The ABCDs of IBS (Irritable Bowel Syndrome)

IBS stands for Irritable Bowel Syndrome. The main symptoms associated with IBS are called ABCDs: Abdominal pain, Bloating, Constipation, and/or Diarrhea. These symptoms can be present all the time or they may come and go. IBS is diagnosed when other reasons of digestive disturbances like structural issues are ruled out and there’s no other explanation of why you’re having the symptoms you’re having. That being said, IBS is associated with other digestive dysfunction like heartburn and gut infections as well as other health concerns like mental health disorders. IBS, like most other chronic issues, is a multifactorial syndrome with genetics, epigenetics, diet, lifestyle, mental health, and other factors playing a role in its development and progression. 

IBS is extremely common globally and affects 13-20% of Canadians. Most people learn to live with it, with ~40% of people seeking out help. These stats are from the Canadian Society of Intestinal Research (https://badgut.org/), which has some great info and resources on its website. There is a higher prevalence in women over men and it really impacts their quality of life – from avoiding food for long periods of time to being afraid of going out in fear of not having access to a bathroom and so much more. 



young woman in bed clutching her abdomen
a white cup and saucer with an orange coloured tea and mint leaves on the side

Everyone’s underlying causes of IBS and treatment plan can look different. Some of the things I see in my practice when it comes to the onset and persistence of digestive disturbances include: 

  • Antibiotic treatment, especially if it was prolonged or aggressive treatment
  • Periods of extremely high stress
  • Parasitic infections or travel where digestion was off
  • Small intestinal bacterial overgrowth
  • With certain classes of medications
  • Post-concussion and post-trauma
  • Food sensitivities: these can vary greatly – from eggs and dairy to gluten and beans

WHAT ARE THE CHANGES AND PROCESSES THAT CAN BE INVOVLED?

  • Gut microbiome 
  • The immune response 
  • Hypersensitivity
  • Bile acid production
  • Inflammation
  • Gut lining changes
  • Nervous system signalling
  • Gut motility changes

WHAT TREATMENT OPTIONS ARE THERE?

Well, this really depends on what your IBS presents as, what else is happening in your body, what was happening when everything started, and what your testing results show. 

Some of the things that can be helpful to resolve IBS and/or help ease IBS include: 

  • Trial of a low FODMAP or elimination diet — these types of diets should be transient and shouldn’t be something you’re on for life
  • Other dietary changes 
  • Adding in fibre
  • Certain probiotics
  • Medications for your certain situation – could be anti-diarrheals, laxatives, antibiotics, or something else
  • Antimicrobial herbs and supplements
  • Exercise
  • Stress management, rest, recovery, sleep support
  • Mental health support 
  • Hormone support especially if your IBS-type symptoms are cyclical 
  • Structural/musculoskeletal support
  • Nervous system herbs and supplements
  • Vagus nerve stimulation
  • Addressing other parts of your health that need support

Like with most chronic conditions, IBS has no one-size-fits-all treatment especially since the presentation varies so significantly. Working with your healthcare team is helpful here and working on different areas of your health can be very important.