Research is still uncovering the causes of and triggers for irritable bowel syndrome (IBS). Many lifestyle and environmental factors affect both the emergence and severity of IBS, including alcohol abuse,1,2 depression,2 psychiatric stress,3,4 and more. Knowing the right questions to inform your patient history rapidly builds the patient relationship as well as improving your diagnostic skills.
One study of military personnel found that an important antecedent for many cases of IBS is previous infectious gastroenteritis, which increases risk by two to three times versus controls. Furthermore, a range of cognitive factors affected the risk of emergence of IBS, including post-traumatic stress disorder (PTSD), depression, life stress, and self-reported anxiety. Significant interactions were found between infection, depression, anxiety and the later emergence of IBS.4
The study did not intervene to treat IBS, but the biopsychosocial model described by the authors suggests that a variety of lifestyle interventions may reduce IBS severity. In addition, restoring a healthy microbiome and reducing gut permeability are known to be crucial for treating IBS.5-7
In a disorder such as IBS, the gut-brain connection has a powerful impact. Without adequate attention to the emotional needs of patients, co-occurring psychological and biological issues go unaddressed. By evaluating lifestyle and medical factors, a treatment plan that deals with each area of patient life makes symptoms more manageable.
Add new tools to your clinical toolkit that can help you recognize and treat the most important antecedents and triggers of gastrointestinal dysfunction at IFM’s GI Advanced Practice Module.
- Hsu T-Y, He G-Y, Wang Y-C, et al. Alcohol use disorder increases the risk of irritable bowel disease: a nationwide retrospective cohort study. Medicine (Baltimore). 2015;94(51):e2334. doi: 10.1097/MD.0000000000002334.
- Ibrahim NK. A systematic review of the prevalence and risk factors of irritable bowel syndrome among medical students. Turk J Gastroenterol. 2016;27(1):10-16. doi: 10.5152/tjg.2015.150333.
- Satake R, Sugawara N, Sato K, et al. Prevalence and predictive factors of irritable bowel syndrome in a community-dwelling population in Japan. Intern Med. 2015;54(24):3105-12. doi: 10.2169/internalmedicine.54.5378.
- Riddle MS, Welsh M, Porter CK, et al. The epidemiology of irritable bowel syndrome in the US Military: findings from the Millennium Cohort Study. Am J Gastroenterol. 2016;111(1):93-104. doi: 10.1038/ajg.2015.386.
- Mezzasalma V, Manfrini E, Ferri E, et al. A randomized, double-blind, placebo-controlled trial: the efficacy of multispecies probiotic supplementation in alleviating symptoms of irritable bowel syndrome associated with constipation. Biomed Res Int. 2016;2016:4740907. doi: 10.1155/2016/4740907.
- Yoon JS, Sohn W, Lee OY, et al. Effect of multispecies probiotics on irritable bowel syndrome: a randomized, double-blind, placebo-controlled trial. J Gastroenterol Hepatol. 2014;29(1):52-59. doi: 10.1111/jgh.12322.
- Ki Cha B, Mun Jung S, Hwan Choi C, et al. The effect of a multispecies probiotic mixture on the symptoms and fecal microbiota in diarrhea-dominant irritable bowel syndrome: a randomized, double-blind, placebo-controlled trial. J Clin Gastroenterol. 2012;46(3):220-27. doi: 10.1097/MCG.0b013e31823712b1.
Given the strong mind-body/brain-gut connection, it is clear that when the normal integrity of the GI tract is compromised, distant systemic complaints can result, even in the absence of overt GI symptoms. Integrative approaches may be helpful for reducing symptoms and reestablishing a healthy gut and a healthy mind.Read More
The gut-brain axis is the bidirectional communication between the gut and the brain, which occurs through multiple pathways that include hormonal, neural, and immune mediators. Interestingly, the signals along this axis can originate in the gut, the brain, or both, with the objective of maintaining normal gut function and appropriate behavior.Read More