Irritable bowel syndrome can be a frustrating diagnosis for both patients and physicians. There is no gold standard test nor treatment protocol within medical practice for IBS, which means medical advice may vary widely based on physician experience and patient history. To complicate the matter anyone who is diagnosed with IBS may have to face living with IBS symptoms for the rest of their lives. And if the symptoms are severe the unpredictable nature of IBS can make day-to-day living difficult.
Despite this difficulty for IBS patients, there is one fact that makes IBS treatment a kind of double-edge sword. Because IBS symptoms alone do not increase risk of bowel disease directly, the condition is not considered as serious as true inflammatory bowel diseases. Having IBS does not increase your risk of developing colon cancer (1) Nor does it shorten the lifespan. So, IBS can be life disrupting but not life shortening, therefore its resolution may not be taken as seriously by physicians as some IBS patients may like.
Is there a stigma towards IBS patients?
Unfortunately some physicians, despite their good intentions, lead patients to believe that their symptoms are “all in their heads.” Yes, there can be an emotional and psychological component to the experience of all inflammatory processes; but in my experience, this is not truer for IBS than any other chronic condition, including chronic pain. The absence of a standard test to diagnose IBS in the clinic does not mean that it is not a real condition.
That said, it is easy to feel isolated with IBS. Research in IBS and IBD has previously demonstrated that IBS patients are more likely to report high levels of perceived and internalized stigma compared to IBD patients (2,3). What is more surprising is that IBS patients were shown to perceive more stigma from their healthcare providers.
Like other conditions that may be manifestations of the complex interactions in the autonomic nervous system (chronic fatigue or fibromyalgia), IBS is still not fully understood, so the emotional or mental stress of the patient may be more likely to be blamed.
What are common medical treatments for IBS?
Irritable bowel syndrome is described as a functional gastrointestinal disorder characterized by symptoms of abdominal pain, bloating, and diarrhea or constipation, which are not associated with any structural abnormalities (4).
Diet alteration and monitoring and medication are the two primary medical interventions for IBS symptoms. But because different factors may trigger IBS in different people, two different people with IBS will be prescribed different medications and given different advice about managing their symptoms.
It is important to remember that there is no perfect cure and no magic solution to all chronic situations like IBS. But there are ways to reduce the frequency, intensity, and duration of your irritable bowel episodes. Some treatment options can make a big difference and improve your quality of life.
What is the low-FODMAP diet for IBS symptoms?
Certain foods can provoke symptoms in most people with IBS. Many IBS patients will be instructed to try a low-FODMAP diet.
Following a low-FODMAP diet is an inexpensive way of keeping symptoms at bay without the side effects of medications. The only downside is that the diet can be limiting, and it takes time to learn the foods which you can and can’t eat. You don’t even have to eliminate all high-FODMAP foods forever. Serve them in small sizes and find out what foods (or perhaps food combinations) are triggering your symptoms. It’s best to keep a daily food journal to be able to identify these patterns.
Examples of foods that contain high FODMAPs are (5):
- Lactose: dairy products such as milk, cheese, and ice cream
- Fructose: fruits and vegetables such as mango, apple, asparagus, peas
- Sorbitol: fruits like peaches, plums, and apricot
- Fructan: peaches, watermelon, artichokes, leeks, as well as grains, nuts, and legumes
What medications may be recommended for IBS?
Medications do not cure IBS but can help reduce symptoms. Keep in mind most drugs have side effects, and some may have sedative effects as they attempt to slow down the irregular bowel contractions that can lead to IBS symptoms. Do not take alcohol with these drugs as they could increase the sedative effect.
- Pain and cramps: antidepressants and anti-spasmodic medications
- Constipation: laxatives, bulking agents
- Diarrhea: anti-diarrhea medication such as loperamide
Can chiropractic care help with IBS symptoms?
Disruption in the gut-brain axis may be a contributor or cause of IBS symptoms for many people. The gut-brain axis is short-hand for the complex communication between the brain and spinal cord (central nervous system) and the nerves of the digestive system (enteric nervous system) that lead to proper digestion. It’s theorized an abnormal position or lock the spinal vertebra (chiropractic subluxation) can cause disruptions in the way the nervous system sends messages to the gut to coordinate the movement of food and waste through the digestive system.
Chiropractic care has been associated with deceased chronic symptoms of the gastrointestinal tract, including heartburn, indigestion, Crohn’s disease, and irritable bowel syndrome. I have personally collected histories from patients have seen these changes either with other chiropractors, or after their care here with me. Here’s a few that have been written about in the chiropractic literature.
- One case study examined the effects of upper cervical chiropractic care on a 32-year-old woman with IBS and depressive symptoms. Following treatment, the patient reported a reduction in the frequency and intensity of IBS symptoms (6).
- A 2015 literature review of 21 studies suggests that chiropractic treatment can be used as “adjunctive therapy” for patients with various digestive disorders such as GERD, colitis, constipation, and inflammatory bowel diseases (7).
You are encouraged to explore different resource sites and learn more about IBS and try different strategies and treatments. If you don’t have the confidence to try other treatment approaches, just knowing what treatment options are available for you will help you get the best from your healthcare provider.
Chiropractic consultations for IBS symptoms?
If you are interested in learning more about the gut-brain axis, the Vagal system, and how both may be related to your IBS symptoms, consider requesting a free consultation with my practice on this page.
(1) American Cancer Society. Colorectal Cancer Risk Factors. Cancer.org. Published 2017.https://www.cancer.org/cancer/colon-rectal-cancer/causes-risks-prevention/risk-factors.html
(2) Taft TH, Riehl ME, Dowjotas KL, Keefer L. Moving beyond perceptions: internalized stigma in the irritable bowel syndrome. Neurogastroenterol Motil. 2014;26:1026–1035.
(3) Taft T, Keefer L, Artz C, Bratten J, Jones M. Perceptions of illness stigma in patients with inflammatory bowel disease and irritable bowel syndrome. Qual Life Res. 2011;20:1391–1399.
(4) University of Michigan. Functional Bowel Disorders (FBD) University of Michigan Health System. www.med.umich.edu. Accessed February 17, 2021. https://www.med.umich.edu/fbd/
(5) Monash University. About FODMAPs and IBS | Monash FODMAP – Monash Fodmap. Monashfodmap.com. Published 2019. https://www.monashfodmap.com/about-fodmap-and-ibs/
(6) Nardi, J. “Resolution of Irritable Bowel Symptomatology in a Patient Undergoing Upper Cervical Chiropractic Care.” Journal of Upper Cervical Chiropractic Research, 2013 Apr: 25-31.
(7) Angus K, Asgharifar S, Gleberzon B. What effect does chiropractic treatment have on gastrointestinal (GI) disorders: a narrative review of the literature. J Can Chiropr Assoc. 2015;59(2):122-133.