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SOME ADDITIONAL REFERENCES

 

Irritable bowel syndrome: Simple lifestyle and dietary modifications can be helpful

Irritable bowel syndrome (IBS) is a group of symptoms that include abdominal pain, bloating or discomfort, and changes in the frequency or consistency of bowel movements (Diarrhea or Constipation). This is a chronic disorder and causes significant morbidity and a decrease in the quality of life in affected patients. The current prevalence of IBS is around 4% in community studies, although it remains an under-reported disease.

Depending upon the predominant symptom (constipation or diarrhea), the IBS is further divided into IBS-C (Constipation), IBS-D(Diarrhea), or IBS-M(Mixed).

What are the symptoms of IBS?

IBS is a chronic disorder and causes significant morbidity and a decrease in the quality of life in affected patients. The current prevalence of this disease is around 4% in community studies, although it remains an under-reported disease.

As discussed above, the person with IBS has long-standing abdominal pain, bloating, cramps or discomfort, bloating, diarrhea, and/or constipation.

Generally, constipation is when the frequency of stool is less than three times a week, straining while passing motions or hard stools which are difficult to pass. The abdominal pain, discomfort, or bloating gets relieved after passing motions, but occasionally it can increase in severity. The abdominal pain may be on an intermittent or daily basis and may be mild or occasionally severe in intensity, such that the person may require hospitalization.

Due to long-standing constipation and straining, hemorrhoids (piles) can develop, causing bleeding while passing motions. Some patients also complain of mucous in the stools. There are additional non-abdominal symptoms such as decreased sleep, fatigue, headache, backache, palpitations, etc. If there are alarming symptoms such as weight loss, blood in stools or black-colored motions, fever, decreased appetite, difficulty in swallowing, etc. they need urgent attention and further evaluation as there might be a more sinister illness within.

What causes IBS?

IBS is a functional gastrointestinal disorder. The exact cause is unknown. Some theories involve Brain-Gut interactions, alterations in the GUT bacteria, or hypersensitive intestines with altered motility. A decrease in the motility of the intestine leads to an increase in the colonic transit time thus leading to constipation.

What are the factors precipitating IBS?

Sustained psychologic stress, depression, anxiety disorders, GI Infection, smoking, alcohol intake, and gluten ingestion, are some factors associated with IBS.

How is IBS diagnosed?

IBS is a functional disorder, thus there is no structural abnormality in the gastrointestinal tract. Some diseases that have similar symptoms can be mistaken for IBS are Ulcerative Colitis, Crohn’s Disease, Colon Cancer, Celiac disease, Microscopic Colitis, Chronic Pancreatitis, Intestinal Tuberculosis, etc. If any of these diseases are missed, they can have disastrous consequences. By doing appropriate tests such as Gastroscopy, Colonoscopy, and appropriate blood and stool tests, these conditions can be safely ruled out and the patient can be termed as having IBS. Hence there is no straightforward diagnosis of IBS and is a diagnosis when other similar illnesses are ruled out (diagnosis of exclusion).

What is the treatment of IBS?

The medications differ in both forms of IBS (IBS-C and IBS-D), but some general principles apply to both these types.

1. Patient Education – It is important first to educate patients that the nature of their illness is real although the tests are normal. At the same time, they need to be reassured that this is not something that leads to cancer or a bigger illness. This helps in reducing the anxiety and fear regarding their illness.

2. Diet and Lifestyle – A high-fiber diet helps in decreasing symptoms of IBS. Foods containing high fiber, or adding a small quantity of Ispaghula husk daily, helps in relieving constipation in the majority.

3. Exercise – Exercise has been shown to improve symptoms of IBS. It improves GI motility and has long-lasting positive effects.

4. Meditation – Meditation techniques help in relaxing stress and balancing thoughts, thus helping in managing the GUT-Brain aspect of IBS.

Concluding, IBS is a common but under-reported condition. It is a lifelong illness but doesn’t cause any long-term complications. At the same time similarly presenting illnesses need to be ruled out by getting appropriate tests done. Any alarming symptoms should not be ignored and one should visit the Gastroenterologist for further evaluation. Simple lifestyle and dietary modifications can be effective in the relief of the symptoms of IBS.

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Why am I bloated? Here are some possibilities to consider

If your tummy seems to feel full or stretched and is rumbling all the time, you’re not alone. Up to 30 per cent of people of all ages experience bloating, with symptoms such as gassiness, a sense of fullness and pressure.

This can be with or without distention (a visible increase in abdominal girth).

So what might be behind your bloating?

The role of gas

Bloating is in fact a complex condition that can be caused by several direct and indirect factors. Gas often plays a role.

Gas production in the digestive system is part of the normal digestion process, and is released through the mouth (burps) or anus (farts).

On average, our gas expulsion is around 600–700 millilitres per day, resulting in around 14 farts a day. That said, there isn’t a set number for the normal amount of gas or expulsions; each body is different.

Bloating can occur as a result of retained gas, excess gas production, altered gas transit (changes in the speed and movement of gas), or intestinal hypersensitivity.

An imbalanced gut microbiome can lead to the overproduction of gas.

We have more than 40 trillion microbes living in and on our body. They can be helpful or harmful. The balance between these helpful and harmful microbes plays an important role in our immune response, metabolism and health.

These bacteria need food to survive. Their food comes from fermenting carbohydrates such as dietary fibre from the plants we eat.

One of the by-products of this fermentation process is hydrogen gas.

Most of these microbes live in the lower parts of our intestine (colon). The upper parts of the intestine (small intestine) have far fewer microbes.

But if an excessive number of microbes colonise the small intestine (a condition known as small intestine bacterial overgrowth), more gas is produced in the small intestine.

This can lead to bloating, abdominal discomfort, diarrhoea and nausea.

Could it be IBS, lactose issues or FODMAPs?

Some disorders of the intestine and colon can affect the amount of gas and severity of bloating symptoms.

For example, in constipation, movement of stools is reduced, allowing more time for the bacteria to ferment the stool content, increasing gas production.

Bloating is also very common in people with irritable bowel syndrome (IBS).

Changes in gut muscle tone and greater sensitivity to gas contribute to bloating in IBS sufferers.

Bloating may also occur because of poor digestion and malabsorption of some carbohydrates.

Lactose malabsorption (in those with lactose intolerance) is a common issue.

Symptoms may also occur with other digestive resistant short-chain carbohydrates known as FODMAPs (fermentable oligo-, di-, monosaccharides and polyols).

FODMAPs are found in a wide variety of foods, including certain fruit and vegetables, grains and cereals, nuts, legumes, lentils and dairy foods.

While these are good foods for our gut bacteria, they can add to gas production and trigger bloating symptoms, especially in people with digestive disorders (like IBS). They can also cause water to be drawn into the intestines, causing distension. This can contribute to bloating.

Other factors: salt, hormones or swallowing air

There are of course other factors that could be behind bloating.

For example, consuming too much sodium or salt in your diet causes water retention, resulting in abdominal distention. But this may also alter the gut microbiome and influence gas production.

For many women, bloating can be linked to the menstrual cycle phase. This is most common at the onset of bleeding, when peak fluid retention occurs, but is also related to underlying hormonal changes.

Swallowing too much air, especially when eating, can also increase the amount of gas entering the gastrointestinal tract and lead to bloating.

Talking while eating, eating in a rush, and carbonated beverages can also increase the amount of air swallowed.

How can I reduce bloating?

Dietary strategies can be effective ways of managing bloating. While foods that trigger symptoms can be different for everyone, you could try to:

• eat fewer gas-producing FODMAP foods such as onion, cabbage, brussels sprouts, cauliflower, dried beans and lentils
• eat fewer foods containing lactose, like milk, ice-cream and some yoghurts (there are lactose-free alternatives for people with intolerance)
• replace carbonated drinks such as soft-drinks with water, and drink less alcohol
• consume more probiotics (such as yoghurt or certain fermented foods)
• do more exercise, as mild physical activity enhances intestinal gas clearance and can reduce symptoms of abdominal bloating
• eat and drink more slowly; taking your time means you can enjoy your food, but will also help you swallow less air.
• See an accredited practising dietitian for personalised advice on managing symptoms using dietary strategies.

When to see a GP

Most of the time, bloating goes away soon enough and is no cause for concern. But consider seeing a doctor if:

• your gas is persistent and severe and it’s impacting your quality of life
• your gas is associated with other symptoms such as vomiting, diarrhoea, constipation, unintentional weight loss or blood in the stool.

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THOMAS’ THOUGHTS

Today, we will talk about the Number One danger that comes with Bloating. We think of it as occurring directly in our gut, like we don’t consider its effect elsewhere. However, when you look at the research, you realize that many people are bloated because they have these issues with their gut junctions. Sometimes bloating is just an early warning sign for more significant problems below, such as disrupted gut lining and broken collagen caused by IBS or other conditions related to poor digestion. When this happens over time, it can lead to serious health concerns, including severe weight gain and even death!

There is a real danger associated with excessive bloating – the problem isn’t just that it causes discomfort. Still, those tiny particles can leak into our bloodstream and cause an inflammatory response elsewhere. We can avoid this situation if we’re aware of what we’re eating. For example, if you notice your gut is inflamed frequently or your joints are hurting more than usual after consuming certain foods, there’s likely a connection between what you ate and how you feel. Inflammation often occurs as part of the natural healing process; however, when it gets out of control, it becomes problematic. We have those days where everything hurts simply because we overate sugar or junk food earlier in the day – at least now we know why!
The three main ways to improve gut health are consuming collagen, having a diverse microbiome, and eating foods you’re not used too. After following these protocols for eight weeks, 93% of participants reported reductions in bloating and IBS symptoms. So if you want to address gut health head-on, start with the Three P’s: Proline (collagen), Glycine (a protein), and Diversity Foods (something new).

If a person only eats meat, they may experience bloating after eating a vegetable for the first time. This is because they lack certain gut bacteria that help with digestion. In addition, eliminating various types of food from one’s diet can also lead to problems down the line- such as bloating. To avoid these issues, it is important to gradually introduce new foods into one’s diet and have a diverse ecosystem of microbes present. One product I recommend which helps with this process is called Seed Synbiotic: it is both a prebiotic and probiotic supplement. Using this technology, researchers are paving the way for a better understanding of human microbiome functions.

There are several ways to decrease inflammation in your body, some more practical than others. One way is to reduce sugar intake; another is to restrict caffeine consumption. Finally, you should gradually cut back on food items containing inflammatory substances.

When it comes to fighting inflammation, consuming sugar in high amounts can be as bad as eating saturated fat. Both types of fats can contribute to the problem, so you should avoid them. However, processed sugars and oils like palm oil or coconut oil are still problematic because they contain many refined ingredients that may cause inflammation. In addition to taking care of your diet overall by including more varied proteins and healthy fats sources, ensure you provide enough collagen for gut health and reduce bloating susceptibility through lifestyle choices such as limiting sugar intake.

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The links above are affiliate links, so I receive a small commission every time you use them to purchase a product. The content contained in this video, and its accompanying description, is not intended to replace viewers’ relationships with their own medical practitioner. Always speak with your doctor regarding the content of this channel, and especially before using any products, services, or devices discussed on this channel or website.