Irritable Bowel Syndrome

Irritable Bowel Syndrome
(Last Updated On: February 19, 2020)
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Irritable Bowel Syndrome (IBS) is a bowel disorder which does not show any abnormalities in the gut. This can make it a very frustrating disorder to have. The complaints you have a very, very real. But still, there is nothing to find!?

For a long time, the problem with IBS was, that it was perceived as something you could not change, and just had to deal with. Luckily, times have changed and this is not the case anymore. About 11,2% of the world population has complaints coming from IBS, and it is more common in women. Thankfully nowadays there are many diets and lifestyle changes that can help relieve IBS.

The Diagnosis

For the diagnosis of IBS, the ROME IV criteria are used. As you could maybe understand from the number, there has been ROME 1, 2 and 3 before. So clearly the diagnosis of IBS has not been set in stone for the last years.

IBS Diagnostic Criteria

Recurrent abdominal pain on average at least 1 day/week in the last 3 months, associated with two or more of the following criteria:
1. Related to defecation
2. Associated with a change in the frequency of stool
3. Associated with a change in the form (appearance) of stool

(These criteria should be fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis.)

Symptoms of IBS

Irritable Bowel Syndrome

The symptoms of IBS can vary greatly and contain basically every discomfort you could feel in your gut. IBS can first show it’s symptoms in early childhood, or could even start to show later in life. Sometimes the start of the symptoms is triggered by a big ‘gut-disturbing’ event, which could be anything from antibiotic use, to stress, to traveler’s diarrhea. Other people just have it without having had a trigger, bad luck.

Common symptoms are:

Even if you recognize these symptoms, it is good to consult your doctor and not create your own diagnosis.
If you have blood coming with the stools, a big and prolonged change of the stools, weight loss and a family history of bowel disease you have an extra reason to check in with your doctor.

Often the symptoms worsen after a meal or at the end of the day and going to the toilet could provide relief. But this is certainly not the case for everyone.

Types of IBS

In literature there are 3 main types of IBS described:

  • IBS – C. Which is predominant in constipation
  • IBS – D. Which is predominant in diarrhea
  • IBS – M. Which has mixed bowel habits

These types are based on the days that there are complaints. Not everyone with IBS has daily complaints. It could be that you have several ‘normal’ days a week and a few bad ones with constipation. Or that you are constipated every day. In both cases, you would fit in the IBS-C type.

Bristol Stool Chart
Bristol Stool Chart

To describe the stools, the Bristol Stool Chart (BSC) is used (see picture). The BSC describes 7 types of stools which vary from hard to liquid.

Type 1-2 means constipation

Type 3-4 means healthy stools

Type 5-7 are different forms of diarrhea

Do you have IBS and would you like guidance from a specialized dietitian? Then schedule an online consultation at my online dietician’s practice Darm diëtist, and I will help you with all your questions!

Possible reliefs for IBS

IBS is often a combination of food choices, stress, and just bad luck.

There will be times when you do everything right, and still have symptoms. This can be very frustrating, but don’t let this get you demotivated! Things can get better eventually.

The following list gives you ideas on how to deal with your IBS, these are purely food and supplement related. Any of the medications or laxatives your doctor could give you are not included. If you are using medications, please discuss your plan with your doctor or dietitian before starting your plan or stopping your medication.

All of the listed interventions will eventually have an article on Positive Gut. For now, the ones Bold provide links to more extensive articles on the subject.

Usually one of these will provide relief or a combination of 2-3 of the interventions will help you.

Fiber and prebiotics
Drinking enough
Reducing gassy foods (like soda and cabbage)
Elimination diet
– Fructose
– Histamine
– Wheat
– Nightshade
Reducing the use of sweeteners and additives
Psyllium fibre
Digestive enzymes
Peppermint oil
Using magnesium to moisten the stools
Reducing stress 
Yoga and/or meditation
Physical activity

Hopefully, your effective intervention is included in the list. Let me know what works for you and what your experience is with the different interventions. Is there anything else you have tried that worked for you?

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