How to Diagnose and Treat Irritable Bowel Syndrome (IBS) video/podcast

Irritable bowel syndrome is a chronic condition that affects how the gut functions. It’s often characterized by abdominal pain that occurs at least once a week for several months, along with changes in the form or frequency of your bowel habits.

IBS is quite common; it’s estimated that approximately 12% of the U.S. population has this condition. It can affect anyone at any age, although it is more often diagnosed in females and people under the age of 50.

“Some data suggests that the incidence of IBS may be on the rise, and that may be due to improvements in our diagnosis of the condition, but also potentially due to changing lifestyle and environmental factors,” says Dr. Maruggi. “IBS is a very complex condition. Anything that disrupts the gut-brain connection can increase the risk.”

Factors may include chronic stress, anxiety, depression, fibromyalgia and even prior trauma as far back as childhood can increase IBS risk. Disruptions in the gut microbiome may also trigger the condition, so gastrointestinal (GI) infections and antibiotics may be potential risk factors.

There also appears to be a genetic link. Recent research has shown that children whose parents have had IBS are more likely to develop it; ongoing studies are trying to shed more light on the genetic factors that can raise the risk.

In most cases, IBS is diagnosed based on the patient’s reported symptoms. IBS symptoms can be similar to other conditions, including celiac disease and colon cancer, so it’s important to talk to your doctor any time you experience gastrointestinal problems ― particularly if they last several weeks to months.

“Any time you’re concerned, we’re concerned. Especially if you’re having abdominal pain that’s happening once a week for several months and you’re noticing a change in the stool characterization or frequency, you should go in to speak to your gastroenterologist or primary care doctor,” says Dr. Maruggi.

In addition, the doctor may order blood tests to rule out other conditions and make the diagnosis of IBS. They also may use the ROME IV criteria, a standardized set of guidelines, to diagnose subtypes of irritable bowel syndrome, such as IBS constipation, diarrhea or even mixed.

IBS treatment depends on each patient’s case and can include dietary changes, lifestyle changes and medications.

Often, having patients try a FODMAP diet is the first step in treatment. FODMAP stands for fermentable, oligosaccharides, disaccharides, monosaccharides and polyols. These are food groups that are poorly absorbed in the gut and can lead to abdominal bloating and pain, as well as bowel changes.

Common high FODMAP foods include wheat, onions, garlic, milk and artificial sweeteners. Studies have shown that patients who follow a low FODMAP diet have a significant reduction in their IBS symptoms, but it can be challenging.

“I always warn patients that the FODMAP diet is really quite restrictive, so the goal is not to have patients follow a low FODMAP diet forever,” explains Dr. Maruggi. “Rather, it’s to identify which high FODMAP groups cause the symptoms and then try to avoid these in a maintenance phase of the diet.”

Dr. Maruggi adds that IBS can be a chronic condition and the goal of treatment is to manage symptoms so patients can go on to live a normal life.

“At different points in someone’s life, treatment may need to be adjusted or tailored, but that’s why it’s so important to have this therapeutic relationship with your physician, so that we can adjust your therapy based on how you are feeling at that time.”

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