If you have diarrhea after eating, you may have irritable bowel syndrome

Author: Lou Wenjia Peking Union Medical College Hospital

Reviewer: Zhu Lan, Chief Physician, Professor, Doctoral Supervisor, Peking Union Medical College Hospital

Many friends suddenly feel stomach pain and diarrhea just after eating or when they are eating. At this time, everyone generally thinks that it is because the food is not clean, but it is very likely due to irritable bowel syndrome.

From the name, you might think that irritable bowel syndrome is a symptom caused by a fragile stomach and intestines that are easily irritated?

This explanation is certainly not completely wrong, but we cannot simply assume that it is just a gastrointestinal problem.

So what is going on?

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1. “Pooping after eating” is a disease

As mentioned earlier, some people often have diarrhea after eating, as if the food they eat is not digested at all. This may not be a simple stomach problem, but may be irritable bowel syndrome.

People with IBS experience abdominal pain and bowel movement problems. Its symptoms vary from person to person, with some experiencing stomach pain or bloating after meals, while others experience a variety of bowel movement problems, such as frequent diarrhea and watery stools, constipation, or repeated alternations of diarrhea and constipation.

If you often experience stomach discomfort and abnormal bowel movements during or after eating, you must pay attention to it, seek medical attention promptly, identify the symptoms, and receive timely treatment.

How to diagnose irritable bowel syndrome

There is no specific test that can make a clear diagnosis of irritable bowel syndrome. However, doctors can make a comprehensive judgment by understanding the specific symptoms of the disease. This diagnostic standard is very important and has been continuously updated and is now called the "Rome IV diagnostic criteria."

Recurrent abdominal pain, occurring at least once a week on average in the past three months, accompanied by two or more of the following symptoms: ① Abdominal pain related to bowel movements; ② Abdominal pain with changes in bowel movement frequency; ③ Abdominal pain with changes in stool characteristics (appearance).

The above symptoms have appeared for at least 6 months before diagnosis and have met the above diagnostic criteria for the past 3 months.

Those who can fully meet the above criteria are basically irritable bowel syndrome, but some patients' symptoms do not fully meet them. Therefore, the above diagnostic criteria are not the only ones, but they can provide a certain basis for the doctor's diagnosis.

If the symptoms do not meet the Rome IV diagnostic criteria, other non-invasive examination methods that can be used as references include blood routine, C-reactive protein, stool routine + fecal occult blood test, fecal calprotectin, celiac disease serology test and thyroid function test, etc. In certain cases, lactose malabsorption breath test or dietary elimination test can be considered.

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3. Can Irritable Bowel Syndrome be Cured?

The treatment of irritable bowel syndrome can be roughly divided into two categories, one is non-drug treatment and the other is drug treatment. But no matter which one, it only improves the symptoms and cannot completely cure it.

Non-drug treatment methods include giving good lifestyle advice and guidance tailored to the patient's specific situation. They are as follows.

1. Keep a food diary to record what you eat, do, and feel every day. This can help patients understand whether what they do or eat makes their symptoms better or worse.

2. Avoid foods that make symptoms worse. Avoid foods that easily cause gas, such as dairy products. Consult your doctor to find out which foods may make symptoms worse.

3. If constipation occurs, increase the intake of fiber in your diet. You can eat more fruits and vegetables, or choose fiber tablets and powders. However, if excessive fiber intake causes symptoms to worsen, you should reduce your intake in time.

4. Keep exercising, 3 to 5 days a week, 20 to 60 minutes each time. Studies have shown that exercise can effectively improve the symptoms of irritable bowel syndrome.

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In addition, some drugs can relieve the symptoms of irritable bowel syndrome, but they cannot completely cure it, including some specific antibiotics. In addition, studies have shown that peripheral opioid agonists, mixed opioid agonists/antagonists, bile acid sequestrants and 5-hydroxytryptamine receptor antagonists can also be used to improve symptoms under appropriate conditions, but they are not commonly used clinically. If you use drugs, be sure to use them with caution under the guidance of a doctor.

In addition, stress and anxiety can also aggravate the symptoms of irritable bowel syndrome, so psychological counseling can also help patients relieve symptoms.

Once diagnosed with irritable bowel syndrome, symptoms may accompany you for life. However, most patients can still find ways to improve their symptoms. Therefore, do not give up after the diagnosis and communicate more with your attending physician.

References

[1] Wu Jianye, Guo Chuanyong, Zhang Jie, et al. Research progress in diagnosis and drug treatment of irritable bowel syndrome[J]. Medical Monograph, 2019, 40(5): 302-308.

[2] Gao Lian, Huang Xiaoming, Wu Qingming. Research progress in the treatment and prevention of irritable bowel syndrome[J]. Chinese Journal of General Practice, 2022, 25(9): 1148-1154.