Types of IBS
Three main types of IBS
Within a broad range of symptoms of IBS and their triggers, we
can roughly differentiate between three different variants of IBS:
- diarrhea predominant IBS
- constipation predominant IBS
- alternating IBS
Irritable Bowel Syndrome is a very individual disorder and very
few patients exhibit the same symptoms or react in a similar way
to the same causes of these symptoms. Therefore, there may be a
considerable degree of cross over between the three types of IBS
enumerated above, and some patients might complain of more than
one symptom of any one of the variants at any one time.
Diarrhea predominant IBS
This variant of IBS is characterized by diarrhea, or abnormal bowel
frequency (more than three times a day), particularly in association
with abdominal pain. Patients complain of frequency and particularly
urgency of bowel movements and of passing several stools in rapid
succession, usually first thing in the morning. Other symptoms may
include bloating, quite often with visible abdominal distension,
and sometimes incontinence. Patients often pass mucus with their
stool and have a sensation of incomplete evacuation. Pain is usually
relieved, at least temporarily, by bowel function.
In its most severe form, patients with diarrhea predominant IBS
avoid socializing and are afraid to leave their houses because the
urgency is so great that their lifestyles revolve around knowing
exactly where the next toilet is located.
Constipation predominant IBS
Patients suffering from this variant of IBS typically complain
of constipation often accompanied by abdominal pain or discomfort,
bloating, especially after meals. Other symptoms include passing
mucus in stool and sensation of incomplete evacuation. Pain is usually
relieved after bowel movement. Patients with constipation predominant
IBS may also report tiredness, nausea, gas, reflux, heartburn, and
in some situations headaches.
Constipation predominant IBS is known not to be caused by the lack
of fiber in the diet, inactivity, or insufficient water intake.
However, increasing exercise level, drinking a lot of fluids, and
including fiber in your diet may help alleviate the symptoms. IBS
patients need to be careful with fiber intake, though, as in some
individuals it can worsen the symptoms and considerably aggravate
bloating. That is why fiber must be gradually introduced, and the
patient should start with small doses which can be gradually increased.
The patient should also make sure that he or she includes both soluble
and insoluble fiber in the diet and strike the right balance between
the intake of insoluble and soluble fiber. Laxatives are one of
the most frequent OTC medications taken to relieve constipation,
but some laxatives can cause habit formation, especially if taken
over a longer period of time.
Alternating IBS
This form of IBS is perhaps most difficult to treat as it is characterized
by both diarrhea and constipation in alternation. Patients often
suffer from urging or severe bloating which may or may not be relieved
by bowel movement. They also complain of abdominal pain or discomfort,
cramping or sharp aches, trapped gas, and sensation of incomplete
evacuation. Some patients may experience the feeling of early fullness
or filling up even after eating very little. Sometimes this form
of IBS can cause indigestion, heartburn, loss of appetite, and,
as a result, loss of weight.
Patients with alternating IBS should watch their diet carefully
and eat in small portions. They should avoid trigger foods and include
soluble fiber into their diet. They can also try to alleviate their
symptoms by using medications that prevent both constipation and
diarrhea.
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