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IBS can be tricky to diagnose, as its symptoms - usually diarrhoea, bloating, constipation and stomach pain - can be caused by so many other things. However, the condition used to be diagnosed through excluding more serious conditions through testing. As clinicians are starting to understand specific symptom details through physical examinations and diagnostic testing, unnecessary testing is on the decline. Yet, many people with IBS are still left in the dark about exactly what has caused their condition and, more importantly, how to find a solution.
One of the first questions we're likely to ask when diagnosed with IBS is, 'how did I get it?' The truth is, there's no clear-cut answer: it's something that often remains a mystery. Blood tests can reveal nutrient deficiencies and other abnormalities (inflammation, anaemia, low levels of serotonin1 are a few common examples) but the reality is that there are so many potential triggers - our guts, just like us, are all so different. Fear not, though, there are some areas worth examining a little more closely, such as:
Breaking down the relationship between these areas and IBS might just help pinpoint a potential root cause of your IBS. From there, you'll be in an informed position ready to tackle the problem healthily.
Let's start with food poisoning. If you're unlucky enough to have ever suffered with it, you'll know just how uncomfortable it can be. When it happens, your gut flora (the community of bacteria that lives in your gut) may change as your body tries to rid itself of bad bacteria. This can sometimes be a precursor to IBS developing down the line (this happens to around 1 in 10 people with IBS).2
Antibiotics are often used to treat acute food poisoning and while these can successfully eliminate the harmful bugs in your digestive tract, they can also eliminate the 'good bacteria'3 that actually benefits our gut. As result of this, there is a chance you may experience bloating and diarrhoea. That's why, if you're ever prescribed antibiotics, it's important to consider taking a probiotic alongside it to help replenish your good gut bacteria.
IBS can also be linked to a stressful period in our lives. The relationship between the gut and the brain is well documented. For example, when we're stressed for a lengthy period, our body can divert attention away from our digestion to preserve energy. This can lead to fewer digestive enzymes being produced (which we need to break food down properly) or food rushing through the gut too quickly.
Have you ever found yourself desperate for the loo before an exam, an important meeting or a first date? Well, now you know why. The link between the gut and the brain is so clear that psychological issues such as stress and anxiety can be both the cause and impact of gut issues. Addressing these stress issues can go a long way in helping you to reduce any gut issues you may be experiencing.
The precise cause of IBS may well be a mystery, but there's certainly evidence to suggest our lifestyle choices may be closely linked to it.4 Therefore, it's important to try to get to the 'root' of what may be causing the symptoms to persist, rather than just relying on strategies to alleviate symptoms.
As mentioned above, there is a strong connection between anxiety and IBS. For example, a study found those with IBS have higher anxiety and depression symptoms (full study information here). That's not to say 'it's all in your head', but that those with anxiety may also find themselves struggling with IBS (and vice versa). Anxiety can certainly cause havoc on our immune system, which could trigger an IBS flare. But it might also be that those with IBS become anxious about living with the condition.
Getting to grips with anxiety can be hugely beneficial for your overall gut health. Strategies like Cognitive Behaviour Therapy (a form of counselling) and meditation may make a real difference to your gut wellbeing simply because you're reducing stress levels.
Most of us are more on the go than ever before and the ready meals we tend to grab - in between staring at our tablets and smartphones - are often low in fibre and high in fat. Too much of this might lead to a 'leaky gut', which is often at the core of many digestive conditions.
It occurs when poor diet choices and overuse of certain medications (such as Ibuprofen) causes the gut lining to become more permeable: food particles (especially gluten) can pass through it without being properly digested. Leaky gut can't be quickly solved, but looking carefully at diet and keeping a food diary, supplementing to support our digestion and lifestyle changes can help get to the root of the issue.
Some people find temporarily eliminating grains to be beneficial, some may find relief in the Palaeolithic diet; it really depends on your individual needs as a person and what your gut responds to. No one person is the same, therefore dietary requirements will always be different. It's always best to do this with the support of a dietician.
Supplementing a gentle form of fibre, however, can help the gut gently eliminate any toxins (from poor food choices and antibiotics) and help support bowel movements.
IBS is often linked to our immune system. It's important to note that two autoimmune diseases, in particular, should always be ruled out since their symptoms can often mimic IBS.
Coeliac disease (an autoimmune disease in which the gut reacts to gluten to cause diarrhoea, stomach pain, vomiting, and anaemia) and inflammatory bowel disease (the symptoms of which are bleeding with bowel movements, diarrhoea, weight loss and mouth ulcers) should always be ruled out.
While IBS does not often progress into autoimmune conditions, it's thought that poor gut health and gut flora may be a potential 'trigger' for them to develop.
As such, improving your gut health may act as a preventive measure against autoimmune conditions, as well as helping to improve your IBS symptoms at the same time. Ensuring your immune system runs optimally is incredibly important to your overall wellbeing. That's easier said than done, of course, and you can find more advice about in our advice centre - likewise, if you fancy learning a bit more about IBS and the role your gut plays.
If you'd like to read more about the benefits of keeping a healthy gut, as well as find more information on how you can promote good gut health, select Digestion from the Your health menu above.
Nothing beats a healthy, balanced diet to provide all the nutrients we need. But when this isn't possible, supplements can help. This article isn't intended to replace medical advice. Please consult your healthcare professional before trying supplements or herbal medicines.
1Adibi, P., Roohafza, H., Bidaki, E., Hasanzadeh-Keshteli, A., Daghaghzade, H. and Afshar, H. (2018). Anxiety, depression and distress among irritable bowel syndrome and their subtypes: An epidemiological population based study.
2Bupa, Irritable bowel syndrome (IBS)
3IBS and Serotonin, GI Society
4Tidy C, Bonsall A, (2017). Irritable Bowel Syndrome, Patient.info
5Goodman, B (2011). Antibiotic Overuse May Be Bad for Body's Good Bacteria, WebMD