IBS (Irritable Bowel Syndrome) Kelsey Timmins EXS 486 Irritable

What is IBS? Irritable bowel syndrome A condition that usually affects the large and small intestines with disturbances in bowel motor function Affects the nerves and the muscles Does not harm the intestines A long term or recurrent disorder of GI functioning Does not harm the intestine Does not cause inflammation like IBD, chrohns, or ulcerative colitis Disturbances in bowel motor function and sensation The nerves and muscles can either work too much or too little

Is IBS Common? IBS affects 10-15% of adults 35-40% male 60-65% female Most common functional gastrointestinal disorder Has a worldwide prevalence Second only to the common cold as a cause for absenteeism from work Functional GI disorder conditions where there are no structural or biochemical abnormalities on common diagnostic tests that could explain the symptoms

Cost of IBS 2.4 – 3.5 million physician visits a year for IBS alone Cost to society ranges from $21 billion up annually Cost in terms of direct medical expenses and indirect costs associated with loss of productivity and work absenteeism

Causes The cause of someone having IBS is not completely understood The possible causes of flairs is more easily understood A bowel of someone with IBS is more reactive to things such as eating, stress, emotional arousal, GI infections, menstrual period, etc.

Brain-Gut Axis Symptoms appear due to disturbances in colonic motility and increased sensitivity These are due to disruptions in the communications between the brain and the gut Factors that may contribute to the disruption in the brain-gut axis: A genetic predisposition of IBS An infection prior to symptom onset Chronic stressful lifestyle or other psychosocial factors The brain gut axis is the communication between the brain and the gut Colonic motility is the muscle contractions of the intestines and the bowels Increased sensitivity to food gas or stool in the bowels

Symptoms Abdominal cramping Abdominal pain or discomfort Change in bowel habits Diarrhea Constipation Urgency Bloating Mucus in stool Feeling of not completely passing stool Symptoms can change over time and their can be period with no symptoms Some people get diarrhea Some people get constipation Some people go back and forth between the two Pain is often relieved by having a bowel movement and can be worse right after eating

Diagnosis The doctor first identifies the symptoms that may indicate IBS The next step is to look for symptoms that may point to a more serious condition. Symptoms such as: Anemia Blood in stool Unexplained weight loss Fever Onset of symptoms after 50 Family history of IBD, celiac, or colon cancer

Testing There are no tests for IBS However, some doctors may perform tests to rule out more serious conditions, and then come to the conclusion of IBS Tests such as: A lactose breath test A celiac blood test A colonoscopy Lactose breath test for lactose intolerance A celiac blood test which is a gluten intolerance A colonoscopy which can rule out things like colon cancer or other inflammatory diseases

Management There is no cure for IBS There are ways to improve symptoms The first line of treatment is implementing lifestyle changes Diet Stress Rest Exercise Reduce or eliminate foods that seem to increase symptoms Try to eliminate unnecessary stress Exercise can reduce stress and it also helps to relax the bowel since blood is taken away from the digestive system during exercise

Exercise as Treatment Exercise can reduce stress Exercise can ease constipation Can give relief to the people that get both constipation and diarrhea Reduce stress – stress is a trigger for symptoms Can reduce constipation since it causes the muscles of the gut to relax Decreasing constipation can also decrease diarrhea for people who get both When people get both once the constipation starts the gut goes into overdrive and ends up causing diarrhea and then slows down and causes constipation and it continues to go in that circle

Medication Laxatives Anti-diarrheals Antispasmodics Probiotics Ex. Miralax Anti-diarrheals Ex. Imodium Antispasmodics Ex. Dicyclomine, hyoscyamine Probiotics

Useful Links IBS Handout

Case Study 24 year old female Mild to moderate IBS Stomach aches every so often and goes back and forth between diarrhea and constipation during flairs Sedentary Non-smoker Blood pressure, cholesterol, and fasting glucose all normal No family history of heart disease BMI of 23 No other health problems

Risk Goals Sedentary Low risk To decrease stress To decrease symptoms To increase amounts of time without any symptoms Only risk factor is being sedentary Since she has only one risk factors and has no symptoms of cardiovascular disease she is low risk

Exercise Testing Since she is low risk either a maximal or sub-maximal test can be performed Neither test requires a physician to be present Since it is not recommended for people with IBS to run, I would perform a walking or biking test

Exercise Prescription Without Symptoms During a Flair Frequency: 4-5 d/wk Intensity: 50-60% Vo2 max Duration: 30-60 min. Type: Hiking, biking, brisk walking, yoga, swimming Do yoga at least 1-2 days per week Frequency: Try for at least 2 days a week, but do more if possible Intensity: Low intensity – 40% Vo2 max Duration: At least 20 min Type: Walking or yoga, do yoga at least 1 day per week

Exercise Considerations Avoid any type of exercise that makes symptoms worse Things like running or weight lifting can make diarrhea worse If something is making symptoms worse, try cutting back on time or intensity for awhile

Helpful Poses to Relieve Symptoms – Gate Pose Start in a tall kneel and stretch out your right leg Exhale and bend to touch your leg Stay for 5-10 breaths Repeat on other side

Half-Seated Spinal Twist Sit in a seated criss cross position Lift your right knee, place your left hand on your knee and twist your torso toward your knee Hold for 5-10 breaths Switch sides

Happy Baby Pose Lie on your back Hug your knees to your chest, pushing your back into the ground Let your knees drop wide apart, and grab the outside of your feet Hold for 10 breaths

Conclusion IBS is very common. There is a good chance that someone you know has it IBS is a condition that can be life altering if the symptoms are not kept under control Exercise is one of the major strategies for keeping the symptoms at bay

Works Cited Drossman, D. (2014, September 15). Intro to IBS. Retrieved from http://www.aboutibs.org/site/ what-is-ibs/intro-to-ibs/ National Institute of Diabetes and Digestive and Kidney Diseases. (2014, July 3). Irritable bowel syndrome. Retrieved from https://www.nlm.nih.gov/ medlineplus/irritablebowelsyndrome.html#cat78 Rodriguez, D. (2015, October 21). Exercise may ease IBS symptoms. Retrieved from http:// www.everydayhealth.com/ibs/ibs-and- exercise.aspx