Sharona Gabai, clinical dietitian, B.Sc RD
A syndrome defined as dysfunction of the digestive system, including a functional disturbance of bowel activity of unknown cause. It leads to recurring gastrointestinal symptoms of varying severity.
It affects 15–20% of the population. Women experience it at least twice as often as men, generally with more discomfort and pain. Statistically, it usually begins in the teenage years or twenties. Symptoms differ between patients and are not necessarily uniform.
Symptoms:
- Abdominal pain, gas, intestinal cramps and bloating, usually reduced after a bowel movement.
- Irregular bowel movements, alternating constipation and diarrhea.
- Straining to pass stool.
- Indigestion.
- A feeling of incomplete emptying after a bowel movement.
- Nausea.
- Belching.
- In more severe cases, heartburn, bad taste in the mouth, vomiting and headaches.
- Mucus in stool.
What causes IBS?
The causes are not entirely clear, but a combination of physiological and psychological factors is suspected. It apparently results from damage to nerves controlling digestive muscle contraction and sensitivity.
IBS is considered common and apparently associated with stress, tension, anxiety and even depression.
The likely reason is the gut’s independent nervous system, which contains more nerve cells than the spinal cord and more neurons than the entire noncentral nervous system. Because the central and peripheral nervous systems, including the gut’s, are closely connected, psychological sensitivity or stress felt in the brain may also appear as intestinal contractions or oversensitivity. No scientific theory supports this, but in calmer periods some people’s bowel problems seem to diminish or disappear.
Physiological factors include hypersensitivity or intolerance to certain foods and a typical Western diet low in fibre, among others.
Conventional treatment:
There is no curative treatment. Western medicine also recommends dietary and lifestyle changes to relieve symptoms. Drugs relaxing intestinal smooth muscle can be used for abdominal pain, and sedatives for stress and anxiety.
Nutrition:
People with bowel problems should know what to avoid generally: caffeine, alcohol, highly spicy or heavily seasoned foods and tobacco, which irritate the intestinal lining. Highly processed foods containing flavour enhancers and other potentially irritating substances are also best avoided. Frozen or chilled foods, cold water, ice and ice cream may cause intestinal contractions from the cold and are also best avoided. Some people with a sensitive bowel have a deficiency affecting milk-sugar breakdown, so avoiding liquid milk is recommended.
For diarrhea, drinking plenty is recommended to maintain fluid balance, along with foods that slow intestinal activity, such as rice and toast. People with diarrhea generally have depleted “good” probiotic bacteria in the bowel.
For constipation, fibre-rich fruit, vegetables and whole grains and plenty of fluids are recommended. Consuming fibre without drinking can cause a “blockage” and worsen constipation.