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Irritable Bowel Syndrome (IBS): Better managing a silent burden

IBS management

April is IBS Awareness Month. Irritable Bowel Syndrome (IBS) is the most common gastrointestinal disorder world-wide. In Canada it affects up to 20 per cent of people, twice the incidence of diabetes and kidney disease. St. Paul’s Hospital Registered Dietitian Dani Renouf explains what it is all about and shares her own experience with it.

Unlike diabetes and kidney disease, which can be diagnosed through a blood test, IBS shows up in different ways in individuals, so only 40 per cent of those with symptoms will seek medical attention. IBS is truly a silent burden, where people live in shame and embarrassment about their symptoms, and instead, lose productivity ($8 billion dollar loss estimated per annum in Canada), motivation, and the desire to socialize.

Ruling out other conditions to establish a diagnosis

Some common symptoms of IBS include abdominal bloating, constipation, and diarrhea. Onset can be sudden, often triggered by stress, food choices, and other controllable lifestyle factors. IBS is not the same as inflammatory bowel diseases (like Crohn’s Disease or Colitis) or Celiac Disease (gluten allergy); however these may need to be ruled out if someone is experiencing any severe gastrointestinal symptoms.

IBS, IBS management, IBS awareness month, dietician
Dani Renouf

The first time I experienced IBS, I was a child and was preparing for a math test. I remember my teacher saying that I was making excuses for missing the test. He was not the first – every time I complained of symptoms that required missing tests, school or activities, nobody believed me (except my family). Later on, when I was diagnosed with IBS, I realized how little is known about it and its impacts on overall health and quality of life. This is why, in part, people do not seek help – sometimes their symptoms are not taken seriously. We also now know the importance of stress management on treatment of IBS, so it makes sense now why I was having these symptoms around exam time!

The importance of good food choices in IBS management

I truly believe “we are what we eat”. I made some poor food choices in the past that made my symptoms worse, and this could be why I chose the profession of dietetics. By changing the way we eat and manage our stress, we can significantly improve the burden of IBS.

Some research-based approaches from the American Society of Gastroenterology Guidelines to manage IBS include:

  1. A low FODMAP diet (fermentable oligo- di-and monosaccharides and polyols) which are short-chain carbohydrates found in certain foods. If you are planning to take on such a diet, it is suggested that you work with a registered dietitian to ensure that you are meeting your nutrition needs, and accessing correct and trusted nutrition information.
  2. Management of constipation through dietary therapy and medications upon consultation with a physician to effectively treat constipation and prevent chronic constipation.
  3. Psychotherapy with a registered professional to help address underlying stress associated with the exacerbation of IBS symptoms.

When someone finds relief from IBS symptoms, they truly can see improvements in their overall quality of life, and therefore, supporting people to seek the health care attention they need in a timely way can help manage this silent burden.