In recognition of IBS Awareness Month, Dr. Eyad Alakrad, Consultant Gastroenterologist and Director of GI Motility Services at Sheikh Shakhbout Medical City (SSMC), sheds light on the complexities of Irritable Bowel Syndrome (IBS)—a highly prevalent but often misunderstood disorder. Emphasizing the shift from viewing IBS as a vague “functional disorder” to a recognized Disorder of Gut-Brain Interaction (DGBI), Dr. Alakrad outlines SSMC’s diagnostic and management strategies rooted in clinical rigor and holistic care.
From the use of Rome IV criteria to non-invasive testing and dietary interventions like the low-FODMAP plan, Dr. Alakrad underscores a personalized approach tailored to each IBS subtype. He also discusses how stress, sleep, and emotional well-being directly impact symptoms, advocating for integrated mental health support including CBT and gut-directed hypnotherapy.
Addressing persistent misconceptions, he urges greater empathy and awareness, noting that IBS is far more than a “stomach issue.” Through community outreach, patient education, and advancing diagnostics, SSMC remains committed to improving IBS care and reducing stigma.
Dr. Alakrad’s key message: Gut health is foundational—not just to digestion, but to mental and physical well-being.
April marked IBS Awareness Month. How important is this initiative in helping patients and the public better understand Irritable Bowel Syndrome?
IBS Awareness Month plays a vital role in educating both the public and healthcare professionals about the true burden of Irritable Bowel Syndrome. It sheds light on the natural history of the condition, the latest diagnostic tools, and evolving management strategies. More importantly, it helps bridge the understanding gap between patients and providers, fostering more empathetic, effective care.
Could you briefly define IBS and explain how it differs from other gastrointestinal disorders?
Irritable bowel syndrome is chronic group of gastrointestinal symptoms characterized of recurrent abdominal pain and change to bowel habits. It has high prevalence and can be debilitating. It is important to make a distinction between a syndrome which is a group of symptoms without any identifiable underlying cause, and a disease which is health condition with clear reason behind it.
IBS is often called a “functional disorder.” What does that mean, and how does it affect the diagnostic process?
Today, we refer to IBS and related conditions as Disorders of Gut-Brain Interaction (DGBI). These disorders involve disruptions in how the gut and brain communicate—affecting motility, sensitivity, and even immune responses—without any visible abnormalities on standard tests like endoscopy or imaging. Therefore, diagnosis relies on clinical criteria, such as the Rome IV guidelines, alongside a limited number of tests to rule out other serious conditions.
What are the most common symptoms your patients at SSMC present with, and how can IBS be differentiated from more serious conditions like IBD or celiac disease? Is there any specific test for IBS, how do you approach diagnosis at SSMC?
At SSMC, the most frequent IBS symptoms we see are recurrent abdominal pain along with constipation, diarrhea, or both. To rule out other conditions with overlapping symptoms, such as celiac disease or IBD, we use non-invasive tests—like anti-tTG antibodies, CRP, and fecal calprotectin. If patients exhibit red flag symptoms—such as unexplained weight loss, anemia, or blood in stool—more advanced investigations like endoscopy may be required. We follow a positive diagnostic strategy rather than a diagnosis of exclusion, using the Rome IV criteria and targeted tests to confirm IBS.
What is the key lifestyle, dietary, or emotional triggers you typically see in IBS patients?
We commonly observe several overlapping triggers: poor sleep, irregular eating habits, lack of physical activity, and unmanaged psychological stress. Emotional factors, especially anxiety and chronic stress, often exacerbate symptoms, underlining the need for a holistic, personalized care model.
Are there specific risk factors such as gender, age, or family history that increase the likelihood of developing IBS?
Yes. Women are 2–4 times more likely to develop IBS, and it’s more prevalent in individuals under 45. A significant number of patients with mood and anxiety disorders are also diagnosed with IBS. Additionally, post-infectious IBS can occur in up to 10% of people after a gastrointestinal infection. Gut microbiome imbalances, genetic factors, and adverse childhood experiences have all been implicated in increasing susceptibility.
IBS doesn’t have a “one-size-fits-all” treatment. What are some of the personalized approaches SSMC uses to manage IBS effectively?
Exactly—there’s no universal treatment for IBS. We tailor management based on the patient’s IBS subtype: IBS-D (diarrhea predominant), IBS-C (constipation predominant), or IBS-M (mixed). For instance, in IBS-C, we might prescribe newer medications that target both constipation and abdominal pain. It’s essential not to treat symptoms in isolation—for example, using an antispasmodic in IBS-C can worsen constipation in some cases. Our goal is always to address the broader symptom pattern while minimizing side effects.
How can dietary interventions, such as the low FODMAP diet, improve the quality of life for IBS patients?
The low-FODMAP diet restricts certain carbohydrates that are poorly absorbed and rapidly fermented in the gut, leading to symptoms like bloating, pain, and irregular bowel habits. We guide patients through a structured 3-phase plan: (1) elimination of high-FODMAP foods for 4–6 weeks, (2) gradual reintroduction to identify triggers, and (3) personalizing the long-term diet based on identified sensitivities. When done correctly—preferably with a dietitian—it can significantly improve symptoms and quality of life.
What role does stress play in IBS flare-ups, and how do you integrate mental health support into patient care?
Stress—both acute and chronic—is a well-established trigger for IBS symptoms. We first educate patients about the benign but impactful nature of the condition, which often brings some relief. If mental health concerns are ongoing, we refer patients for cognitive behavioral therapy or gut-directed hypnotherapy, both supported by strong evidence and GI society guidelines. For more severe cases, we collaborate with psychiatrists to select appropriate medications—like tricyclic antidepressants for IBS-D and SSRIs for IBS-C.
Is SSMC involved in any ongoing research or clinical trials aimed at better understanding or treating IBS? Are there any emerging diagnostic tools or treatments for IBS that you find promising?
While we’re not currently conducting IBS-specific research at SSMC, our institution is highly committed to fostering clinical research across specialties. We’re optimistic that opportunities in IBS will grow. Exciting developments include emerging blood-based biomarkers to aid in diagnosis, although more validation is needed. On the treatment front, newly approved medications like Tenapanor for IBS-C and Alosetron for IBS-D have shown promise for patients with severe, refractory symptoms.
Many people dismiss IBS as “just a stomach issue.” What are some of the most common misconceptions you encounter?
The most harmful myth is that IBS is “all in the patient’s head.” Because it lacks visible abnormalities on tests, patients may feel disbelieved or stigmatized—sometimes even by their own doctors. This can lead to delayed care, social withdrawal, and worsening of symptoms. Recognizing IBS as a legitimate, complex disorder is crucial to better care and patient well-being.
How can greater awareness during IBS Awareness Month reduce stigma and encourage earlier diagnosis?
Awareness initiatives can break down stigma, enhance patient-provider trust, and improve understanding of IBS as a serious condition with real quality-of-life impacts. When people understand the disorder better, they’re more likely to seek care earlier, leading to quicker diagnosis and more cost-effective management.
What advice would you give to someone who suspects they may have IBS but hasn’t sought medical attention yet?
You are not alone. IBS is common, and there are more resources and support options available than ever before—from online communities to well-informed providers. Advances in diagnostics and treatment have made IBS more manageable. Don’t let it define your life—seek medical attention and reclaim your wellbeing.
How is SSMC supporting patients during IBS Awareness Month, and are there any initiatives or outreach programs currently running? What message would you like to share with the wider community regarding gut health and IBS?
At SSMC, we prioritize community engagement through media outreach, seminars, and internal education sessions. For example, I recently gave a lecture to internal medicine colleagues on IBS management. This very interview is part of that mission—to spread awareness and foster understanding.
My message to the community is simple: Gut health is essential to both physical and mental well-being. The gut-brain connection is real, and understanding it can empower people to make healthier choices, detect issues earlier, and ultimately lead a better life.
source : Mediworld
