Irritable Bowel Syndrome (IBS) affects many people, causing a range of digestive issues. It is the most common digestive issue, affecting up to a third of the population at some point in their lives, most commonly between 20 and 40 years old. Whilst the jury is still out on why exactly does IBS start in the first place, there are various known factors that we know can contribute to the onset of IBS, including genetics, stress, diet, lifestyle, gut microbiome imbalances, infections, and hormonal changes.
Family History
Family history may play a role in the development of IBS. If your relatives have IBS, you could be 2-3 times more likely to develop it too. Genetics could also influence how your gut functions, making some people more susceptible to IBS. Researchers have identified there might be specific gene variants that could be associated with the condition, although the exact mechanisms by which these work, are still being studied. It is also unclear how much genes and the environment interact to affect someone’s susceptibility to IBS.
Stress and Anxiety
We know that chronic stress and anxiety can significantly impact gut health. When you’re stressed, your body releases hormones like cortisol and adrenaline which can alter gut function, causing or exacerbating IBS symptoms. Stress can increase gut sensitivity, increasing the pain signals being sent up to your brain from your gut, making you more prone to discomfort and pain from sensations in your gut. Also, stress can affect how your intestines contract, slowing things down or speeding things up, potentially leading to either diarrhoea or constipation, sometimes both in turns. Learning stress management techniques, with mindfulness or through cognitive-behavioural therapy, can help mitigate these effects.
Diet and Lifestyle
Diet and lifestyle can also trigger IBS. Common dietary triggers include high-fat foods, caffeine, and alcohol. Irregular meal times, feeling stressed or distracted whilst eating and lack of exercise also contribute to IBS. Eating too quickly or not chewing food properly can also cause digestive symptoms. It can be helpful to identify which behaviours, thoughts and beliefs around food may be contributing to trigger your symptoms to learn to manage IBS effectively. Additionally, things like incorporating fibre-rich foods and staying hydrated can help regulate bowel movements.
Gut Microbiome
The gut microbiome consists of trillions of bacteria that play a crucial role in digestion and overall health. An imbalance in gut bacteria can lead to IBS. Factors such as antibiotics, diet, and infections can disrupt the microbiome, resulting in IBS symptoms. Maintaining a healthy balance of gut bacteria is vital for preventing and managing IBS. Probiotics and prebiotics may support a healthy microbiome by promoting the growth of beneficial bacteria, but nothing will ever replace eating a varied diet, filled with whole-foods.
Infections and Inflammation
Gastrointestinal infections are thought to be a potential reason why IBS starts. After an infection, some people develop post-infectious IBS, where symptoms persist even after the infection has cleared. Inflammation caused by infections can damage the gut lining, leading to ongoing IBS symptoms as the gut-brain communication axis becomes out of balance. This connection highlights the importance of treating infections promptly and thoroughly. Additionally, chronic inflammation from other conditions, like inflammatory bowel disease (IBD), can increase the risk of developing IBS.
Hormonal Changes
Hormonal fluctuations, especially in people who menstruate, can impact IBS. Many women and people who menstruate report worsening IBS symptoms during their menstrual cycle. Hormones like oestrogen and progesterone can affect gut motility and sensitivity, leading to increased discomfort and digestive issues. The massive hormonal changes that occur during or after pregnancy, or with menopause can also cause or worsen IBS symptoms. Understanding how hormones influence IBS can help in managing symptoms effectively.
Other Contributing Factors
Beyond the primary causes, other factors could be contributing to the onset of IBS. Food intolerances, like lactose or gluten intolerance, can mimic or exacerbate IBS symptoms. Some people with IBS have a heightened sensitivity to certain foods, which can trigger symptoms even in small amounts. Additionally, early life stressors and trauma has been linked to a higher prevalence of IBS, possibly due to the long-term impact of trauma on the body’s stress response system.
Managing IBS
Understanding the various potential causes of IBS can help to give some clarity to start better understanding your condition. IBS may start due to a combination of genetic, psychological, and environmental factors. Genetics, stress, diet, gut microbiome, infections, and hormonal changes all play a role in the onset and progression of IBS. Once you know what triggers your symptoms, you can take steps to avoid or mitigate those triggers. For example, practicing stress management techniques to reduce the impact of stress on your gut, trying out some gentle movement, and possibly working with a hypnotherapist can all contribute to better IBS management.
