What causes irritable bowel syndrome?

If you also suffer from irritable bowel syndrome, here are some possible causes that you can consult your doctor about.

Sensitivity to FODMAP

FODMAP stands for Short Chain Carbohydrates (oligosaccharides, disaccharides, monosaccharides and polyols) – sugars found in large quantities in foods such as garlic, leeks, beans, apples, and many sweeteners. Some do not absorb them properly, so they spend longer in the gut than normal. This can cause constipation, bloating, flatulence and diarrhea. Experts note that 75 to 80 percent of patients suffering from irritable bowel syndrome experience a significant improvement or even cessation of symptoms on a diet low in FODMAP.

How do I know if this is my problem?The simplest way to check for sensitivity to FODMAP is with a diet that completely excludes them. Such a diet should last for about eight weeks. If your symptoms disappear during this time, you are definitely sensitive to at least one type of FODMAP.

Whats next?It is not necessary to avoid FODMAP for the rest of your life, as a dietitian can help you determine which sugar is causing you problems. For foods that you adore but are on a banned list, an expert can also help you determine how much you can eat without triggering the onset of symptoms. The ideal is to find a way of eating that will allow you to enjoy as many foods as you like.

Bacterial growth in the small intestine (SIBO)

Bacteria in the gut are usually found in the colon. In the case of SIBO, however, their number in the small intestine increases, leading to the development of irritable bowel syndrome-like symptoms. In about a third of patients with irritable bowel syndrome and sixty percent of those whose main symptom of irritable bowel syndrome is diarrhea, SIBO is to blame for at least part of their symptoms.

How do I know if this is my problem?There is a respiratory test as bacteria emit hydrogen and methane, but the accuracy of the results has been questionable lately. Instead, your doctor may prescribe the antibiotic rifaximin, which is used to treat SIBO. If the condition improves after taking it, SIBO is the main cause of your symptoms.

Whats next?In fifty percent of patients, initial treatment is sufficient to completely stop the onset of symptoms. In the second half, symptoms recur in about six months. In this case, antibiotic treatment is repeated.

Diarrhea caused by bile acid

If diarrhea is the main symptom of your irritable bowel syndrome, talk to your doctor about diarrhea caused by bile diarrhoea (BAD). Studies in the UK estimate that thirty per cent of patients with irritable bowel syndrome, whose main symptom is diarrhea, actually have BAD. Due to the higher content of bile acid (which is created in the liver during digestion) in the intestine, the path through the intestine is accelerated, which in turn causes a very frequent discharge of liquid stool.

How do I know if this is my problem?The cheapest method of diagnosis is experimental treatment with cholestyramine. This binds excess bile acid to itself and stops the onset of symptoms. In patients with BAD, the condition improves significantly after starting treatment.

Whats next? You will need to take cholestyramine for long-term control of symptoms.

Celiac disease

It is a reaction of the immune system to the protein gluten, which is found in wheat, rye, oats and barley. It can manifest with symptoms such as bloating, abdominal pain, and tense bowel movements. Doctors estimate that about ten percent of people with irritable bowel syndrome actually have celiac disease.

How do I know if this is my problem?The doctor will perform a blood test and confirm celiac disease. You can also buy a quick test at a pharmacy and do it yourself, as only a drop of blood is needed for a successful test. It is important to eat gluten-containing foods at the time of testing, otherwise the test results will not be accurate.

Whats next?If the test is positive, you will need to change your diet as a strict diet is currently the only form of treatment. You will need to remove all wheat, rye, barley and oat products from your diet, and special gluten-free flours, breads and pastas are available in stores.

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