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Irritable Bowel Syndrome

IBS


Irritable bowel syndrome (IBS) is a common functional disorder of the gut. A functional disorder means there is a problem with the function of a part of the body, but there is no abnormality in the structure. So, in IBS, the function of the gut is upset, but all parts of the gut look normal, even when looked at under a microscope. IBS can affect anyone at any age, but it commonly first develops in young adults and teenagers. IBS is twice as common in women as in men.

What are the symptoms of irritable bowel syndrome?

  • Pain and discomfort may occur in different parts of the abdomen. Pain usually comes and goes.
  • Bloating and swelling of your abdomen may develop from time to time. You may pass more wind than usual.

Stools:

Some people have bouts of diarrhea, and some have bouts of constipation. This may happen on a alternate basis also. You may have a feeling of not emptying your rectum after going to the toilet. Some people have urgency, which means you have to get to the toilet quickly. You feel an urgent need to go to the toilet several times shortly after getting up. This is often during and after breakfast.

Other symptoms sometimes occur and include: nausea (feeling sick), headache, belching, poor appetite, tiredness, backache, muscle pains, feeling quickly full after eating, heartburn, and bladder symptoms (an associated irritable bladder).

Do I need any tests?

There is no test that confirms the diagnosis of IBS.  However, a blood sample is commonly taken to do some tests to help rule out other conditions such as ulcers, colitis, coeliac disease, gut infections, etc.

  • Full blood count (FBC) - to rule out anaemia, which is associated with various gut disorders.
  • Erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP)
  • Antibody testing for coeliac disease.

More complicated tests such as endoscopy (a look into the bowel with a special telescope) are not usually needed.

What causes irritable bowel syndrome?
The cause is not clear. It may have something to do with overactivity of part or parts of the gut. The cause of overactivity in parts of the gut is not clear. One or more of the following may play a part:

Overactivity of the nerves or muscles of the gut. Intolerance to certain foods may play a part in some cases. However, this is thought to be only in a small number of cases.
Infection and bacteria in the gut.

What are the treatments for irritable bowel syndrome?

Many people are reassured that their condition is IBS, and not something more serious such as colitis. If symptoms are more troublesome or frequent, one or more of the following treatment options may be advised:

  • Fibre
  • Have regular meals and take time to eat at a leisurely pace.
  • Avoid missing meals or leaving long gaps between eating.
  • Drink at least eight cups of fluid per day, especially water or other non-caffeinated drinks such as herbal teas. This helps to keep the faeces (stools) soft and easy to pass along the gut.
  • Restrict tea and coffee to three cups per day (as caffeine may be a factor in some people).
  • Restrict the amount of fizzy drinks that you have to a minimum.
  • Don't drink too much alcohol.
  • Limit fresh fruit to three portions (of 80 g each) per day.
  • Probiotics  are nutritional supplements that contain good bacteria. That is, bacteria that normally live in the gut and seem to be beneficial. Taking probiotics may increase the good bacteria in the gut which may help to ward off bad bacteria that may have some effect on causing IBS symptoms.
  • Other lifestyle factors Regular exercise may also help to ease symptoms. Stress and other emotional factors may trigger symptoms in some people. So, anything that can reduce your level of stress or emotional upset may help.

Treating constipation

Constipation is sometimes a main symptom of IBS. If so, it may help if you increase your fibre as discussed earlier (that is, with soluble fibre such as ispaghula). Sometimes laxatives are advised for short periods if increasing fibre is not enough to ease a troublesome bout of constipation.

Treating diarrhoea

An antidiarrhoeal medicine may be useful if diarrhoea is a main symptom. Loperamide is the most commonly used antidiarrhoeal medicine for IBS.

Psychological treatments (talking treatments)

Situations such as family problems, work stress, examinations, recurring thoughts of previous abuse, etc, may trigger symptoms of IBS in some people. People with anxious personalities may find symptoms difficult to control.

Psychological treatments are generally mainly considered in people with moderate-to-severe IBS, when other treatments have failed. Or, when it seems that stress or psychological factors are contributing to causing symptoms.

What is the outlook ?

In most people with IBS, the condition tends to persist long-term. However, the severity of symptoms tends to wax and wane and you may have long spells without any symptoms, or with only mild symptoms. Treatment can often help to ease symptoms when they flare up. In a minority of cases, symptoms clear for good at some stage.


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