Irritable bowel syndrome (IBS) is a common syndrome, symptoms of which include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. IBS is a chronic condition, and often needs long-term management. While some people are able to control their symptoms with easy, over-the-counter approaches like fiber supplementation, most people with IBS require a morebin-depth strategy, focusing on diet, lifestyle, stress-management, gut-targeted cognitive behavioural therapy, and in some instances, prescription medications.
A diagnosis of IBS can often be made just by talking to you, and getting a thorough assessment and understanding of your symptoms. Always talk to your family doctor or primary care doctor first, as they can ensure you don’t have any symptoms that would warrant further investigations.
IBS treatments differ from person to person. What works well for one person might not work well for another. Treatment generally involves a multi-modal approach using a combination of dietary and lifestyle support, and some medications, either by prescription or available over the counter. Your family or primary care doctor is always the best place to start, as they can exclude other conditions, and often get the ball rolling on treatment. In some instances, they may refer you to a gastroenterologist, usually to rule out other conditions if you have red flag symptoms. Otherwise, they may refer to you other allied health providers, like a registered dietician to help manage your diet, or therapist with expertise in IBS management, for mindfulness based stress reduction or cognitive behavioural therapy. If a model like this exists where you live, they may refer you to a multi-modal treatment clinic like The Tummy Clinic, where all of this is available under one roof, and is approached holistically with all providers working together to tailor a program to your individual and unique needs.
Mental Health Professionals
Mental health professionals also play a crucial role in treating IBS. For some people, IBS symptoms are triggered by, or themselves trigger, stress, anxiety, depression, and other strong emotions. A strong connection exists between one’s mental health and the health of one’s gut. Multiple studies have shown a strong link between cognitive behavioural therapy and mindfulness based stress reduction in reducing IBS symptoms. Other psychological therapies such as hypnotherapy are being explored and show promise.
In many cases, IBS is triggered by certain foods. Your doctor might recommend making changes to your diet, such as avoiding gas-producing foods or certain types of carbs. You might also need to include more fibre in your diet as well as probiotics, which are gut-supporting good bacteria. A qualified dietitian would draw up a suitable diet plan, advising you on which foods to avoid, and also ensuring you are consuming your required nutrients. A dietitian would also be able to tackle specific questions and issues related to your individual requirements.
IBS brings with it the challenge of unexpected urges to use the bathroom. The prospect can be especially challenging when you are travelling or outdoors. A pelvic floor physical therapist might be able to teach you how to gain more control over the situation by retraining your bowels. Biofeedback would provide information about how your body functions. Biofeedback is a process whereby electronic monitoring of a normally automatic bodily function is used to train someone to acquire voluntary control of that function. Based on this information, you would be able to make changes such as learning to control the muscles that affect your bowels.
There are many non-conventional options also available for treating IBS. Though the evidence isn’t always clear, many do find certain alternative treatments useful. There are medical centres which also use a combination of alternative approaches along with traditional medicine. It’s important to make sure all your health providers know about the other members of your IBS health team as well as your treatments. You could consult licensed alternative providers such as –
Acupuncturist – An acupuncturist may help to alleviate symptoms such as diarrhea, pain, bloating, stool output, and stool abnormality, as well as anxiety or sleeplessness.
Herbalist – A herbalist may use a combination of herbs which could relieve IBS symptoms.
Massage therapist – A massage therapist may be able to ease stress and anxiety, which play a role in triggering IBS.
It is important to have a good therapeutic relationship with your healthcare practitioner, as well as confidence in the treatment. A positive physician-patient relationship helps achieve the most beneficial treatment option for symptom relief. Physicians who show warmth, empathy, active listening, and a positive outlook help bring about greater reduction in IBS symptoms and improvements in quality of life.