I’m back today continuing our conversation on Irritable Bowel Syndrome or IBS. As I mentioned last week, the exact cause of IBS is not fully understood.
Nonetheless, several theories exist and are currently being investigated. In many cases, it is less likely one specific cause and instead, multiple influences combined.
Here are some current thoughts on what might trigger IBS and its constellation of symptoms.
One of the leading theories begins with an insult to the gastrointestinal (GI) environment leading to a disruption of the dynamic and complex GI ecosystem. This includes an alteration in the delicate balance of bacteria living in our GI tract referred to as our “microbiome”. A vicious cycle of chronic inflammation ensues leading to increased intestinal permeability (“leaky gut”) and more inflammation (an even leakier gut). Some of the most common insults to the integrity of the gut lining include:
· GI infections – viral or bacterial
· Medications – such as antibiotics, steroids, anti-inflammatories like Ibuprofen or Naproxen and acid-reducing medications to name a few
· Psychosocial Stressors – The role of stress in IBS relates to something referred to as the Gut-Brain connection or the enteric nervous system. Some even call it the “second brain”! When we are confronted with stress our GI tract may respond with symptoms common to IBS such as cramping, bloating, + changes in motility leading to diarrhea or constipation. Think about some of the common sayings such as “I have butterflies in my stomach” or “I have a gut feeling”. These and many other metaphors are rooted in the strong biologic connection between our GI system and brain.
Although yet to be proven, some also believe that genetics play a role in the development of IBS.
No matter the underlying cause, the symptoms appear to result from disturbances in colonic motility (muscle contractions) and increased sensitivity to food, gas, or stool in the bowel. These symptoms, once present, can be further exacerbated by various factors such as certain foods, stress, and even changes in reproductive hormones during the menstrual cycle.
Stop back next week, where I’ll be diving into the recommended evaluations and testing involved in making an accurate diagnosis of IBS!