About Irritable bowel syndrome (IBS)

Irritable bowel syndrome (IBS) is one of the most common problems of the digestive system. IBS is what’s referred to as a functional disorder and is a long-term condition that causes recurring pain or discomfort in the abdomen and altered bowel habits.

Irritable bowel syndrome (IBS) can develop at any age, but for most people, the first symptoms tend to show up in early adulthood. Women are more likely than men to get IBS and to have more severe symptoms.

Types of IBS

Irritable bowel syndrome can present in three basic forms. It can be predominantly:

• Constipation based – Bowel movements alternate between constipation and normal stools with symptoms of abdominal cramping or aching commonly triggered by eating.
• Diarrhoea based – Diarrhoea is a major problem first thing in the morning or after eating with an urgent need to go to the toilet. Sometimes incontinence may be an issue.
• Alternating constipation and diarrhoea.

IBS risk factors

You’re more likely to have IBS if you:

• Are a woman — around twice as many women have the condition than men
• Are young — IBS tends to affect people under age 45 with the first signs showing up in early adulthood
• Have a family history of IBS — people who have a family member with IBS may be at increased risk
• Suffers from anxiety or depression

Symptoms of IBS

Although symptoms vary from one person to the next, some of the more common indicators of IBS include:

• abdominal pain or cramping (often relieved by passing wind or faeces)
• diarrhoea, constipation or a combination of both
• a sensation that the bowels are not fully emptied (especially just after having a bowel movement)
• abdominal bloating
• mucus in the stools
• excess wind
• nausea
• indigestion
• backache
• tiredness
• bladder problems

To some people, IBS symptoms don’t tend to warrant a visit to their doctor, However, if you find these symptoms seriously affect your lifestyle, or you find it quite difficult to cope with these symptoms, talk to your doctor.

Important! These symptoms are not specific to IBS. They may be attributed to conditions other than IBS, including Coeliac Disease which can damage the lining of the intestine. If you have any of the above symptoms, let your doctor determine if Coeliac Disease is present or if the symptoms point to other conditions.

When should you see your doctor?

If you have any of the symptoms of IBS, a persistent and noticeable change in your bowel habits, or if you have any of the more serious signs listed below, see your doctor as soon as possible.

• Rectal bleeding
• Abdominal pain that progresses or occurs at night
• Sudden weight loss

Your doctor can help you find ways to relieve your IBS symptoms as well as rule out any conditions of the colon, such as inflammatory Bowel Disease and Colon Cancer. Your doctor can also help you avoid possible complications from problems such as chronic diarrhoea.

Causes of IBS

The walls of the intestines are lined with layers of muscle that rhythmically contract and relax as food moves from your stomach through your intestinal tract to your rectum. If you have irritable bowel syndrome, the contractions may be stronger and last longer than normal, causing gas, bloating and diarrhea.

But sometimes the opposite is also true. Weak intestinal contractions slows the passage of food and leading to hard, dry stools.

Abnormalities in your gastrointestinal nervous system also may play a role causing you to experience greater than normal discomfort when your abdomen stretches from gas or stool.

And it could also be poor coordination between the brain and the intestines that makes your body overreact to the changes that normally occur inside the digestive process — which in turn causes pain, diarrhea or constipation.

Irritable bowel syndrome is just another one of those conditions where there doesn’t seem to be a definitive cause. That said, there are some things that trigger attacks including:

• Infection — persistent bowel symptoms can linger after a bout of gastroenteritis — sometimes long after the offending bacteria or virus has been eliminated. Up to 25% of IBS may be due to this problem.
• Food intolerance — Sugars, particularly lactose (found in dairy and many processed foods) is the most common dietary trigger for IBS. Fructose and sorbitol are also believed to trigger IBS.
• General diet — low fiber diets can lead to constipation-predominant IBS. Some people find foods such as chocolate, spices, fats, fruits, beans, cabbage, cauliflower, broccoli, milk, carbonated beverages and alcohol all cause problems.
• Emotional stress — stress or anxiety, can affect the nerves of the bowel.
• Medications — such as antibiotics can bring about constipation or diarrhea.
• Hormones —women are twice as likely to have IBS which leads researchers to suggest that hormonal changes can play a role in bringing about symptoms of IBS. Many women find that IBS symptoms are worse around and during their menstrual cycles.

Diagnosis and testing for IBS

Conditions such as: Coeliac Disease, Crohn’s Disease, Ulcerative Colitis and Endometriosis all have similar symptoms to IBS. So it’s important not to self-diagnose and see your doctor as soon as you can.

Your doctor may:

• Ask about your symptoms
• Give you a physical examination
• Ask you to have a blood test
• Ask you to have a stool test
• Ask about your medical history
• Ask about your pain — when it comes on and what makes it better or worse
• Ask about your bowel movements — including how often you go, how easy this is and what your faeces look like

Your doctor may also refer you for a sigmoidoscopy or a colonoscopy. This involves using an endoscope (a flexible, tube-like instrument to look inside your bowel). A bowel biopsy may also be taken for examination in a laboratory to help rule out more serious conditions.

However, if you’re under 50 and have typical symptoms of IBS, you may not need any further tests. Where your doctor maybe concerned, is if you have any of the following other symptoms which could point to other more serious conditions.

• sudden weight loss
• blood in the stool
• symptoms developing after age 60
• Family history of bowel problems
• diarrhoea without other symptoms
• anaemia.

Treatment of IBS

IBS cannot be cured with medications or special diets. A good doctor is one who will work with you to create a plan based on treating, alleviating or even eliminating the symptoms of IBS. These may include:

• a modest increase in dietary fiber, together with plenty of clear fluids
• reducing or eliminating common gas-producing foods, such as beans and cabbage
• reducing or eliminating dairy foods, if lactose intolerance is a trigger
• establishing eating routines and avoiding sudden changes of routine.
• stress management, if stress seems to be triggering the attacks

Some medications may also help to ease the symptoms of IBS if and when they flare up. These may include:

• anti-diarrhea medication can be an essential part of management in those with diarrhea-predominant IBS
• Medication for pain relief. A common side effects is constipation, which may also help if you have diarrhea-predominant IBS
• constipation treatments
• antispasmodics (to ease cramping)
• Additionally, a physiotherapist may be able to teach you how to use your muscles to control your bowel function more effectively.

If you suffer from psychological issues like anxiety, depression and stress, we recommend seeing a psychologist or counsellor who can help you to deal with these issues and for coping with IBS.

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