Is irritable bowel syndrome lifelong?

IBS is an ‘umbrella’ term given to a group of symptoms affecting the bowel for which there may be many causes.  The most common causes or ‘trigger’s' for the symptoms include diet, stress and anxiety.  

In the past, the medical focus was more on the stress and anxiety aspects but more recently, diet has become a major focus of intervention.  It does seem that there are certain personality types that are more prone to IBS symptoms and one of the treatments offered are mild antidepressants as this can sometimes reduce anxiety, release of adrenalin and stimulation of the bowel. In these people, it may be that IBS will be a lifelong condition.  

However, not all people have anxious personalities and in these people a change in diet may not only reduce symptoms, but eliminate symptoms entirely.   Possible dietary causes include food chemical intolerance and reduced fermentable carbohydrate (FODMAP) absorption.  Coeliac disease should always be investigated in any one presenting with IBS symptoms as the symptoms can be the similar.  

The mechanism of food chemical intolerance is not well understood but the mechanism of reduced FODMAP absorption is understood.  In both, a reduction of the offending chemical or FODMAP causes improvement of  symptoms.  Food chemical intolerance tends to be a lifelong problem although the severity of symptoms will vary depending on health and stress.  Some FODMAP intolerance may be lifelong, some may be temporary.  One possible cause of IBS symptoms is the type of bowel bacteria present.  Probiotics have been proven useful in some IBS patients by changing the type of bowel bacteria. So perhaps this is the only possible cause of IBS which is not necessarily lifelong.

Whilst sensitivity of the bowel to certain triggers may be a permanent feature, quite possibly genetically determined, there are many options available for the management and control of symptoms so that the discomfort caused by IBS does not need to be lifelong.

Most cases of IBS can be resolved with correct diagnosis and treatment, provided the cause is figured out correctly.

IBS is unlikely to go away on it's own. But it's not all bad news! IBS can often be managed with diet so it's a good idea to see an Accredited Practising Dietitian who can help you with that.

Julie Markoska
Accredited Practising Dietitian & Nutritionist
http://www.juliemarkoska.com.au/

I can only answer the Q from a dietetic perspective. In my experience, those people that respond to dietary manipulation (incl. low FODMAP, modified roughage, probiotic, digestive enzymes etc), find an improvement within a couple of months. What is more interesting is that those foods that were once offensive, are often able to then be RE introduced with no trouble. Everyone is diiferent. Do not only do on line searches, visit an experienced dietitian with an interest in the gut.
MS

I concur with all the above comments from dietitians.
Just to add another aspect, I have seen many clients who have had IBS in the past and now are completely fine.

I have also seen clients who have been told they have IBS by their GP or specialist after all medical causes were ruled out, only to discover a general improvement in diet cleared up most of the symptoms.

I have also had a number of clients who tested positive to fructose malabsorption on breath testing find their symptoms resolved with ensuring a healthier diet and they did not have to restrict/limit their intake and FODMAPs/fructose.

While some people can eat a not so healthy diet without affecting their digestion, others find that an intake of fatty/sugary or processed foods and inadequate dietary fibre in an otherwise healthy diet is enough to produce IBS symptoms. Speaking for myself, I have a very healthy diet with little processed food but if I don't get me daily 25-30g dietary fibre, I start to have troubles. I do not consider myself to have IBS, but certainly our family has more sensitive guts and if we don't eat well are more prone to issues.

You may feel your diet is already healthy and very well balanced, however it would be a good idea to check this with an accredited practising dietitian and then you can also discuss the possibility of food intolerance while you're there.

IBS can be managed successfully if you have the right diagnosis and subsequent treatment. IBS causes are multifactorial and a treatment plan has to formulated for each individual. Recent theories include dysregulation of the gut-brain axis, altered serotonin signalling, infection, alterations to gut flora and food hypersensitivity.
Intolerances including, lactose, mannitol, fructose and certain food proteins should be investigated to discover possible contributing factors or causes. Structural abnormalities are assumed to be absent in IBS. Diet is the primary treatment and therefore treatment by a qualified Nutritionist is advised. They will consider your digestion and possible malabsorption issues. A diet plan to improve gut health and integrity and absorption of nutrients will be paramount. Reduction and even resolve of symptoms is possible with these approaches.