Irritable Bowel Syndrome: 5 Myths in Check
Much has been reported about the irritable bowel for several years. A few myths have persisted, however. We explain what is really true!
The irritable bowel can be many things: Stomach pains, bloating, you eat three bites and you feel full. Or you suddenly get diarrhoea, have constipation, possibly both alternating. It’s as if there’s a sensitive person sitting in the middle of your stomach who’s often not well-disposed towards you. The good news is that the more you know about irritable bowel syndrome, the better you can deal with it. So here’s where we dispel a few myths.
Myth 1: Irritable bowel? All mental.
Irritable bowel patients still encounter such beliefs. After all, there is no test or examination that proves that one suffers from irritable bowel syndrome. If gastroscopy, colonoscopy, laboratory tests, ultrasound and so on are inconspicuous, the diagnosis is virtually all that remains. But that doesn’t mean that the psyche is the trigger.
“Even if we cannot detect any organic disorder with our diagnostics, irritable bowel syndrome is an organic clinical picture and not something psychosomatic,” says Professor Ahmed Madisch, chief physician and gastroenterologist at Klinikum Region Hannover. Studies show that there are differences in the intestinal flora compared to healthy people.
People with irritable bowel syndrome have an altered nervous system in the intestinal wall and therefore react more sensitively to what happens in the intestine. “We also know that some patients have an increased immune response in the intestinal mucosa, i.e. there are more defence cells, which release more messenger substances that activate the nervous system and trigger symptoms,” says Dr. Viola Andresen, gastroenterologist at the Israelite Hospital in Hamburg. What exactly causes irritable bowel syndrome is still not known exactly – and presumably these are different disorders, although it is not yet possible to differentiate between them.
Myth 2: An irritable bowel comes out of nowhere.
This may of course be the case in individual cases or may appear so to some people. However, if you look at the totality of those affected, you will see that irritable bowel syndrome occurs more frequently under certain conditions. “Bacterial intestinal infections are among the most important risk factors,” says Andresen. This can be caused by pathogens brought back from a long-distance journey or simply Campylobacter bacteria, which are often found on raw poultry meat, for example.
Stress increases the risk of developing irritable bowel syndrome after an infection. And people who were traumatised in childhood or adolescence, for example by abuse or similar, are more likely to develop functional digestive problems (i.e. those for which no organic cause can be found) later on – such as irritable bowel syndrome. “Even in healthy people, the psyche and the gastrointestinal tract are connected,” says Andresen. “There are often trigger factors in the lives of patients that temporarily aggravate irritable bowel syndrome, such as divorce or job loss. When life calms down again, the intestines also calm down.”
How exactly these things are related is something that people are beginning to understand. In the treatment of irritable bowel syndrome, however, the interplay between body and soul is already being used in a targeted manner. For example, the guidelines recommend not only medication but also psychotherapeutic procedures such as hypnosis, relaxation exercises or behavioral therapy.
Myth 3: Irritable bowel syndrome is a woman’s thing.
That’s only partly true. Two thirds of the patients* are women, but this is especially true for the constipation, i.e. the constipation irritable bowel. The type of diarrhoea, on the other hand, is equally common in both sexes. “There are certainly hormonal reasons why constipation is primarily a female problem,” explains Andresen. “Pelvic floor problems after pregnancy and childbirth are an additional risk.”
Myth 4: An irritable bowel never goes away.
No, often the complaints only occur in certain phases of life, irritable bowel syndrome is most common in middle age. And there are certainly cases in which the symptoms disappear completely. There is every reason to hope for this. But it is not possible to predict when this might happen – there is still no cure for irritable bowel syndrome. Viola Andresen: “It is a chronic disease. Most patients have to deal with it from time to time. Just like there are people who have headaches on a regular basis.”
Myth 5: The irritable bowel gets better if you ignore it.
Just going over it is not a good idea. Because studies show that the quality of life of irritable bowel patients is very low, comparable to that after a stroke and lower than that of other bowel conditions such as ulcerative colitis or Crohn’s disease, although they can cause more severe symptoms. There is a strong case for starting treatment quickly once the diagnosis of irritable bowel syndrome is reached.
The primary aim is to get the most troublesome symptoms under control. And depending on what is most important, there are many ways to do this, including herbal remedies, probiotics, fibre, laxatives, diarrhoeal medicines, antispasmodics and antidepressants. However, there is no guarantee that the respective drugs will bring improvement. This also applies to changes in eating habits – towards several, not too sumptuous meals – as well as to changes in diet such as the elaborate FODMAP diet (the letters stand for fermentable carbohydrates and sugar alcohols), which should not be made permanently and preferably with a nutritionist.
The important thing is: After four to eight weeks, you should check what the medication or measure has achieved – and try something new if necessary. If you do this consistently, there is a good chance that you will experience relief. This also makes it clear what almost all irritable bowel patients need: Patience.