Irritable Bowel Syndrome (IBS)

Irritable Bowel Syndrome is a chronic condition of the gut (bowel) that causes episodes of stomach cramps, bloating and either constipation or diarrhoea. Irritable bowel syndrome is a problem with how the bowel works. There is otherwise nothing wrong with the bowel.

Irritable bowel syndrome may not cause harm to your body but can cause discomfort. Symptoms range from mild to severe.

What is IBS?

In IBS function of the bowel is affected, but the gut is normal when examined. IBS can affect anyone at any age but often first develops in young adults, women more than men.

Symptoms

This may be:

  • Pain and discomfort occurring in different parts of the stomach. The length and severity of each bout of pain varies. Pain often eases when you pass stools or wind.
  • Bloating and swelling of the stomach
  • Changes in stools – Some people have bouts of diarrhoea, some have constipation and some get a combination of both (alternate between constipation and diarrhoea)
  • Other symptoms which may occur – nausea, headaches, belching, poor appetite, tiredness, backache, muscle pains, heartburn

Causes

The exact cause isn’t known. It may have something to do with overactivity of the gut. This may be due to:

  • Overactivity of the nerves or muscles of the gut. Stress worsens symptoms.
  • Intolerance to certain foods.
  • Infection in the gut may sensitise or trigger symptoms. But IBS is not caused by infection.
  • Oversensitivity to pain. People with IBS feel more pain when their gut expands, than those without IBS.

Diagnosis

There is no test that confirms the diagnosis of IBS. It is diagnosed from the typical symptoms, examination of the abdomen, blood and stool tests.

Tests like gastroscopy or colonoscopy are usually not needed. They may be done if symptoms atypical or developing over the age of 50, when other conditions need to be ruled out.

Treatment

There are different treatments that may be tried for IBS. Many people with mild IBS don’t need any treatment.

1. Lifestyle/dietary changes

Exercise – Regular exercise helps ease symptoms.

Managing stress – Reduction in stress and emotional upset may help.

Symptom diary – Food and lifestyle diary for 2-4 weeks. This identifies triggers such as a food, alcohol, or emotional stresses, and if exercise helps ease symptoms.

Dietary changes – Modifying fibre intake, reducing fatty foods, increasing water intake, probiotics, low FODMAP diet

2. IBS Medications

Antispasmodic medicines for pain – Medicines that relax the muscles in the wall of the gut.

Treating constipation – Increasing fibre, fluids and short courses of laxatives.

Treating diarrhoea – Antidiarrhoea medicine (example loperamide) may be useful.

Treating bloating – Peppermint oil may help with bloating and wind.

Antidepressant medicines – Tricyclic antidepressant (example Amitriptyline) or an SSRI antidepressant (example Fluoxetine) can also be used for IBS.

3. Alternative IBS treatments

Psychological therapies – Cognitive behavioural therapy, hypnotherapy and psychotherapy helps some people.

If you are experiencing symptoms or think you may have IBS, please book in with our doctors to discuss treatment options.

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