What to Do If You Have IBS and GERD

Some scientists believe they may be the same disease

man at diner with heartburn
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In one of those unfortunate twists of fate, persons with irritable bowel syndrome (IBS) will often find themselves having to deal with another disorder, known as gastroesophageal reflux disease (GERD), affecting the upper GI tract.

In fact, studies suggest that anywhere 25 percent to 32 percent of people with IBS will suffer both disorders. Because IBS and GERD share many of the same characteristics, as many as 81 percent will experience an overlap of symptoms.

This can sometimes lead to a delay in the diagnosis of the co-existing (comorbid) condition as well as the delivery of appropriate treatment.

Understanding why this happens can help you develop a more effective strategy for managing your range of symptoms if you both IBS and GERD.

Signs and Symptoms GERD

GERD is a condition in which the sphincter at the bottom of your esophagus does not work properly. Because of this, the contents of the stomach can sometimes back up (reflux) into the esophagus.

Symptoms of GERD include:

  • A burning sensation in the chest (heartburn), sometimes spreading to the throat accompanied by a bitter taste in the mouth
  • Regurgitation of food or liquid (acid reflux)
  • Chest pain
  • Difficulty swallowing (dysphagia)
  • Dry cough
  • Sore throat
  • Hoarseness
  • Sensation of a lump in the back of your throat

Causes of Comorbid IBS and GERD

There are no definitive answers as to why these two disorders co-existing.

However, some people are starting to believe that it is not so much as an issue of cause but rather one of definitions. There are those who believe, for example, that IBS is but one aspect of the full spectrum of GERD.

Others have hypothesized that both IBS and GERD are triggered by a common digestive dysfunction.

One such theory suggests that visceral hypersensitivity (the extreme sensitivity of internal organs) can trigger abnormal intestinal contractions (motility dysfunction) that can affect either the upper or lower GI tract depending on where the contractions are located.

If this were the case, it would suggest that IBS and GERD are one and the same disease. This theory is supported, in part, by evidence which shows that 22 percent of people with revert back and forth between periods when they solely have symptoms of IBS and other when they solely have symptomss of GERD.

Treating IBS and GERD

If you suffer from both IBS and GERD, it is important to work with your doctor to develop a comprehensive management plan to address both conditions. This may include a combination of diet, stress reduction, and prescription and non-prescription medications.

Part of the goal would be to identify any trigger foods that cause IBS and/or GERD. An elimination diet involving bland foods is often used to establish a baseline during which there are no symptoms. Gradually, over time, new foods are introduced to see which trigger IBS, GERD, or both.

Each condition would then be treated separately with medications.

Antacids and acid-blocking medications are typically used for GERD. Antispasmodics and anti-anxiety medications are common, first-line treatments for IBS.

Sources:

Gasiorowska, A.; Poh, C.; and Fass, R. "Gastroesophageal Reflux Disease (GERD) and Irritable Bowel Syndrome (IBS)—Is It One Disease or an Overlap of Two Disorders?" Digestive Diseases and Sciences. 2008; 54:1829-34.

Lee, S.; Lee, K.; Kim, S. et al. "Prevalence and risk factors for overlaps between gastroesophageal reflux disease, dyspepsia, and irritable bowel syndrome: a population-based study." Digestion. 2009; 79:196-201.

Sperber, A. and Dekel, R. "Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes." J Neurogastrointen Mobil. 2010; 16(2):113-119; DOI: 10.5056/jnm.2010.16.2.13.

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