What you need to know about irritable bowel syndrome
Irritable bowel syndrome (IBS) is a common chronic bowel disease. It is estimated that about 10 to 15 percent of the Dutch population suffers from it. A lot is already known about the disease, but some pieces of the puzzle are still missing. There are also quite a few myths going around. What is fact and what is fable?
IBS is all between your ears
fable. The exact cause of irritable bowel syndrome is not yet known. It is clear, however, that stress is a strongly influencing factor and can sometimes be a trigger to develop IBS. In essence, IBS is a disorder of the connection between the gut and the brain. The symptoms are not the same in all patients. One patient suffers from constipation, the other from diarrhoea. And yet another patient will mainly suffer from a disturbed microbiome, while another patient will mainly have stress-triggered complaints. To be able to treat IBS properly, all factors must be considered.
If you suffer from constipation due to irritable bowel syndrome, it is better not to eat fiber
fable. There is no average IBS patient and so there is no treatment that will work for everyone. There are many possible lifestyle changes that can help you along the way, by adapting to what you eat, your physical activity and condition, and becoming a more relaxed person. Everyone needs fiber for healthy bowel movements. These are indispensable for your intestines. Do you suffer from an irritable bowel? Then determine together with a specialized IBS dietitian how much fiber your gut can handle and which food is right for you.
It is better not to take laxatives with IBS, because they can make your intestines lazy
fable. If fiber isn’t enough to soften hard stools, you can try laxatives. Many people are afraid to use laxatives for a long time because it would lead to so-called ‘lazy bowels’. That’s definitely a myth, softening stool consistency doesn’t affect the enthusiasm with which your gut does its job! On the contrary, if the composition is softer, the intestinal motor itself will run more smoothly. Most laxatives are safe and generally have few side effects.
In the majority of patients with IBS, complaints are triggered by certain foods
Fact. Your diet is extremely important for the course of irritable bowel syndrome. Eating can cause or aggravate complaints, on the one hand due to the stimulating effect that filling the stomach has on the rest of the digestive system, on the other hand, the various components of the diet will also determine how the intestinal contents are composed. The more difficult-to-digest nutrients, the more they can have an effect on the microbiome. General dietary adjustments can therefore reduce the complaints, for example: sufficient fiber, not too much fat, limiting coffee and alcohol. The most successful nutritional therapy currently used in the treatment of IBS is the so-called FODMAP diet.
Painkillers are better avoided with IBS
Not a fact, but not a myth either. Preferably, the choice is made to treat IBS with antispasmodics and antidepressants. They are not perfect (no medication is), but a decent efficiency and an acceptable range of side effects make them the first choice for IBS. In any case, they are preferable to other, more classic painkillers such as NSAIDs or morphine-like products, which may have a short-term analgesic effect, but which have a number of unpleasant side effects that mainly torment the gastrointestinal system. A paracetamol every now and then won’t hurt, but NSAIDs such as ibuprofen and diclofenac or morphine-like products such as tramadol or oxycodone are best avoided.
Hypnotherapy can reduce IBS complaints. Fact or fable?
Fact. Scientific research has shown that hypnotherapy can reduce IBS complaints. Medical hypnotherapy can induce a state of relaxation that suppresses your pain signals. Look for a well-trained therapist who also understands what a functional bowel disease entails. On the website of the Dutch Professional Association of Hypnotherapists – www.hypnotherapie.nl – you can search for a specialized therapist in your area.
This article was produced in collaboration with Prof. Dr. Heiko de Schepper. He works in the Gastrointestinal Diseases department of the Antwerp University Hospital and is coordinator of the motility unit and the Klein Pelvic Clinic. He also conducts research into irritable bowel syndrome at the University of Antwerp, where he also teaches at the Faculty of Medicine. His book Irritable bowels was recently published (Pelckmans publishing house, € 22.50).
