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Sunday, April 13, 2014

IBS Awareness Month 2014

5:02 AM Posted by Tiffany Taft , , ,
Every April is IBS Awareness Month, and we're half way through already.  You may have heard of Irritable Bowel Syndrome before, a relatively common condition that affects around 15% of the U.S. population and 7-10% of the global population.  Even though IBS is common, there's still a lot of misinformation out there about it; partly because the medical community itself still hasn't really figured out IBS, and partly because of stigma related to conditions that affect our poop.


IBS is a chronic condition of the digestive tract that causes abdominal pain, bloating, altered bowel habits (constipation, diarrhea, or altering back and forth between these two), fatigue, and nausea.  Once considered a diagnosis of exclusion - aka you were told you have IBS when they ruled out other things like Inflammatory Bowel Disease (IBD), colon cancer, or diverticulitis - there are now set diagnostic criteria for IBS known as the Rome III criteria.
Rome III Criteria for IBS
I've seen a lot of people living with IBS.  My first research studies were on IBS, including the aforementioned stigma, and I've been involved in a large, multicenter clinical trial using cognitive-behavioral therapy to treat IBS.  So I've heard a lot of stories about life with this chronic illness from all sorts of people, enough to know that while IBS is a "functional" condition, its potential for being severe and debilitating should never be undermined.  I'm not going to get into the physiology of IBS right now as this is an emerging field of understanding.  However, the predominant theory of IBS is that the brain-gut axis malfunctions and results in the functioning of the digestive tract to be thrown into a tizzy (technical term).  Why this happens is unclear, and some patients struggle with the nebulous nature of IBS.  Combined with a lack of good pharmacological treatments, IBS can be a downright maddening condition.

So what are some of the facts about IBS?  Let's learn.  Because I'm a research nerd, here are some factoids about IBS.  There's a test next Tuesday.
  • IBS results in a $20 billion economic burden, annually.  This is both from direct medical costs and lost work productivity.  This is also second only to the common cold.
  • Women are 1.5 times more likely to have IBS than men.
  • While not part of the Rome III criteria, 76% of people with IBS report abdominal bloating as a symptom.
  • Our digestive systems have their own nervous system, called the enteric nervous system, which contains 95% of the body's serotonin. Serotonin is a chemical in the body that's implicated in mood and an overproduction of serotonin can cause IBS with diarrhea while too little can cause IBS with constipation.
  • People with IBS with constipation spend around $11,000 annual on health care costs related to their condition, compared to $4,800 for healthy controls  Of that $11,000, 78% is for medical services and 22% for prescription medication.
  • People with IBS feel to a greater degree processes such as hunger, fullness, passage of food, and bowel sounds than those without the condition, and this hypersensitivity is thought to be a main contributor to abdominal pain in IBS.
  • In a study in Canada, people with IBS reported 5.6% work absenteeism, 31.4% presenteeism (being at work but not really working), and 34.6% overall work productivity loss, which is equivalent to 13.8 hours lost productivity per 40-hour workweek.  Similar findings occur in the U.S.
  • Many people with IBS report a negative effect on their mood, with 30% experiencing significant anxiety, 28% reporting depression, and 15% having panic disorder.  
  • Finally, IBS and IBD are not interchangeable terms.  I don't know how many times I've seen "Irritable Bowel Disease" and "Inflammatory Bowel Syndrome" out there, including on reputable news websites.  Yes, they're both diseases of the digestive tract with similar symptoms but very different physiology and treatments.