IBS-D is irritable bowel syndrome with diarrhea. The symptoms most bothersome with IBS-D include sudden urges of bowel movements, abdominal pain or discomfort. Intestinal gas, nausea, loose stools, frequent stools and the feeling of being unable to completely empty the bowels are some of the other symptoms. IBS-C is irritable bowel syndrome with constipation.
Do note that IBS is not the same as inflammatory bowel disease IBD , a more serious condition that causes inflammation in the digestive tract and can result in severe complications. As there are no structural problems in the intestines of people who have IBS, and tests such as stool tests, or endoscopic procedures such as colonoscopy are usually normal, it can be frustrating for IBS sufferers.
The pain, discomfort and bloating sensations can have a significant impact and be really disruptive to daily routine and lifestyle. Thus, the different causes should be addressed to help relieve such symptoms and psychological impact. The exact cause of IBS is unknown. Health experts believe that a disruption in communication between the brain and the intestinal tract is one cause of the symptoms IBS can affect people of all ages, but it's more likely for people in their teens through their 40s.
It occurs more often in women than in men. Although there is currently no known cure for IBS, the symptoms can often be managed by the change in diet and lifestyle and understanding the nature of the condition. In some cases, medication or psychological treatments may also be helpful. Here are a few ways:. Probiotics are dietary supplements that can help improve digestive health.
They contain "good bacteria" that can help restore the natural balance of gut bacteria when it has been disrupted. Some people take probiotics regularly to help them relieve the symptoms of IBS. To try a probiotic product, follow the manufacturer's recommendations on dosage. Meta Align is a gluten-free probiotic daily supplement with a unique patented strain.
Avoid heavy meals or high fat foods that over-stimulate the gut. Have your daily breakfast, as this is the meal that is most likely to stimulate the colon and give you a bowel movement. Medications - Medical treatment includes anti-spasmodic medicines, anti-diarrheal medicines, anti-depressants, laxatives and other drugs.
Patients with IBS are usually diagnosed at a young age, and IBS is more common in women than in men 3 — 6 , 8 , 9 , 11 , 12 , 14 , 15 , 18 , Although IBS is not associated with increased mortality, it considerably reduces the quality of life 1 , 19 — 21 and is an economic burden to society Dietary fiber includes non-digestible carbohydrates and the complex polymer, lignin, which are present in plants and have physiological effects in humans Dietary fiber has long been used in the treatment of several gastrointestinal conditions 24 — It is widely believed that IBS is caused primarily by a deficient intake of dietary fiber Increasing the dietary fiber intake has been the standard recommendation for patients with IBS 1.
However, a systematic meta-analysis based on 12 small studies showed that increased dietary fiber consumption by patients with IBS did not improve IBS symptoms compared to placebo or a low-fiber diet Other studies have shown that while consuming water-insoluble fiber does not improve IBS symptoms, consuming soluble fiber improves overall IBS symptoms 40 , Subsequent studies have shone new light on fiber supplementation as a treatment for IBS.
Several comprehensive reviews have been published recently on the role of dietary fibers in IBS 42 — The present review aimed to discuss the efficacy of fiber supplementation in the treatment of IBS, the type of dietary fiber that should be recommended, and the mechanisms underlying the effects of dietary fiber, particularly those concerning the interaction between fibers, microbiota, the immune system and the neuroendocrine regulatory system of the gut.
Different types of dietary fiber are characterized by marked differences in physical and chemical structure, with the health benefits of dietary fiber being specific to each fiber type Dietary fiber can be divided into soluble types i. Soluble dietary fiber can be subdivided into viscous gel forming and non-viscous 23 , Dietary fiber can be divided further into short-chain and long-chain carbohydrates, and fermentable or non-fermentable types 49 — Fermentable oligosaccharides, disaccharides, monosaccharides and polyols FODMAPs are closely associated with the focus of this review, and are to be considered to be the short-chain carbohydrate, soluble, and highly fermentable type of dietary fiber.
Short-chain, soluble and highly fermentable dietary fiber e. On the other hand, long-chain, intermediate viscous, soluble and moderately fermentable dietary fiber e. Soluble dietary fiber is fermented by bacteria in the large intestine, which increases the stool bulk by increasing the biomass by fermentation byproducts, such as gas and short-chain fatty acids 61 , The oro-anal transit time and sensation are affected by these changes and probably also through other effects on microbiota, immune cells, intestinal endocrine cell, enteric nervous system and permeability 64 — 75 Fig.
Soluble viscous dietary fiber e. Likely mechanisms through which dietary fiber affects the functions of the gastrointestinal tract. Dietary fiber acts as a prebiotic to intestinal microbiota that causes changes in their composition and induces the growth of beneficial bacteria. The intestinal microbiota in turn causes the fermentation of the dietary fiber, producing gas, short-chain fatty acids, and other byproducts. The gas production increases the fecal mass and increases the luminal pressure.
These mechanisms together with lowering of the luminal pH stimulate the secretion of serotonin from the EC-cell. Serotonin plays an important role in visceral sensitivity. Short-chain fatty acids act also on immune cells and thereby reduce inflammation. There is an increasing body of evidence to indicate that dietary fiber acts as a prebiotic that influences the composition of the intestinal microbiota 80 — 88 Fig. Furthermore, the fermentation of dietary fiber byproducts, such as short-chain fatty acids acetate, propionate and butyrate and the decrease in luminal colonic pH promote the growth of beneficial bacteria, such as lactobacilli and bifidobacteria 80 — Butyrate is one of the short-chain fatty acids that are produced by the fermentation of dietary fiber 23 , The NES of the gastrointestinal tract comprises gastrointestinal endocrine cells and the enteric nervous system Fig.
Various different types of endocrine cells are scattered between the epithelial cells of the mucosa 1 , 92 — The distribution, functions and modes of action of the most important gastrointestinal endocrine cells have been described in detail elsewhere 95 , , The enteric nervous system comprises two plexi: the submucosal plexus and myenteric plexus.
The NES regulates several functions of the gastrointestinal tract, including sensation, motility, secretion, absorption, local immune defense and food intake 22 , 92 , 93 , 95 , The components of the NES interact and integrate with each other, the autonomic nervous system, and the afferent and efferent nerve fibers of the central nervous system 22 , 95 , , Changes in the luminal intestinal pH and pressure can stimulate the release of the hormone serotonin, which is known to play a pivotal role in visceral sensitivity The short-chain fatty acids produced by the fermentation of dietary fiber appear to affect several intestinal hormones, such as peptide YY PYY and glucagon-like peptide-1 — PYY is known to stimulate the absorption of water and electrolytes, and regulate the 'ileal brake' — Furthermore, PYY inhibits prostaglandin E2 and vasoactive intestinal polypeptide, which stimulate intestinal fluid secretion — This can explain the effect of dietary fiber on gastrointestinal transit and secretion.
It has recently been reported that changing from a typical Norwegian diet to a FODMAP-reduced diet is accompanied by changes in densities of the gastrointestinal endocrine cells in patients with IBS — Since FODMAPs by definition constitute dietary fiber, these observations show that changing the dietary fiber intake is associated with changes in the gastrointestinal endocrine cells. Short-chain fatty acids, particularly butyrate, produced by the fermentation of dietary fiber have been found to affect neurons of the enteric nervous system , Whether this is a direct effect on the enteric nervous system or involves indirect effects on the gastrointestinal endocrine cells remains to be determined.
Physicians particularly those in the primary care system usually recommend patients with IBS to increase their intake of dietary fiber to 20—35 g daily in order to regulate the stools and reduce abdominal pain and meteorism — Supplementation with long-chain, intermediate viscous, soluble and moderately fermentable dietary fiber such as psyllium improves the global symptoms of IBS 26 , — A recent meta-analysis that evaluated dietary fiber supplementation in 14 randomized controlled trials involving patients with IBS found that fiber supplementation especially with psyllium was effective in improving global IBS symptoms compared to placebo Recommending fiber supplementation to patients with IBS is also inexpensive while having documented effects on IBS symptoms and other health benefits 23 , , Dietary fiber affects the bowel habits through increasing the stool bulk with mechanical stimulation of the colonic mucosa.
The fermentation of dietary fiber by intestinal microbiota lowers the luminal pH and has several byproducts, such as gas and short-chain fatty acids. The gas increases the luminal pressure while short-chain fatty acids, particularly butyrate, affect the NES and consequently affect gastrointestinal secretion and motility.
Dietary fiber has additional health benefits such as lowering the blood cholesterol level, improving glycemic control, and body weight management 23 , 54 , The different types of dietary fiber exhibit marked differences in physical and chemical properties, and not all types of fiber are beneficial for patients with IBS.
A general recommendation to increase fiber intake in this group of patients would be inappropriate since it could worsen the symptoms Long-chain, intermediate viscous, soluble, and moderately fermentable dietary fiber e. The studies conducted by the authors and cited in this review were supported by grants from Helse-Vest, Norway grant no.
National Center for Biotechnology Information , U. Int J Mol Med. Published online Jul Author information Article notes Copyright and License information Disclaimer.
Received Mar 12; Accepted Jun 9. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License , which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
This article has been cited by other articles in PMC. Abstract Irritable bowel syndrome IBS is a common chronic gastrointestinal disorder. Keywords: microbiota, enteric nervous system, fermentation, immune system, intestinal endocrine cells, laxation, meteorism, psyllium.
Types and characteristics of dietary fiber Different types of dietary fiber are characterized by marked differences in physical and chemical structure, with the health benefits of dietary fiber being specific to each fiber type Open in a separate window. Figure 1. Interaction of dietary fiber with microbiota and the immune system There is an increasing body of evidence to indicate that dietary fiber acts as a prebiotic that influences the composition of the intestinal microbiota 80 — 88 Fig.
Interaction between dietary fiber and the neuroendocrine system NES of the gastrointestinal tract The NES of the gastrointestinal tract comprises gastrointestinal endocrine cells and the enteric nervous system Fig. Fiber supplementation in the treatment of IBS Physicians particularly those in the primary care system usually recommend patients with IBS to increase their intake of dietary fiber to 20—35 g daily in order to regulate the stools and reduce abdominal pain and meteorism — Conclusion Dietary fiber affects the bowel habits through increasing the stool bulk with mechanical stimulation of the colonic mucosa.
Acknowledgments The studies conducted by the authors and cited in this review were supported by grants from Helse-Vest, Norway grant no. References 1. Nova Science Publishers Inc. Thompson WG. A world view of IBS. Irritable bowel syndrome.
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Impact of irritable bowel syndrome on quality of life. Things you buy through our links may earn us a commission. Irritable bowel syndrome, or IBS, is a tricky condition. For starters, symptoms vary between each patient and can even shift over time. Johanna Iturrino-Moreda , a gastroenterologist at Beth Israel Deaconess Medical Center — typically presents with constipation or diarrhea or, in some cases, both, as well as bloating, gas, and abdominal pain.
Lawrence Brandt , a gastroenterologist at the Montefiore Medical Center. Four out of five gastroenterologists we spoke with recommend taking peppermint oil as a way to reduce abdominal pain, bloating, and gas. IBGard slowly releases peppermint oil into the digestive tract, relaxing the bowel and relieving any discomfort you may be experiencing. And unlike Gas-X, it can be taken either as a source of relief or as an everyday preventative medication, before you experience any gassiness.
But ask your doctor which might work best for you. Brandt also recommends Iberogast, which has a mixture of different plants — including peppermint and chamomile — that help relieve abdominal discomfort. If you have a spasm, it will relax it, similar to how plain peppermint oil works within the digestive tract.
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