I don’t mean to brag, but I’ve got irritable bowel syndrome, says a character of a sitcom, in the episode aired a few years ago. Irritable bowel syndrome, also known as IBS, used to be a rare condition, but - due to industrialization and urbanization - it is now one of the most common disorders in the world. The term is even used figuratively, in a derogatory sense.
The numbers of new reported cases of irritable bowel syndrome (IBS) kept increasing into the 21st century when they reached almost epidemic proportions. As the amount of information available on the Internet exploded, so did the web searches about IBS. But then the disorder "came out of the closet", and google searches for "irritable bowel syndrome" started to dwindle, reaching a quarter of what they used to be at the peak. This downtrend mirrored ambulatory data (National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey) showing that by 2010, the rate of IBS-related visits decreased roughly by 37%.
Is IBS no longer a problem?
The numbers of new reported cases of irritable bowel syndrome (IBS) kept increasing into the 21st century when they reached almost epidemic proportions. As the amount of information available on the Internet exploded, so did the web searches about IBS. But then the disorder "came out of the closet", and google searches for "irritable bowel syndrome" started to dwindle, reaching a quarter of what they used to be at the peak. This downtrend mirrored ambulatory data (National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey) showing that by 2010, the rate of IBS-related visits decreased roughly by 37%.
Is IBS no longer a problem?
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Online health communities, blogs and social networks have, over the years, changed the relationship between sufferers of IBS (and many other conditions) and their doctors. Clinical practice shifted from treatment to self-management and from medical specialists (secondary care) to primary care physicians and ‘expert patients’.
10-20 years ago, doctors were experimenting with many different medications to address IBS complaints (especially medicines used to alleviate depression and supplement fiber), but now they are more likely to prescribe non-medication therapies: diet/nutrition counseling, mental health counseling, and/or stress management. Among prescribed medications, there was increased use of gastrointestinal-specific antibiotics and probiotics, but also laxatives, proton pump inhibitors (for heartburn), antiemetics (against nausea), bile acid sequestrants (for diarrhea), opioid and non-opioid analgesics (p=0.001 for each). Prescription of fiber (p=0.001), antidepressants (p=0.002), antacids (p=0.010), and histamine-2 receptor antagonists (p=0.001) significantly decreased.
Modern IBS patient is more informed. Modern doctors know more about IBS. They know it's not in your head and even started suggesting this is a disease, not a syndrome. But diagnostic tests confirming IBS are still lacking and so are answers to many questions.
10-20 years ago, doctors were experimenting with many different medications to address IBS complaints (especially medicines used to alleviate depression and supplement fiber), but now they are more likely to prescribe non-medication therapies: diet/nutrition counseling, mental health counseling, and/or stress management. Among prescribed medications, there was increased use of gastrointestinal-specific antibiotics and probiotics, but also laxatives, proton pump inhibitors (for heartburn), antiemetics (against nausea), bile acid sequestrants (for diarrhea), opioid and non-opioid analgesics (p=0.001 for each). Prescription of fiber (p=0.001), antidepressants (p=0.002), antacids (p=0.010), and histamine-2 receptor antagonists (p=0.001) significantly decreased.
Modern IBS patient is more informed. Modern doctors know more about IBS. They know it's not in your head and even started suggesting this is a disease, not a syndrome. But diagnostic tests confirming IBS are still lacking and so are answers to many questions.
As interest in ambulatory care for IBS was dropping, diets reducing IBS symptoms started to explode in popularity. So that sufferers of IBS-related symptoms have been even outpaced by the growing numbers of people following these trendy diets.
Gluten-free has been one of the biggest diet trends that made social events much less isolating for IBS sufferers with gluten and wheat sensitivities. Low sugar and Paleo were also helpful to many. But low FODMAP diet seemed to be most beneficial for IBS. Yet, even this diet might not be a cure-all for IBS and can't be recommended in the longer term.
Gluten-free has been one of the biggest diet trends that made social events much less isolating for IBS sufferers with gluten and wheat sensitivities. Low sugar and Paleo were also helpful to many. But low FODMAP diet seemed to be most beneficial for IBS. Yet, even this diet might not be a cure-all for IBS and can't be recommended in the longer term.
While there are dietary and stress management approaches along with a few drugs that can be used to treat IBS, what works best is when the sufferer can find a pattern of when their disease is at its worst, and can figure out ways to avoid these conditions.
Social support is another important factor. Analyses indicated that it reduces severity of IBS symptoms, suggesting that the mechanism by which social support alleviates pain is through a reduction in stress levels.
And so IBS sufferers keep joining online support groups. In the last 5 years, IBSgroup.org got 25 thousand more sign ups, growing from 41 to over 66 thousands. New IBS support groups on Facebook merged, some as large as 11 thousand members. Yet, as a new US survey reveals, IBS sufferers see healthcare providers and the public in general lacking in empathy and understanding. The condition is still difficult to diagnose and often even more difficult to treat.
Afraid no more, but still in search of empathy and cures.
Social support is another important factor. Analyses indicated that it reduces severity of IBS symptoms, suggesting that the mechanism by which social support alleviates pain is through a reduction in stress levels.
And so IBS sufferers keep joining online support groups. In the last 5 years, IBSgroup.org got 25 thousand more sign ups, growing from 41 to over 66 thousands. New IBS support groups on Facebook merged, some as large as 11 thousand members. Yet, as a new US survey reveals, IBS sufferers see healthcare providers and the public in general lacking in empathy and understanding. The condition is still difficult to diagnose and often even more difficult to treat.
Afraid no more, but still in search of empathy and cures.
REFERENCES
Camilleri M, Oduyebo I, & Halawi H (2016). Chemical and molecular factors in irritable bowel syndrome: current knowledge, challenges, and unanswered questions. American journal of physiology. Gastrointestinal and liver physiology, 311 (5) PMID: 27609770
Lacy BE, Patel H, Guérin A, Dea K, Scopel JL, Alaghband R, Wu EQ, & Mody R (2016). Variation in Care for Patients with Irritable Bowel Syndrome in the United States. PloS one, 11 (4) PMID: 27116612
Dorn, S., & Meek, P. (2013). Su1024 Ambulatory Care for Irritable Bowel Syndrome in the United States, 1993-2010 Gastroenterology, 144 (5) DOI: 10.1016/S0016-5085(13)61392-X
Lackner, J., Brasel, A., Quigley, B., Keefer, L., Krasner, S., Powell, C., Katz, L., & Sitrin, M. (2010). The ties that bind: perceived social support, stress, and IBS in severely affected patients Neurogastroenterology & Motility, 22 (8), 893-900 DOI: 10.1111/j.1365-2982.2010.01516.x
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