One recent study found that IBS pain is more severe in postmenopausal females than in either men or menstruating women. Lin Chang, M.D., a gastroenterologist at University of California, Los Angeles and coauthor on the study, is now conducting federally funded research comparing the brain-gut-microbiome interactions in premenopausal versus postmenopausal women. The researchers’ hypothesis, she said, is that when estrogen levels dip (as they do in menopause, as well as during various points in the menstrual cycle), that leads to greater dysregulation of brain-gut interactions, affecting the microbiome. This in turn could lead to bloating, pain, changes in the stool or stool frequency — basically, an increase in IBS symptoms for those who already suffer from it.
4. Infections and stress can spark IBS
The precise cause of IBS isn’t known, but many factors appear to play a role in its development.
Some cases come on after a bout of food poisoning or a bad stomach bug. “But a lot of people get food poisoning and they don’t all get IBS,” Chang said. Risk factors for getting this type of IBS, known as postinfectious IBS, include being young, being female, having a more severe infection, being under stress at the time, and having a history of anxiety or depression, Chang said.
IBS can start other ways, too. Researchers increasingly believe that for many patients, the stage for the disorder is set early in life, Sayuk said, but may go dormant until an event or issue — like a stomach bug, stress, anxiety or even sleep deprivation — sets a patient’s symptoms off again.
5. Medication and lifestyle changes can help
IBS can’t be cured, but it can be managed with certain medications and lifestyle modifications.
There are drugs that can treat IBS, but they don’t work for everyone, said Darren Brenner, M.D., a gastroenterologist and researcher at Northwestern University Feinberg School of Medicine. For those who primarily suffer from diarrhea, a two-week course with the antibiotic rifaximin can bring relief. Longer-term medication regimens can be prescribed for people who deal with constipation.
Other treatments — many of which target the mind in an attempt to calm its reaction to the body’s signals — include meditation, cognitive behavioral therapy, acupuncture and even peppermint oil pills. Your doctor may also recommend a change in diet, including an eating plan that cuts out certain carbohydrates known to trigger IBS symptoms. Avoiding foods and drinks that cause gas can also help curb symptoms in some — so can going gluten-free.
Because the science surrounding IBS remains imprecise, so are the treatments. Shah recommends testing out one new treatment at a time, be it a therapy, diet, drug or whatever. “Then you give it two to three months to see if that one thing is going to work,” he said. Whether it does or doesn’t, if you’re still looking for improvement, add on or try something else.
Finally, pay attention to the latest research on the topic because scientists are learning more about the condition all the time. “There’s going to be some big stuff,” he said. “We’re really looking forward to the next five to 10 years, in seeing what we can achieve.”