What is Irritable Bowel Syndrome (IBS)?

What is Irritable Bowel Syndrome?  This is not one of the questions that I get asked all that often but comes up when I am taking patient histories.  

Rarely does a patient ever go in and say I have IBS, it normally has to be teased out when we are discussing what finally brought them into the office.  This is not because the patients are trying to hide something from me; they are doing this simply because most people are unaware of what irritable bowel syndrome is or the symptoms.  

What they will tell me is that they suffer from gas belching bloating.  My favorite though is when I ask about their bowel movements, they say they are regular, and they go once a week every week. The surprising statistics is that about 20% of the population is suffering from a form of IBS.  That means about one out of every five people you meet have a stomach that isn’t happy with them.  

They are always suffering from either gas, constipation, diarrhea or worse of all of those symptoms.  It is usually helpful to define the signs and symptoms of IBS.  IBS is diagnosed when a person has had abdominal pain or discomfort at least three times a month for the last three months without other disease or injury that could explain the pain.  The pain or discomfort of IBS may occur with a change in stool frequency or consistency or be relieved by a bowel movement. There are some other essential criteria that can help you define which type of IBS you have:

Irritable Bowel Syndrome with constipation (IBS-C) - You will have hard or lumpy stools at least 25% of the time and loose and watery stools less than 25 percent of the time.

Irritable Bowel Syndrome with diarrhea (IBS-D) - You will have loose or watery stools at least 25 percent of the time and hard or lumpy stools less than 25 percent of the time.

Mixed Irritable Bowel Syndrome (IBS-M) - (The most common I see in practice.) You will have hard or lumpy stools at least 25 percent of the time and loose or watery stools at least 25 percent of the time.

Unsubtyped Irritable Bowel Syndrome (IBS-U) - You will have hard or lumpy stools less than 25 percent of the time and loose or watery stools less than 25 percent of the time.

Each of these types and sub-types has slightly different definitions but ultimately in my experience, the same causes, which include dehydration, lack of quality fiber from vegetables (not grains), increased sugar and lack of proper digestive physiology.

These all can lead to dysfunction of the ileocecal valve which helps control the flow of chyme from the small intestine into the large intestine. So what causes IBS?  

Well, there are many things, let's start with the most familiar, dehydration. If you do not consume enough high-quality water then, your large intestine will pull every bit of the water out of the stool, thus making your bowel movements hard, lumpy and constipated.  The key is to drink at least 2/3 of your body weight in water.

The next key to controlling Irritable Bowel Syndrome is to make sure that you are consuming fiber, not from grain source. In the next post, we will talk about why grains are making your IBS worse but for now, just trust me that grains are not all they are cracked up to be by the modern dietary establishment.  I hate to keep you all waiting, but we will also talk about how increased sugar and grain consumption destroys healthy GI physiology, decreasing stomach acid and unbalancing your Ileocecal valve leading to a whole myriad of symptoms.