Irritable Bowel Syndrome (IBS)

Introduction

Irritable bowel syndrome (IBS) is a disorder that affects the functioning of the gut or colon, and is estimated to affect between 10 and 20 per cent of the population. The actual number of people with IBS may be higher, as people with IBS symptoms do not seek medical advice due to embarrassment. Although there is no cure for IBS, there are treatments available to help manage the symptoms.

1. What is irritable bowel syndrome (IBS)?
2. What are the symptoms of IBS?
3. What are the causes?
4. How is IBS diagnosed?
5. What is the treatment for IBS?
6. How to help yourself

What is irritable bowel syndrome(IBS)?

The muscular wall of the gut or colon normally contracts rhythmically to move food from the stomach to the rectum.

In people with IBS however, the gut appears to be hypersensitive and goes into a painful spasm and pushes the food through the gut too quickly, causing diarrhoea, or too slowly, causing constipation. Sometimes both diarrhoea and constipation occur alternately.

Symptoms often arise between the ages of 20 and 30 and it appears to affect more women than men.

What are the symptoms of IBS?

Some changes in bowel function can indicate IBS including:

• Straining when going to the loo (constipation)
• An urgent need to go to the loo (diarrhoea)
• A feeling of incomplete evacuation
• Passing mucus
• Abdominal bloating or a feeling of fullness
• Chronic or acute abdominal pain and/or discomfort linked to bowel function
• Worsening of symptoms after eating
• Passing excess wind

What are the causes?

No one really knows and it's likely that there are several causes. A bout of gastroenteritis or a gastrointestinal infection appears to be a common trigger for developing symptoms of a first attack of IBS.

Some foods, such as coffee, high-fibre and fatty foods may act also as triggers. And although stress has not been shown to cause IBS, it is known to exacerbate symptoms, while an increased sensitivity or intolerance to certain foods may also make things worse .

Around 60 per cent of IBS sufferers have also been diagnosed with anxiety and depression.

How is IBS diagnosed?

The latest medical guidelines state that if a person has had abdominal pain or discomfort, a change in bowel habit, such as those outlined above, or bloating, your doctor will arrange blood tests to exclude other conditions, such as coeliac disease and inflammatory bowel disease.

The doctor may also arrange for you to have further tests, such as colonoscopy, at a hospital, if you suffer chronic diarrhoea, are over 40 years of age when you first experience symptoms, or have experienced unusual weight loss. This is to eliminate more serious underlying bowel conditions, such as ulcerative colitis or bowel cancer.

What is the treatment for IBS?

First your doctor will explain the condition fully and tailor any treatment and advice to your specific set of symptoms. Treatments include medicines to ease the painful spasms, dietary changes, stress management and relaxation techniques.

Treatments may include:

• Anti-spasmodic drugs, such as mebeverine, can relieve the pain with few side effects. You may also be prescribed peppermint oil, which can be effective in easing wind and pain
• Anti-diarrhoea drugs,such as loperamide, are effective at controlling diarrhoea, but you should only take them when needed and not on a regular basis
• Bulk-forming laxatives, such as ispaghula can help with constipation by absorbing water, which makes the stools more bulky and stimulates the need to go to the loo
• Dietplays an important part and it is now recognised that the previous advice to increase insoluble fibre, such as bran and some fruits and vegetables, can worsen symptoms. If you are advised to increase dietary fibre, eat foods high in soluble fibre, such as oats. This type of fibre also helps regulate blood sugar levels and also reduces cholesterol in the blood
• You should also cut out tea, coffee and alcohol and reduce your intake of fatty foods as these can 'excite' the gut and cause spasms. Drink at least two litres of water a day as this will keep your stools soft, if constipation is the problem, or replace lost fluids if diarrhoea is one of your main symptoms
• Stress is not a cause of IBS, but can worsen symptoms and many people with IBS also suffer high levels of stress. You may be prescribed anti-depressants, such as selective serotonin reuptake inhibitors (SSRIs), but cognitive behavioural therapy and hypnosis may also help with learning how to manage stress
• Evidence suggests inconclusively that biofeedback can help control IBS symptoms. Biofeedback is where a patient is connected to a monitor that takes readings of 'involuntary' activities, such as blood pressure and muscle tension. Learning how to use this information to recognise the onset of, say, a muscle spasm and learn to control it before it gets worse, is how this method works
• Relaxation techniques include yoga, meditation and even an aromatherapy massage with essential oils

How to help yourself

If certain foods make your symptoms worse, try keeping a food diary for a week or so. Then check with your doctor or dietitian for advice on how to eliminate these foods, or cut down consumption.

Take regular exercise as this not only helps keep bowel movements regular it also releases the 'feel-good' hormones known as endorphins, which can help your body to relax.

Take up meditation or yoga to help you manage stress.

Clickthrough information and support links:

The Gut Trust
The Digestive Disorders Foundation (Core)