Living With IBS and GERD
If you have IBS, research shows, you are much more at risk for GERD. Learn about both conditions and symptoms management that may help.
By Chris Iliades, MD
Medically Reviewed by Pat F. Bass III, MD, MPH
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In the alphabet soup of digestive disorders, IBS and GERD aren’t just problematic on their own — they often occur together.
Irritable bowel syndrome, or IBS, causes belly pain along with changes in bowel habits, either diarrhea or constipation. Gastroesophageal reflux disease, or GERD, causes acid reflux, commonly referred to as heartburn. Having one of these conditions can be bad enough, but many people have to deal with both.
Several studies have found a strong link between GERD and IBS. A 2010 study published in the World Journal of Gastroenterology looked at data on more than 6,000 people and found that about 63 percent of those diagnosed with IBS also had GERD symptoms. The research also showed that having both GERD and IBS was more common in women, and that having both conditions made all symptoms worse.
“Is there a link between IBS and GERD? Absolutely,” said Maged Rizk, MD, a gastroenterologist and director of the Chronic Abdominal Pain Center at the Cleveland Clinic in Ohio. “I see it all the time in our clinic. If you combine the results of all the studies, GERD is probably about four times more common in people with IBS.”
Stephanie Sikora, a 23-year-old university student from Calgary, Alberta, Canada, is one of those people who has both IBS and GERD. “My symptoms consist of heartburn, severe stomach cramps, constipation, bloating, gas, and sometimes nausea,” she said. “They began back in January 2010, shortly after I recovered from a case of the flu. After various diagnostic tests and emergency-room visits for the pain, I was finally officially diagnosed in April 2012 with IBS and GERD. I am also a migraine sufferer, and I find that my digestive symptoms and migraines often go hand-in-hand.”
How Are IBS and GERD Linked?
One link is that both IBS and GERD are extremely common. You may be diagnosed with IBS, which affects up to 20 percent of the population, if you have symptoms of abdominal pain at least three times a month for at least three months, and that pain cannot be explained by any disease or injury. GERD causes acid reflux and regurgitation; about 7 percent of the population experiences it on a daily basis.
“The links between GERD and IBS are mostly hypothetical, but probably involve an increased sensitivity of the digestive system,” Dr. Rizk said. “People with GERD and IBS become uncomfortable at a lower threshold than people without these conditions. We call that visceral hypersensitivity.”
Another link between IBS and GERD symptoms may be gastrointestinal motility, referring to the process of moving food through the digestive system. If the movements are disordered, it’s called motility disorder. Some experts now consider both IBS and GERD to be motility disorders.
“Stress and food sensitivities may be other links,” Rizk said. “There is a strong link between mental stress and digestive stress. Stress is a known trigger for both IBS and GERD symptoms.”
“My symptoms are triggered by a combination of stress and food,” Sikora said. “Food is the main culprit. For the first three years after the symptoms began, I could only eat an extremely bland and simple diet, often living off applesauce and rice cakes for weeks at a time.” However, she also has an anxiety disorder that became apparent about the same time as the IBS and GERD. “I find that stress does play an important role, as these conditions definitely feed off of each other,” she said.
Symptoms Management for GERD and IBS
Rizk said that diet and lifestyle changes that reduce stress should benefit both IBS and GERD. “An elimination diet that starts with very bland and simple foods, and then introduces new food groups in stages, may help identify foods that trigger symptoms,” Rizk said. “Each condition may also be treated separately with medications. Antacid and acid-blocking medications are often used for GERD; antispasmodic medications and anti-anxiety medications may be used for IBS.”
That’s in line with Sikora’s treatment. “I manage through a combination of diet, medication, and lifestyle changes,” she said. “I am on a proton-pump inhibitor twice a day for the GERD, and always carry a supply of over-the-counter antacids. The IBS has improved a lot since I began taking a medication for my anxiety. However, I still rely on antispasmodic medication and heating pads for my bad IBS days.”
Despite her conditions, Sikora has managed to get both IBS and GERD under control enough to resume an active life — working part-time as a preschool teacher and pursuing a master’s degree in psychology.
“I am able to eat a greater variety of foods these days, but still have trouble with spicy, acidic, processed foods, nuts, and high-fat foods,” she said. “I do my best to avoid those trigger foods and to add probiotics and fiber to my diet, which seems to help both the IBS and GERD.”
But there’s more. “I've also learned not to sweat the small stuff,” Sikora said.
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