35-year-old Mehul Sharma was diagnosed with Irritable Bowel Syndrome (IBS) after he visited the doctor for painful abdominal cramps with diarrhoea and bloating. IBS is a functional gastrointestinal disorder in which there aren't any identifiable structural or biochemical abnormalities in the digestive tract; rather, it involves problems with how the brain and gut work together, leading to increased sensitivity and altered muscle contractions in the intestines. This means that in people with IBS, the digestive system doesn't work as it should, even though it appears normal on standard tests.
While Mehul has learnt ways to avoid triggers that cause or worsen IBS flare-ups, time and again, he finds himself questioning whether his IBS can increase his risk for cancer. And this is the case with most patients with IBS. To answer this common doubt, the OnlyMyHealth team spoke toDr Sharad Malhotra, Senior Consultant and Director -Gastroenterology, Aakash Healthcare, Delhi.
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How Does Irritable Bowel Syndrome (IBS) Affect Digestion?
"IBS is a gastrointestinal condition that leads to abdominal pain, bloating, gas and altered bowel habits such as diarrhoea or constipation," explained Dr Malhotra. "It also influences digestion by interfering with the motility of the gut – if slowed, constipation and bloating ensue, and conversely, rapid gut motility results in diarrhoea."
According to the doctor, IBS is not an organ-damaging disease but affects the quality of life and is caused by stress, diet or gut-brain problems.
Can IBS Cause Cancer?
The good news is IBS does not predispose to colon cancer. "There has been no evidence of a direct relationship, and in some cases IBS patients were shown to have fewer colorectal polyps as a result of the numerous screenings," said Dr Malhotra.
A 2015 Taiwanese study published in the Annals of Epidemiology followed nearly 30,000 people with IBS to see if they had a higher risk of cancer. At first, results showed slightly higher rates of cancers like colon, liver, pancreas, and kidney. But when cancers found within the first year of IBS diagnosis were excluded, the risk was no longer significant.
This suggested that the increase may be due to early testing and detection rather than IBS itself causing cancer. However, more research is needed to confirm the link.
In contrast to Inflammatory Bowel Disease (IBD), an illness that increases the risk of cancer, IBS is a functional illness. Symptoms that persist should be re-examined as a way of eliminating other complications, but IBS is not a precancer symptom.
Colonoscopy is advised among the high-risk patients.
How To Differentiate Between Symptoms Of IBS Vs. Colon Cancer?
The symptoms of IBS that overlap with colon cancer include:
- Abdominal pain and cramps
- Bloating
- Alterations of bowel movements
- Mucus in the stool
- Incomplete bowel evacuation
Dr Malhotra shared, “The symptoms of cancer can be subtle, and at the start they resemble IBS, which is harmless. Such red flags as weight loss or bleeding are helpful in distinguishing them. To make the diagnosis accurate, it is necessary to carry out tests such as endoscopy to eliminate such severe diseases as cancer or IBD.”
Also Read: Colon Cancer Vs. Irritable Bowel Syndrome (IBS): How To Tell The Difference
Warning Signs IBS Patients Should Never Ignore
The symptoms of IBS, such as abdominal pains, bloating, and alterations of bowel movements, converge with colorectal cancer symptoms, which are confusing. Both may show cramping, mucus in the stool or incomplete evacuation. The symptoms of cancer can be subtle, and at the start they resemble IBS, which is harmless. Such red flags as weight loss or bleeding are helpful in distinguishing them. To make the diagnosis accurate, it is necessary to carry out tests such as endoscopy to eliminate such severe diseases as cancer or IBD.
Some of the symptoms or warning signs people with IBS should never ignore or overlook include:
- Unintentional weight loss
- Rectal bleeding
- Blood in the stool
- Anaemia
- Incessant vomiting
- Agonising constant pain
Moreover, the symptoms that develop after the age of 50 should never be overlooked by IBS patients. Drenching night sweats, fever, or detectable masses are also clues to more serious problems such as cancer or IBD, which are not characteristic of IBS. "These need a prompt medical diagnosis, including blood tests, scans, or colonoscopies that can be very dangerous to pre-existing illnesses," Dr Malhotra emphasised.
What Does Long-Term IBS Management Look Like?
“To manage IBS in the long term, practise a low FODMAP diet, therefore avoiding trigger foods and small frequent meals, and consider more soluble fibre (oats, psyllium),” Dr Malhotra advised.
FODMAP stands for Fermentable Oligo-, Di-, Mono-saccharides, and Polyols, which are a group of short-chain carbohydrates poorly absorbed by the small intestine.
Other recommendations include:
- Avoid spicy foods, caffeine, and alcohol.
- Exercise 30 minutes a day.
- Engage in stress-relieving exercises such as yoga or mindfulness.
- Get enough sleep.
Conclusion
IBS is often a harmless condition and does not cause cancer. However, it can affect patients’ quality of life and make it difficult to go about day-to-day activities. However, it is crucial to monitor the symptoms and address any signs that signal towards a more serious condition like colon cancer. The two ailments can sometimes coincide and hence, lead to confusion and delay in diagnosis. Hence, regular screening is advised.