Irritable Bowel Syndrome (Gas Type): What Are the Causes?
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The feeling of an extremely bloated and distended abdomen: What is gas-predominant Irritable Bowel Syndrome (IBS)? For those who experience abdominal discomfort even without diarrhea.
Hello. This is Baeknokdam Korean Medicine Clinic.
Today, we would like to discuss gas-predominant IBS, a lesser-known but actually very common type of Irritable Bowel Syndrome.
“My abdomen feels full immediately after eating.”
“I can’t stop burping, and my stomach keeps making gurgling noises.”
“I go to the bathroom as usual, but this bloating is extremely uncomfortable.”
You've probably heard sentiments like these before, haven't you? Many of you might even be experiencing this yourselves.
However, when tests at the hospital reveal nothing is wrong, it's easy to just endure it or dismiss it by thinking, 'I must be too sensitive.'
But this is not simply a matter of sensitivity. Something is actually going wrong in your intestines.
The Lesser-Known Type – Gas-Predominant IBS
Irritable Bowel Syndrome, commonly known as IBS, is usually divided into diarrhea-predominant (IBS-D), constipation-predominant (IBS-C), and mixed-type (IBS-M).
However, there is another type that we frequently hear about in clinics: those who don't suffer from diarrhea or constipation, but experience frequent abdominal bloating, excessive burping, and intestinal noises, which makes their daily life difficult.
This is what we commonly refer to as 'gas-predominant IBS.' While not an official classification, a great many people actually suffer from these symptoms.
Gas-Predominant IBS: It's Not Simply About Having a Lot of Gas
These symptoms aren't something you can just dismiss by thinking, 'Oh, I must have some gas in my intestines.' There are quite complex mechanisms at play.
For example, there are cases where there's an excessive amount of bacteria in the small intestine, where it shouldn't be. Normally, the small intestine should have very few bacteria, but when bacteria from the large intestine migrate upwards, they ferment sugars in the small intestine prematurely.
When gases like hydrogen or methane, produced during this process, put pressure on the intestines, you experience a feeling of rapid abdominal distension and fullness after meals. This is called SIBO (Small Intestinal Bacterial Overgrowth), and a significant number of gas-predominant IBS patients actually fall into this category.
However, it's not just a bacterial issue. Some people experience abdominal distension even without a large amount of gas in their intestines. This is because their intestines are overly sensitive to that gas.
Their sensory nerves are hypersensitive, so even slight distension makes the brain perceive it as if 'the abdomen is about to burst.' This can be seen as a state of visceral hypersensitivity.
Furthermore, there are cases where gas doesn't escape easily. If peristalsis is not smooth, or if the anal sphincters are tense, the gas remains trapped inside, leading to a feeling of distension.
Some people even say, 'My abdomen is bloated, but no matter how long I wait, I can't pass gas.'
Additionally, people whose abdominal walls are not flexible, or who don't practice diaphragmatic breathing effectively, may feel much more uncomfortable even with the same amount of gas. This means body shape, tension levels, and breathing habits also play a role.
Food also plays a part. Foods that we commonly consider healthy, such as vegetables, fruits, legumes, and dairy products, can actually cause rapid fermentation and generate gas in some individuals.
Especially fermentable carbohydrates, known as FODMAPs, are a significant trigger for gas-predominant IBS patients.
Finally, stress and states of tension amplify all of this. The intestines are very sensitive to emotions. The gut and brain communicate in real-time, so when the brain sends a signal like 'I'm anxious,' the intestines react in the same way.
That's why some people experience symptoms like abdominal bloating, gurgling, and discomfort just before a presentation or during meetings. This is also referred to as a problem with the gut-brain axis.
Relationship with SIBO
Among gas-predominant IBS patients, it is very common to find Small Intestinal Bacterial Overgrowth, or SIBO, as the symptoms are almost identical.
Abdominal fullness immediately after meals, increased burping, intestinal noises, and a feeling of being completely full – these symptoms appear exactly the same in SIBO patients.
Therefore, gas-predominant IBS can also be a starting point for suspecting SIBO.
It's Not About Enduring, But About Reading the Signals
Many people dismiss this by saying, 'You're too sensitive.' However, this isn't sensitivity; it's a signal from your intestines.
When something is wrong, your intestines protest in ways like bloating, burping, or making noises. Even if tests show nothing abnormal, this discomfort is a real issue.
Functional abnormalities, sensory problems, nervous system issues – all are areas that can be approached pathologically. So, don't just dismiss it.
This isn't just a matter of having some gas; it could be a structural message that your intestines are not functioning properly.
Instead of simply enduring this discomfort, it's time to find the exact cause and consider treatment directions that can restore intestinal function.
Thank you.