Have you experienced chronic problems with gastrointestinal (GI) pain, gas and bloating, diarrhea and/or constipation? I know, it's not proper to discuss this in polite company, but ignoring symptoms won't make them go away!

Individuals who suffer from chronic GI and related symptoms may have Irritable Bowel Syndrome. This is a functional gut disorder (more on that below) clinically defined by the Rome IV criteria as 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/bowel movements, 2) associated with a change in frequency of stool, and 3) associated with a change in form/appearance of stool. For a clear IBS diagnosis, these criteria should have been fulfilled for at least 3 months, and onset of symptoms at least 6 months before diagnosis. So if this sounds like you, it may be time to get checked out by your primary care provider or a GI specialist.

It's also important to rule out other possible GI concerns, such as ulcerative colitis or crohn's disease (these are collectively called Inflammatory Bowel Disease), food allergies or chemical intolerances, autoimmune disorders such as celiac disease, or cancer (and in women, endometriosis), before a diagnosis of IBS can be safely made. This is when a gatroenteroloigist and a registered dietitian can be especially useful to help you navigate the range of issues and ensure you're on the right track to feeling better.

What makes IBS a "functional gut disorder" is that it is a series of symptoms based on the overall functioning of the gut and the interaction between the brain and gut (they do a lot of talking!), versus an inflammatory or infectious disease. (However, there are some times when these can overlap - this is for a future blog post). For individuals with IBS, this means that their GI tract may have motility issues (food can digest much faster or much slower than in non-IBS individuals, causing discomfort or abnormal bowel habits), normal gut bacteria may be altered (which can change your gut from a happy, healthy place to one that's cranky and unsettled), there can be increased sensitivity to and intense pain (called visceral hypersensitivity) with normal digestive processes such as gas or bloating, changes in the gut's immune function, and changes in how the brain sends and receives messages from the gut. So while your gut may not be infected with anything, there is a LOT going on.

The problem with IBS is often that it is a diagnosis of "last resort" for some individuals. After suffering painful, anxiety producing or embarrassing symptoms for months to years, many IBS sufferers begin to lose hope for relief or start to self diagnose and self treat, which can mask more serious issues and/or lead to insufficient relief. There are no specific diagnostic tests for IBS, (though a few are used in the diagnostic process, such as breath tests) and it's largely a diagnosis of exclusion of other issues or diseases via various other lab tests and scans, such as blood tests for celiac, stool tests to rule out bacterial or parasitic infections, endoscopies and/or colonoscopies. This lack of clarity can lead people to feel frustrated and hopeless, or like they're alone and a bit crazy.

If this is you, know this: It is not hopeless and you are not crazy. There are some great diet and lifestyle treatments that can dramatically reduce IBS symptoms and improve quality of life. Future blog posts will discuss the low FODMAPs diet and other complementary treatments that can help IBS sufferers get their lives back. If you have any questions in the mean time, please feel free to get in touch via the contact page.

You can also read more about IBS here:

https://www.aboutibs.org/diagnosis-of-ibs.html
https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/diagnosis-treatment/drc-20360064,m
https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/diagnosis

Here's to happy eating. And happy pooping. :)