When it comes to managing our health, many of us are guilty of reading too deeply into every pain, pinch and discomfort, but what if that nagging symptom is actually a sign of something more serious?
The usual signs of Irritable Bowel Syndrome (IBS) can be masked as pretty common symptoms, such as bloating, cramping, diarrhea or constipation, but the main indicator is often a change in bowel movement frequency or form of the stool—and also whether you’re experiencing these symptoms simultaneously.
Living with digestive discomfort can range from frustrating to debilitating. We spoke with Dr. Premysl Bercik, a gastroenterologist and professor of medicine at McMaster University in Hamilton, Ont., to learn more about the common warning signs of IBS, and how to spot them early on.
“The hallmark symptom of IBS is chronic abdominal pain,” says Dr. Bercik, adding that chronic doesn’t necessarily mean constant. You could be suffering for weeks, and then experience a lull for a week or two before it returns again. You might experience pain anywhere from your belly to your lower midsection, since the large intestine snakes around your abdomen. What might the pain feel like? According to the International Foundation for Functional Gastrointestinal Disorders, it can range from cramping and stabbing to aching and throbbing.
A change in bowel habits
Dr. Bercik notes there is quite a range in what’s considered “normal” when it comes to bowel movements: ranging from three per day, to one every three days—it really depends on your personal eating and digestive patterns. When looking out for IBS, it’s vital to notice any changes to your personal pattern; for instance, if you’re accustomed to going once a day and now you’re only going once every three days, that’s worth investigating.
Diarrhea or constipation—or both
There are three types of IBS: IBS-C refers to experiencing constipation, IBS-D refers to diarrhea and IBS-M is a mix of both. It’s common to experience either condition occasionally in your life depending on your diet, but frequent bouts of either or rotating between both conditions on a regular basis is worth investigating.
Frequent gas and bloating
While it’s common for all of us to feel gassy and bloated after eating a meal packed with cruciferous veggies—think broccoli or brussels sprouts—a 2015 study found that people with IBS experience gas and bloating at a higher rate. And according to a review published in the Journal of Neurogastroenterology and Mobility, the severity bloating and gas symptoms can range from mild to severe, and IBS patients note that these symptoms affected their overall quality of life.
“Certain food components are known triggers of IBS,” says Dr. Bercik. While gut irritants vary from person to person, common ones include processed foods, caffeinated drinks, alcohol, dairy products and anything high in fibre or gluten. Why you ask? These ingredients and food types are higher in sugars and carbohydrates which are usually more difficult for your gut microbiome to absorb and digest—resulting in them lingering in your gut and fermenting (cue gas and bloating).
Again, this is subjective because everyone’s body reacts differently. Your long-term diet and lifestyle gradually shape your microbiome—a complex community of microbes and bacteria found in the pocket of your large intestine known as the cecum. It has a pretty vital role as it controls your digestion process, immune system and even your brain health.
Feeling exhausted or suffering from insomnia on its own doesn’t necessarily mean you have IBS, but if you experience it alongside other symptoms, it could be a sign. A 2016 review found that fatigue is quite prevalent among IBS patients; in fact, 54 percent of sufferers experience this symptom. Reasons may include an imbalance in gut bacteria—which can be linked to a lower mood and overall energy level—along with malnourishment, which can occur when sufferers under eat or limit themselves to a restrictive diet in an attempt to keep symptoms at bay.
Anxiety or depression
Scientists frequently refer to the gut as our second brain since our enteric nervous system (ENS) lies within the walls of our digestive system. The ENS relies on the same neurotransmitters as our central nervous system—the brain and spinal cord—and the two systems essentially talk to one another.
“Irritable Bowel Syndrome is a disorder of the gut-brain communication,” says Dr. Bercik. “Changes in the gut can trigger anxiety or depression, but also on the contrary, if you are experiencing more stress, it can worsen symptoms of IBS.”
That’s why your anxiety might be triggered when you experience a gut-related imbalance and vice versa. Research hasn’t reached a consensus on what comes first, but it’s clear the two are frequently experienced hand-in-hand, in fact, 40 to 60 percent of IBS sufferers also experience these psychological symptoms.