Irritable bowel syndrome (IBS) is a common condition that affects the large intestine, or colon. Symptoms usually include abdominal pain, cramps, bloating, constipation, diarrhea, and gas. Other symptoms of IBS may include urgent bowel movements or the feeling of incomplete evacuation.
The bowel muscles that are responsible for moving food through the intestinal tract may contract more forcefully or more irregularly in patients with IBS. This pushes food through the system abnormally. If waste material moves too fast it can cause diarrhea. If it moves too slow it can cause constipation.
Although it may make you uncomfortable, IBS doesn’t cause inflammation, nor will it permanently damage the colon.
Understanding acid reflux and GERD
Gastroesophageal reflux (GERD) is a disease that may cause significant damage to the tissues and cells of the esophagus over time. GERD occurs when stomach acids back up into the esophagus due to a poor-functioning lower esophageal sphincter (LES). The LES is a band of muscle that acts as a valve between the esophagus and the stomach.
The main symptom of both acid reflux and GERD is frequent heartburn. Other symptoms may include burning in the throat or a sour liquid taste in back of the mouth. While occasional acid reflux is normal, GERD symptoms are persistent and typically require treatment to relieve symptoms such as coughing, sore throat, and difficulty swallowing.
The IBS/GERD connection
IBS is classified as a functional disorder. This is a condition in which symptoms are real, but physiological causes aren’t easily identifiable. Although the causes of IBS are unknown, it’s frequently exacerbated by stress.
IBS also often accompanies the chronic form of acid reflux, GERD. This dual presentation suggests that the two conditions may share common disease mechanisms, but these are not well understood.
One mechanism may be poor muscle function of the intestinal tract. Some experts suspect there may be an incoordination of the muscles that line the esophagus, stomach, and intestines, contributing to symptoms of both IBS and acid reflux.
Another observation is that individuals with both IBS and GERD report more sleep difficulties and more episodes of abdominal pain than people who just have IBS or GERD alone.
However, IBS is a complicated condition and less well-understood than GERD. Experts believe there are a variety of individual, intestinal, and environmental factors that contribute to IBS. This makes the relationship between GERD and IBS even more complicated.
Different stimuli may trigger IBS symptoms in different people. For instance, in one person things like intestinal infection or medication may cause symptoms, while other people may react to certain foods or stress.
Women are more likely than men to suffer from IBS. Often, women will find that IBS symptoms are worse during menstruation. This has led researchers to believe that hormones may play a role in the development of IBS.
Foods to avoid
Perhaps not surprisingly, IBS and acid reflux are often triggered by the same kinds of foods. Those suffering from one or both conditions may find relief by avoiding the following:
- alcoholic beverages
- caffeinated beverages, such as coffee
- carbonated beverages, such as colas
- citrus fruits
- fatty and fried foods
- garlic and onions
- spicy foods
- tomato-based foods, such as pizza and spaghetti sauces
- certain sugars like high fructose corn syrup and lactose
- certain sugar alcohols like sorbitol and xylitol
Lactose intolerance rather than IBS
If trigger foods include dairy products such as milk, cheese, or ice cream, the problem may be lactose intolerance, not IBS. People who have cramping or bloating after only eating dairy products should stop eating these foods for a period of two weeks to see if symptoms subside. If symptoms subside after avoiding dairy, speak with your doctor about the possibility of lactose intolerance. If other non-lactose foods in addition to dairy aggravate your symptoms, you are more likely to have IBS.
Treatments for acid reflux with IBS
While medications may provide relief in many cases, the preferred treatment for most people suffering from both acid reflux and IBS is lifestyle and dietary modification. In addition to avoiding certain foods, people with IBS or GERD may find relief by losing weight, quitting smoking, and learning stress-reduction techniques such as deep breathing, exercise, or yoga.
Although lifestyle and dietary changes can benefit many people with IBS, if you have GERD symptoms as well, certain medications may help:
- Proton pump inhibitors, such as omeprazole, are the drugs of choice for GERD sufferers.
- Antacids may be enough to relieve symptoms for people with occasional mild acid reflux.
- Anti-gas medications like simethicone (Gas-X) can work for occasional gas, bloating, and indigestion.
Medications that focus on the management of IBS vary greatly depending on whether the main symptoms are constipation, diarrhea, or both. Your doctor can help guide your treatment.
If you have symptoms of GERD, IBS, or other intestinal problems, see your doctor for a thorough exam. Depending on your symptoms, you will likely need evaluation and testing to determine your diagnosis and which treatment options are best for you.