What are the most common symptoms of irritable bowel syndrome?

Irritable bowel syndrome can cause various symptoms, which can vary in severity from patient to patient. The most common symptoms include complaints such as abdominal pain, bloating, diarrhoea or constipation, as well as bowel movements with unusual frequency or consistency [1].

A bloated feeling in the abdomen and increased urge to defecate are also possible. Some patients may also suffer from nausea and pain in the intestinal area. There may also be a feeling of incomplete evacuation or alternating between diarrhoea and constipation [1].

In addition, back pain can occur with irritable bowel syndrome. This back pain can have different causes. If the faecal mass presses on the sacral nerve during constipation, this can lead to back pain. In addition, the relieving posture due to abdominal pain can lead to back pain. Back pain can also be caused by the increased tension in the abdominal muscles, as the muscles of the back and abdomen have an influence on each other.

Psychological symptoms such as anxiety and depression are also possible, as there is a connection between irritable bowel syndrome and the patient's stress level [4]. Irritable bowel syndrome can therefore significantly affect the quality of life of those affected and lead to restrictions in daily life.

It is important to note that these symptoms can also occur with other diseases of the gastrointestinal tract. It is therefore important that an accurate diagnosis is made to enable effective treatment of the condition.

Symptoms at a glance:

Diarrhoea
Constipation
Bloating
Stools with unusual frequency and consistency
Stomach and intestinal pain
Back pain
Anxiety and depression

How is irritable bowel syndrome diagnosed?

In addition to a thorough examination of the stomach and intestines, an important role in the diagnosis of irritable bowel syndrome is played by the doctor recording the patient's medical history and symptoms. The patient is asked about the type, frequency, duration and intensity of the symptoms [1]. A dietary history can also be helpful in identifying possible triggers for the symptoms. In some cases, a stool examination can also be carried out to rule out possible inflammatory processes or infections as the cause of the symptoms.

In order to facilitate the diagnosis of irritable bowel syndrome, various diagnostic criteria have been developed, such as the Rome criteria [1]. Certain criteria must be met, such as the presence of abdominal pain and changes in bowel movements over a period of at least six months.

To date, there are no specific tests that can reliably detect irritable bowel syndrome. However, other bowel diseases that can cause similar symptoms are ruled out by laboratory tests, imaging techniques and endoscopy [1].

Crohn's disease is a disease that is symptomatically similar to irritable bowel syndrome, but differs in cause and treatment. Crohn's disease is an inflammatory bowel disease that can cause pain and inflammation throughout the digestive tract, whereas irritable bowel syndrome does not cause inflammation. The underlying mechanisms that lead to the symptoms are also different in both conditions.

What causes can lead to irritable bowel syndrome?

The exact causes of irritable bowel syndrome are not yet fully understood. However, it is assumed that various factors can play a role, including diet, stress, genetic predisposition and a disruption of the intestinal flora [1].

Other factors that can lead to irritable bowel syndrome are impaired intestinal motility or increased sensitivity of the intestinal nerves [1]. Hormonal changes, such as those that occur during menstruation, can also lead to irritable bowel symptoms. Some studies have shown that psychological stress such as anxiety or depression can also increase the risk of irritable bowel syndrome [4].

Although the exact causes of irritable bowel syndrome are not yet fully understood, it is important that sufferers take a holistic view of their symptoms and work with their doctor to find suitable treatment options to alleviate their pain and other symptoms in the best possible way.

How can I adjust my diet if I have irritable bowel syndrome?

It is recommended that nutritional therapy is carried out under the guidance of a dietitian or doctor. A low FODMAP diet is often recommended, which restricts certain carbohydrates that can cause digestive problems in some people [3]. A low FODMAP diet excludes certain food sources such as onions, garlic, wheat, dairy products and some pulses. The diet can be individually adapted to find out which food sources trigger digestive symptoms in a person affected.

However, it is important to ensure that there are no nutritional deficiencies and that sufficient amounts of fibre, protein and other important nutrients are consumed, which can also promote healthy bowel function.

Suitable foods include:

rice
quinoa
gluten-free products
lean meat and fish
suitable fruit and nuts

These foods can then be carefully integrated into the diet while checking whether diarrhoea, constipation, bloating and the like continue to occur. Avoiding caffeine and alcohol can also be helpful, as can sufficient fluid intake.

Which medications can help with irritable bowel syndrome?

There are various medications that can be used to treat irritable bowel syndrome. These include antidiarrhoeals, antidepressants, probiotics, antispasmodics and anti-inflammatories [1]. If necessary, the doctor can also prescribe targeted treatment with antibiotics to treat a possible bacterial overgrowth in the intestine.

In addition, certain herbal preparations, such as peppermint oil or psyllium, can help to alleviate symptoms [2]. Peppermint oil can help with cramps in the gastrointestinal tract and flatulence, while psyllium husks can be useful for both constipation and diarrhoea.

A precise drug therapy should, however, be tailored to the individual patient. It is recommended to always consult a doctor before taking a new medication.

What treatment options are available for irritable bowel syndrome?

A variety of treatment options can be used for irritable bowel syndrome. One option is to adjust the diet. As already described, it can be helpful to try a low-FODMAP diet [2]. Probiotics, prebiotics and synbiotics can also be used [1].

In some cases, medication such as antidiarrhoeals, laxatives or antispasmodics can also be prescribed [3]. Relaxation exercises or psychotherapy are also options that can alleviate irritable bowel symptoms [4].

Alternative therapy methods such as acupuncture or yoga can also help to alleviate irritable bowel symptoms and back pain. Moderate physical activity and sufficient sleep can also have a positive influence on the course of the disease.

However, it is important that the therapy is individually tailored to the patient and that a combination of several therapy options is used if necessary. Regular communication with a doctor, alternative practitioner or therapist is essential in order to monitor the course of therapy and possible changes in symptoms and adjust them if necessary.

Can psychotherapy help with irritable bowel syndrome?

Yes, psychotherapy can help with irritable bowel syndrome. Cognitive behavioural therapy (CBT) is a form of therapy used for irritable bowel syndrome to help patients deal with their condition and the resulting discomfort and pain. One study showed that CBT significantly improved the quality of life and symptoms of irritable bowel syndrome patients [4].

Another form of therapy that can also be helpful is hypnotherapy. Hypnotherapy is often used for patients with severe irritable bowel syndrome symptoms and has shown positive results in several studies.

However, it is important to note that neither form of therapy offers a cure for irritable bowel syndrome, but can only help to alleviate the symptoms and thus achieve an improved quality of life.

How can I avoid stress with irritable bowel syndrome?

Stress can lead to a worsening of symptoms in irritable bowel syndrome patients. It is therefore important to avoid or reduce stress in everyday life. Relaxation exercises, yoga, meditation or autogenic training can be useful here. Reducing your workload or prioritising your tasks can also help to reduce stress levels.

Which foods should I avoid if I have irritable bowel syndrome?

As every irritable bowel syndrome is individual and can react to different foods, there is no universal list of foods that should be avoided if you have irritable bowel syndrome. It can be helpful to keep a food diary and note which foods cause symptoms. One possible strategy is to reduce fermentable carbohydrates [3].

Some of the foods that most often cause symptoms in irritable bowel syndrome patients are:

very fatty meat products
legumes
onions
garlic
wheat and wholemeal products
carbonated drinks
artificial sweeteners
certain fruits such as apples, pears and stone fruit

Are there any home remedies that can help with irritable bowel syndrome?

There are some home remedies that can help with irritable bowel syndrome. These include ginger, camomile and peppermint [3]. These home remedies can have an anti-inflammatory and antispasmodic effect on the stomach and intestines and therefore help to relieve irritable bowel symptoms such as abdominal pain, bloating, constipation or diarrhoea. However, it is important to consult a doctor before using home remedies.

Sources

[1] https://www.dgvs.de/wp-content/uploads/2022/02/ZfG_Leitlinie-LL-Reizdarmsyndrom_08.02.22.pdf
[2] https://www.gesundheitsinformation.de/was-hilft-bei-reizdarm-und-was-nicht.html
[3] https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/treatment
[4] https://journals.lww.com/ajg/Abstract/2019/01000/Effect_of_Antidepressants_and_Psychological.11.aspx

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