Overview

IBS (irritable bowel syndrome) is a long-term condition that affects both the stomach and the intestines. Its symptoms include cramps, bloating, loose stools, constipation, and gas.¹ As this is a lifelong condition, you might feel a little distressed. But don't worry, because by adjusting your lifestyle, you can better manage your symptoms.

Although IBS flare-ups can happen without reason, it can often be triggered by routine habits. So, to manage your symptoms effectively, you need to identify what triggers your IBS as these triggers can vary from person to person. 

Some common IBS triggers are:²

• Stress
• Anxiety
• High cholesterol foods
• Alcohol
• Caffeine
• Spicy foods

Let's learn more about IBS, its types and triggers. We will also discuss how you can manage your symptoms at home. 

About IBS

IBS or Irritable Bowel Syndrome is a chronic (long-term) condition that affects your gastrointestinal system. It causes bouts of pain and discomfort when opening your bowels. Unfortunately for those with IBS, it does not progress or develop into a life threatening condition. 

So, with timely diagnosis, regular checkups, and guidance from your physician, you can improve your quality of life.³  

Some facts about IBS

• It is common and affects about 10-15% of the population around the world.⁴ 

• Women are twice as prone to develop IBS than men.⁵
• The chances of developing IBS after 50 years of age are low. It is more common in teens and early adults. ⁶ 

Types of IBS

IBS is majorly categorized into 4 types that are:

IBS-C, IBS-M, IBS-D and IBS-U.⁷ These types present with different symptoms and so their treatment and management are also different.

1. IBS-C

IBS-C is the type of IBS where constipation is predominant. Other symptoms may include constipation, abdominal pain, bloating, change in bowel movements and discoloration of stool. 

A person is diagnosed with IBS-C if 25% of their stools are hard and bulky, and less than 25% of them are loose in consistency.⁸ 

Note that IBS-C and chronic constipation are two different things. Symptoms that are common to IBS-C (abdominal pain and bloating) usually are not seen in chronic constipation.⁹ 

So it is important to get a professional diagnosis of your condition to treat it accordingly. 

2. IBS-M

In this type of IBS, there are mixed bowel movements. Constipation and diarrhoea ,the two main symptoms of IBS-C and IBS-D respectively, are present at the same time in IBS-M. 

The criteria to be of IBS-M diagnosis states  that, if a person has hard and bulky stools as well as soft loose stools for 25% of the time, they qualify for a diagnosis of IBS-M.¹⁰ 

3. IBS-D

In IBS-D, diarrhoea (loose stools) is the primary symptom. You might feel the need to use the toilet frequently. Other symptoms are abdominal pain, bloating and mucus in stools. 

To be diagnosed as IBS-D a person should have more than 25% soft loose stools and less than 25% hard stools.¹¹ 

This particular type of IBS can have a significant impact on a patient’s day to day activities. Around 1 in every 3 patients suffering from IBS-D will lose control of their  bowels,resulting in soiling. 

4. IBS-U

IBS-U stands for unclassified IBS. This type does not have a defined set of symptoms. A person is diagnosed with IBS-U if their symptoms do not fall in either of the above categories that is IBS-C, IBS-M, or IBS-D.

Thus, persons with less than 25% hard stools and less than 25% soft and watery stools, are diagnosed with IBS-U.¹²

Common IBS triggers

Although the exact cause of IBS is still being researched, common triggers have been identified. There are many factors that directly and indirectly contribute to developing this condition. The following are some of the common triggers of IBS:

1. Bacterial infection

About 1 in 10 individuals develop IBS after acute gastroenteritis. Gastroenteritis (stomach flu) can be caused by parasites, bacteria and viruses. The risk of getting IBS is greater after parasitic infections.

Moreover, if IBS occurs with diarrhoea (IBS-D) then there's a high chance that it is caused by a parasitic bacteria called Brachyspira.¹³

2. Emotional disturbance

Chronic stress and emotional disturbance can take a serious toll on your health. Studies show that psychological stress has a negative impact on your intestinal sensitivity, motility (movement) and secretion of digestive enzymes. Stress also alters the composition of gut bacteria, which are important for digestion and maintenance of gut health.¹⁴

Another downside of emotional distress is that it may predispose individuals to  alcohol abuse, which can also worsen IBS symptoms through suppression of gut bacteria.¹⁵  

Unfortunately, many individuals rely on alcohol to cope with difficult situations, which can further worsen a person’s overall physical and mental health. If you feel like you are struggling, do not hesitate to reach out to your local health professional for support.

3. Fatty and spicy Foods

Foods that are spicy and high in cholesterol can contribute to the symptoms of IBS.¹⁶ Explanations include poor fatty food absorption and subsequently impaired gas transport in the gut. As for spicy foods, these have been shown to increase inflammation in the gut and contribute to IBS symptoms. 

4. Dairy

Around 70% of the world population is lactose intolerant, eaning that most of us cannot digest milk protein (lactose). As a result, lactose passes undigested in the colon, leading to eventual gas production via bacteria fermentation. 

Thus, dairy (except yoghurt) ought to trigger IBS and it's better to avoid it.¹⁷ If you can't avoid it completely, then consult your dietician, and they will come up with a plan fit for you.

5. Some medicines

Medicines that cause diarrhoea or constipation as a side effect can trigger IBS. Out of all the classes, NSAIDs (commonly known as pain medicine) are notorious for triggering IBS.¹⁸ 

Other drugs include certain antibiotics, antidepressants, and chemotherapy drugs that can trigger IBS.   

6. Sedentary lifestyle and unhealthy sleep cycle

According to a recent study, individuals with sedentary lifestyle and unhealthy sleeping habits are at a greater risk of developing IBS. It is recommended to sleep more than 7 hours to mitigate the risk.¹⁹

7. Ultra processed foods 

Over consumption of ultra processed foods (UPFs) and artificial sweeteners can trigger IBS. UPFs include ice cream, breads, ham, sodas, instant noodles, soups, and cereals.

According to the Clinical Gastroenterology and Hepatology Journal, every 10% increase in the consumption of UPFs increases the occurrence of IBS by 8%. Due to the increasing popularity and occurrence of UPFs, it is important to be mindful of the quantity and quality of our food consumption. 

Managing IBS at home

Your symptoms of IBS can improve at  home with the appropriate and necessary adjustments. 

1. Plan your meals

Eating home cooked foods that are low in fats and high in fibre can help you pass stools easily. It is recommended to take five to six small portions of meals throughout the day, instead of having large portions twice or thrice daily.²⁰

Always take your breakfast as it is the first meal of the day and stimulates the colon to pass stool. 

Tracking your meals and recording what triggers your IBS into a diary can be used to avoid them in the future. 

2. Take probiotics

Probiotics can help reduce bowel movements and improve the consistency of stools, thereby decreasing the frequency of toilet trips.²¹

Probiotics are naturally present in yoghurt, sauerkraut, kimchi, kombucha, buttermilk, and bananas.

You can also consult your physician to prescribe you probiotic supplements if needed. 

3. Try low FODMAP diet

Trying a low FODMAP diet for two to six weeks has shown valuable benefits for IBS patients. FODMAP is an acronym for some micronutrients that cause gut disturbance – fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.

This diet plan follows three steps:

• Eliminating FODMAP containing foods for two to six weeks
• Slowly reintroducing them to check what triggers your IBS 
• After identifying your triggers you can avoid them completely or take them in consideration

Please discuss with your doctor before making any diet changes. Your physician will guide you through the whole process and will help you identify your triggers.²²

4. Exercise regularly

Incorporate moderate exercise in your routine, like taking a 30 minute walk in the morning. 

Studies show that daily physical activity has positive psychological effects and can help relieve IBS symptoms in the long run.²³

But make sure you don't over do it, as excessive and strenuous exercise may also trigger IBS. 

5. Try meditation to relieve stress

As stress can trigger IBS, effective stress management can have a significant impact of your quality of life

Meditation has been proved to be effective in managing stress. According to a recent study, which involved  two groups of IBS participants, he group that was involved in mindfulness/meditation activities had a lower severity of IBS symptoms compared to those who weren't.²⁴

This study shows how important your mental wellbeing is for your physical health. 

6. Get enough sleep

Getting enough sleep helps rejuvenate your body. If you do not get a proper night's sleep chances are that you're going to have gastrointestinal symptoms the next day.²⁵

Therefore, getting at least 8 hours of sleep and proper rest are essential to help avoid triggering IBS. 

Summary

IBS is one of the few chronic conditions that can be successfully managed by making individual lifestyle changes as mentioned above. If you are concerned about your IBS and how it may be impacting your life, see your physician where they will be able to explore your condition in further details. It may be helpful to be mindful of the food you consume in order to avoid certain food which may exacerbate your IBS.