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What is IBS?

IBS should not be confused with inflammatory bowel diseases (IBD). It is a functional disorder of the gut usually presenting with abdominal discomfort (pain or cramps) and altered bowel movements with an unspecific cause. The Rome diagnostic criteria describes IBS as recurrent abdominal pain/discomfort at least 3 days monthly for 3 consecutive months associated with 2 or more of:

  • Pain/discomfort relieved with bowel emptying
  • Pain/discomfort associated with change in frequency of movement
  • Pain/discomfort associated with appearance of stool

Various mechanisms to the underlying cause of IBS have been postulated, they are:

Determinants

Explanation

Genetic

Although environmental factor largely contributes to IBS, genetics have been found to have a modest role. IBS is seen to cluster within families experiencing similar symptoms. Studies have identified possible variations in genes responsible for impairment of gut signalling pathways. Furthermore, individuals who are genetically predisposed to over-reactive immune function may develop more severe inflammation in the gut following infections.

Change in gut motility

Though unclear, it has been postulated that the alterations in gut responses to intestinal distension from gas or from peristaltic motions (gut contractions to enable passage of food) may account for an over-active bowel.

Hypersensitivity to pain

Due to variation in pain innervations of the gut, some individuals have an altered perception to normal digestive processes in the gut. Thus, intestinal movement and distension usually after eating may cause an acute sensation of pain or cramps.

Psychological cause

Individuals who are more likely to have IBS have also been found to be psychologically inclined to feel more worried or distressed about having a certain disease. Other causes, though unclear are feelings of anxiety, depression and lifestyle-related stress.

Inflammation

Infections can cause a temporary phase of IBS also during recovery due to stimulation of immune function which disrupts normal gut processes. Another theory is an overgrowth of bacteria in the gut producing excessive gas and gut distension.  As certain foods are more allergenic than others, underlying food intolerances such as coeliac disease and lactose intolerance have also been associated with IBS.

Training & IBS Management

  • Physical exercise may have a double effect on the gut in which mild-moderate activity can relieve constipation but diarrhoea and abdominal pain may be exacerbated by sudden strenuous exercise. Even elite athletes have been found to experience gut problems at some point due to exercise-induced changes in the normal interaction of the digestive, nervous, hormonal and immune systems. Hence, lifestyle modifications especially in training and diet are recommended.
  • Effective training techniques should be included in normal regimes. For example participating in long-endurance exercises may cause diarrhoea. Hence, short interval exercises with moderate intensities would be preferable. Strength training with maximal intensity is not the only route to achieving a well-defined physique (refer to training method sections).
  • Probiotics are naturally occurring bacteria found in fermented foods such as yogurt, sauerkraut and kimchi that have been found to benefit our health. Probiotic supplementation, whether pharmaceutical or natural will help maintain a balance of good and bad bacteria in the gut. Although more scientific studies are required to assess the ergogenic effects of probiotics, a healthy gut indirectly contributes to improved digestive and immune function, possibly reducing the severity of allergies.
  • Given that food intolerance may also be responsible for IBS, avoiding foods which cause abdominal pain/discomfort and altered bowel habits can be beneficial. However, this may take trial and error to identify particular foods in the diet. Wheat fibre for example may be help relieve constipation or worsen symptoms in other individuals (refer to “allergenic foods list”, another topic to write on here)
  • Ultimately, the psychological aspect of training can definitely contribute in various aspects from reducing anxiety and stress to encouraging a positive mindset to cope with any barriers to achieving your bodybuilding goals.

Casey, E., D.J. Mistry and J.M. MacKnight, 'Training room management of medical conditions: sports gastroenterology' (2005) 24(3) Clinics in sports medicine 525Heiman, D.L., T.S. Lishnak and T.H. Trojian, 'Irritable bowel syndrome in athletes and exercise' (2008) 7(2) Current Sports Medicine Reports 100
Mayer, E.A., 'Irritable bowel syndrome' (2008) 358(16) The New England journal of medicine 1692Medscape.com, Medscape Reference: Drugs, Diseases & Procedures (2011)  <http://reference.medscape.com/medicalstudents
Nichols, A.W., 'Probiotics and athletic performance: A systematic review' (2007) 6(4) Current Sports Medicine Reports 269
Öhman, L. and M. Simrén, 'New insights into the pathogenesis and pathophysiology of irritable bowel syndrome' (2007) 39(3) Digestive and liver disease 201

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