut infections like gastroenteritis occasionally precede IBS onset by disrupting normal gut-immune interactions long-term.
• Dietary factors – Certain poorly absorbed short-chain carbohydrates called FODMAPs as well as probiotic-rich fermented foods influence IBS in susceptible individuals.
• Psychological stress – Stressful life events and ongoing emotional stressors can promote abnormal gut reflexes and visceral sensitivity in IBS patients.

Symptoms of IBS

The hallmark symptoms of IBS – abdominal pain or discomfort, bloating, and changes in bowel habits – can vary significantly between individuals and even fluctuate over time within a person [6].

Abdominal pain is usually relieved with defecation and is associated with a change in bowel frequency or form. Bloating may occur either constantly or intermittently. Stools vary between diarrhea, constipation, or alternating between the two. Some also experience mucus in the stool [7].

Other possible symptoms include painful cramps, urgency, the feeling of incomplete evacuation, abdominal distension, and fatigue. Symptoms can worsen with stressful events, diet changes, or certain foods [8].

Diagnosing IBS

There are no objective tests to definitively diagnose IBS, so a diagnosis is made primarily by eliminating other possible conditions based on symptom patterns and diagnostic tests. Key diagnostic criteria include:

• Abdominal pain relieved with defecation or associated with changes in stool frequency/form.
• Symptoms present at least one day per week in the last 3 months [9].

Doctors will conduct blood testing to check for inflammation or anemia. Stool samples check for infection or bleeding [10]. Further tests like colonoscopy may be done if symptoms warrant or to rule out conditions like Crohn’s disease or celiac disease[11].

No single test can diagnose IBS, but ruling out other conditions via testing provides a process of elimination diagnosis. Diagnostic tests help providers craft an appropriate management plan.

Managing IBS

Treatment aims to control symptoms and improve quality of life. Lifestyle modifications play a key role and may include stress management techniques and regular exercise[12].

Dietary changes can also help. The low FODMAP diet temporarily eliminates certain fermentable carbs to establish food triggers[13]. Some also find relief with the Paleo, AIP, or carnivore diets [14].

Medications are not always needed but may involve antispasmodics, antidepressants, antidiarrheals, or laxatives depending on symptoms [15]. Probiotics may aid management by restoring healthy gut bacteria balance [16].

Psychological therapies such as CBT help patients understand IBS and manage stressors[17]. For severe cases when lifestyle therapies do not suffice, prescription medications are needed under medical guidance.

Complementary approaches including acupuncture, gut-directed hypnotherapy, and herbal remedies also show promise[18]. The key is finding an individualized plan catering to personal symptom patterns and triggers.

The Carnivore Diet for IBS

Following a strictly animal-based “carnivore” diet is emerging as a potential management approach for some with IBS. By eliminating all plant foods that are harder to digest like fiber, FODMAPs, and potential allergens/irritants, proponents claim symptoms can significantly improve.

A key theory is that the removal of poorly absorbed fermentable carbs allows the gut to fully heal. Consumption of nutrient-dense meat, organ meats, bone broth, and animal fats/proteins provides building blocks to repair the gut lining. However, long-term risks from nutritional deficiencies require supplementation and medical supervision.

Anecdotally, many report alleviation of abdominal pain, constipation/diarrhea, bloating, and other IBS signs within just a few weeks. However, rigorous clinical testing is still lacking. Discover more about how the carnivore diet aims to control symptoms through elimination in my dedicated blog post analyzing this approach.

Recipes to relieve IBS

Finding gentle, gut-soothing recipes is an important part of IBS self-management. Browsing my recipe page can provide meal ideas free of common dietary triggers that may set off digestive distress.

Recipes focus on easy-to-digest protein sources like chicken, fish, and lamb in preparations that nourish but do not overburden the stomach. From quick skillet meals to nourishing soups and satisfying bakes, you’ll discover options for varied lifestyles and dietary preferences.

Each recipe lists detailed ingredients and instructions for reliable recreation at home. Don’t hesitate to modify ingredients based on your unique needs and symptoms. Monitoring your body’s feedback will help identify the combinations that keep you feeling your best.

References:

[1] Lovell RM, Ford AC. Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol.2012 Nov. https://pubmed.ncbi.nlm.nih.gov/22426087/

[2] Saha L. Irritable bowel syndrome: Pathogenesis, diagnosis, treatment, and evidence-based medicine. World J Gastroenterol.2014 May 7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4051916/

[3] Canavan C, West J, Card T. The epidemiology of irritable bowel syndrome. Clin Epidemiol. 2014.https://pubmed.ncbi.nlm.nih.gov/24523597/

[4] Talley NJ, et al. Functional gastroduodenal disorders. Gastroenterology. April 2006. https://www.gastrojournal.org/article/S0016-5085(06)00508-7/fulltext

[5] Ford AC, et al. Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. BMJ. 2008 November 13.https://pubmed.ncbi.nlm.nih.gov/19008265/

[6] William D Chey, Jacob Kurlander, Shanti Eswaran. Irritable bowel syndrome: a clinical review. JAMA. 2015 Mar 3.https://pubmed.ncbi.nlm.nih.gov/25734736/

[7] Spiller RC, et al. Guidelines on the irritable bowel syndrome: mechanisms and practical management. Gut. 2007 Dec. https://pubmed.ncbi.nlm.nih.gov/17488783/

[8] H R Bahrami, et al. Herbal Medicines for the Management of Irritable Bowel Syndrome: A Systematic Review. Electron Physician. 2016 Aug 25. https://pubmed.ncbi.nlm.nih.gov/27757180/

[9] Ford AC, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol. 2014 Oct. https://pubmed.ncbi.nlm.nih.gov/25070051/

[10] Lekha Saha. Irritable bowel syndrome: Pathogenesis, diagnosis, treatment, and evidence-based medicine. World J Gastroenterol. 2014 Jun 14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4051916/

[11] Saha L. Irritable bowel syndrome: Pathogenesis, diagnosis, treatment, and evidence-based medicine. World J Gastroenterol.2014 May 7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4051916/

[12] Lovell RM, Ford AC. Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol.2012 Nov. https://pubmed.ncbi.nlm.nih.gov/22426087/

[13] Talley NJ, et al. Functional gastroduodenal disorders. Gastroenterology. April 2006. https://www.gastrojournal.org/article/S0016-5085(06)00508-7/fulltext

[14] William D Chey, Jacob Kurlander, Shanti Eswaran. Irritable bowel syndrome: a clinical review. JAMA. 2015 Mar 3.https://pubmed.ncbi.nlm.nih.gov/25734736/

[15] Ford AC, et al. Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. BMJ. 2008 November 13.https://pubmed.ncbi.nlm.nih.gov/19008265/

[16] Canavan C, West J, Card T. The epidemiology of irritable bowel syndrome. Clin Epidemiol. 2014.https://pubmed.ncbi.nlm.nih.gov/24523597/

[17] Spiller RC, et al. Guidelines on the irritable bowel syndrome: mechanisms and practical management. Gut. 2007 Dec. https://pubmed.ncbi.nlm.nih.gov/17488783/

[18] H R Bahrami, et al. Herbal Medicines for the Management of Irritable Bowel Syndrome: A Systematic Review. Electron Physician. 2016 Aug 25. https://pubmed.ncbi.nlm.nih.gov/27757180/