April is recognized as Irritable Bowel Syndrome (IBS) Awareness Month. Throughout the month, we raise awareness for the gastrointestinal disorder that may greatly influence the way of life of those affected. Dr. Osman Ahmed, a Gastroenterologist at Humber River Health, often assists patients with IBS. In honour of the month, Dr. Ahmed has provided useful information to help educate the community on the signs and symptoms of IBS.

Tell us about your role.
We have a fairly robust digestive diseases program at Humber River Health and are one of the largest and most comprehensive centres in Ontario. Within this program, I cover gastroenterology and hepatology-related diseases. I am also one of the therapeutic endoscopists involved in patients with pancreatobiliary diseases and gastrointestinal malignancies. We are one of the few hospitals in all of Canada that provide an almost full-spectrum of services including endoscopy, endoscopic ultrasound, ERCP, capsule endoscopy, motility, pediatric GI, laparoscopic-assisted endoscopy, and more. We also have an extensive surgical program that we collaborate with regularly.

What is Irritable Bowel Syndrome (IBS)?
Irritable Bowel Syndrome, also known as IBS, is a group of diseases characterized by specific symptoms of the gastrointestinal tract. The main characteristics is that it is chronic and associated with abdominal pain and change in bowel habits. It is the most common gastrointestinal condition encountered by people.

What are the symptoms?
IBS symptoms can vary widely. They can range from mild to severe. Common symptoms include abdominal pain, bloating, abdominal cramping, constipation, diarrhea, and belching.

What causes IBS?
We do not know for sure what causes IBS. Some theories point to it being caused due to a combination of environmental factors, diet, increased abdominal sensitivity, stress/anxiety, fecal microbiome, and genetics.

How is IBS treated?
Since IBS has such a varied presentation, there is no one-size-fits-all. Each therapy has to be tailored to each patient in accordance with their symptoms. For example, patients with diarrhea-predominance might be treated differently than those with constipation-predominance. The mainstay of treatment includes:
• Diet modifications
• Ensuring regular bowel movements
• Ensuring you are taking adequate fibre and hydration
• Practicing physical activity and cognitive therapies
In terms of medications, they depend on the predominant symptom but can include laxatives, anti-diarrheals, anti-depressants, and anti-cholinergics.

Why is IBS Awareness Month important?
IBS is the most common referral to a gastroenterologist and one of the most common reasons for primary care visits. It is also one of the most common reasons for absence from work. Although IBS is generally not associated with serious health problems, it is important to be aware of the condition to allow for re-assurance and early-targeted therapy. In addition, it is very important for patients to know about red flags such as rectal bleeding, weight loss, anemia, and family history that should trigger further investigations to rule out more ominous pathology.

What are some tips to practice proper gut health & potentially avoid IBS?
The most important tips that I tell all my patients is the importance of a healthy diet and physical activity. A well-balanced diet with appropriate fiber and hydration is paramount for good gut health. In addition, physical activity and exercise are not only helpful for overall health, but specifically for the gut as well. Finally, addressing mental health issues can also improve gut health due to the gut-brain axis.