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What is IBS?
Also known as Irritable Bowel Syndrome, it is one of the most frequent gastrointestinal problems in the world. 12-20% of the population worldwide has IBS, and it is 2-3 times more common in women.
Symptoms can include cramping, abdominal pain, abdominal bloatedness or distension, diarrhoea and constipation. In addition, the symptoms are often related to passing of motion. Patients may feel the sensation of incomplete evacuation. IBS is a long-term condition that will need a long-term management. Now the exact causes of IBS are not known.
Factors that appear to play a role includes
Firstly, Changes in the gut microbes.
There may be changes in the bacteria, fungi and virus composition within our gut due to various factors like our food and water. Research indicates that the microbes in people with IBS might differ from those in people who don’t have IBS. Patients with IBS may have lower levels of Lactobacillus and Bifidobacterium in their gut and higher levels of harmful streptococcus, E. Coli and clostridium. IBS may also be related to a surplus of bacteria in the small intestines known as bacteria overgrowth.
Secondly, Severe bowel infection.
Irritable bowel syndrome can develop after a severe bout of diarrhoea caused by bacteria or virus infections. This is known as gastroenteritis.
Thirdly, altered Gut-mind axis.
Our nervous system and our gut are linked via the autonomic nervous system. People exposed to stressful events tend to have symptoms suggestive of IBS. Poorly coordinated signals between the brain and the intestines can cause your body to overreact to changes that typically occur in the digestive process resulting in pain, diarrhoea or constipation.
Whatever the cause is, we know that IBS is commonly associated with
- Poorer quality of life
- Mood disorders like depression and anxiety.
Now treatment of IBS focuses on relieving symptoms so that you can Iive as symptoms free as possible. Medications that can be given includes
- Anti diarrhoea medications and anti-cholinergic medications
- Laxatives and sometimes even antidepressants.
But before we even talk about medications, some of the natural methods of managing IBS includes
- Managing your stress
- Getting 7-8 hours of sleep a day
- Exercising regularly
- Modifying diet to avoid food that can trigger your symptoms such as gluten, certain carbohydrates and gassy food and beverages like carbonated drinks and alcohol.
Increasingly, probiotics has been studied for the treatment of symptoms of IBS. As one of the factors contributing to IBS is changes in gut microbiomes - supplying our gut with probiotics makes a lot of sense. The beneficial effects of probiotics in IBS could be explained by increasing the amount of beneficial bacteria in the digestive tract, decreasing disease-causing bacteria in the small bowel and enhancing the intestine’s barrier immune functions and reducing the intestinal inflammatory state.
In recent years, there have been numerous publications which have shown that probiotics could improve the global symptoms of IBS. This table listed studies done over the past 20 years that have shown that probiotics significantly reduce symptoms of bloatedness, distension, pain and constipation due to IBS. Many good clinical studies use mainly Bifidobacterium or lactobacilli or a combination of the two.
Probiotics are safe and effective in IBS patients. Adding probiotics to IBS patient's routine can bring about symptomatic relief.
By : Dr Chen Yiming
Family Physician, MBBS (Singapore), GDFM (NUS), GDFP Dermatology (NUS)