What is Irritable Bowel Syndrome (IBS)?

Irritable Bowel Syndrome (IBS) previously known as colitis, mucous colitis, spastic bowel, or spastic colon. There is no established link between IBS and cancer or any other inflammatory bowel disease such as Crohn’s or ulcerative colitis.

Symptoms of  Irritable Bowel Syndrome

• Changed bowel habits, going frequently (more than three times a day) or going less (less than three times a week)
• Feeling bloated
• Flatulence
• Cramping abdominal pain, that may be relieved when the bowels have been opened
• Abdominal distension, after meals or at night
• Toilet problems such as straining, a sense of urgency, or incomplete defecation
• Passing mucus or strange shaped stools
• Constipation and/or diarrhoea

Three categories of IBS

1.      IBS with diarrhoea predominance (IBS-D) presents with abdominal discomfort, frequent, urgent and loose bowel movements – more than three per day.

2.      IBS with constipation predominance (IBS-C) presents with abdominal pain, less than three bowel movements per week, straining and hard lumpy stools. A feeling of fullness and/or bloating.

3.      Alternating IBS (IBS-A) this too presents with abdominal pain but alternates between constipation and diarrhoea.

Who gets Irritable Bowel Syndrome?

IBS is very common, it affects twice as many women as men and is one of the main reasons why people visit their doctors. Those with a stressful lifestyle are more likely to develop an irritable bowel disorder than anybody else.

What causes IBS?

At the moment no specific cause for IBS has been pinpointed. Sufferers seem to have a colon that is more sensitive than others to stress or certain foods. It is also possible that the immune system is also somehow involved.

Some people with IBS are more aware of the workings inside her stomach and gut that are not normally noticed by others. This is known as visceral hypersensitivity.

Others have a bowel (small or large) that does not contract properly when food is passing through the digestive system. The muscle contractions in the bowel are not coordinated. This is known as disordered motility.

The food you eat could also cause IBS. Some people are intolerant to sugars which are not absorbed correctly in the small intestine and pass into the large intestine where they are fermented by bacteria. The excessive gases produced cause wind, bloating and pain.

Irritable Bowel Syndrome Diagnosis

If you present with IBS symptoms any other problem such as inflammatory bowel disease, celiac disease, colon cancer, diverticulitis need to be discounted. Keep a diary of your symptoms, this will help your doctor make the diagnosis. You may also have to undergo a:

• Blood test – this will be checked for iron, haemoglobin and possibly hormone and calcium levels.
• A stool sample – this will be checked for infection
• A Colonoscopy – may be asked for. This is to check for damage to the bowel and a biopsy may be taken.
• A Gynaecological exam – may be done for women to check that the reason for the abdominal pain is not gynaecological.

Treatment of IBS

Diet

The foods that aggravate IBS can vary from person to person. Keep a diary of the foods you eat in relation to your IBS attacks. Your doctor may refer you to a dietician who will give you an elimination diet to pinpoint the foods that are causing you problems.

Those whose IBS is triggered by the malabsorption of certain sugars or sugar free sweeteners should try avoiding food products that contain them such as chewing gum, cordials, yoghurt, stone fruits, kidney beans and chick peas.

IBS may be caused by lactose intolerance. Insufficient amounts of the enzyme lactase means they are unable to digest the sugar in milk, lactose. Try a low dairy or non dairy diet for a few weeks to see if it makes any difference.

Dehydration can cause constipation. Make sure you are drinking plenty of water. Tea, coffee, sports drinks and sodas do not hydrate, they are diuretics that actually make the situation worse. Drink at least 8 glasses of water per day to keep your body hydrated.

If you are constipated you should try increasing the amount of insoluble fibre that you are eating. Do this gradually over several weeks to allow your bowel to get used to the increased levels. Insoluble fibre is present in fruit, vegetables, whole grain bread and pasta, cereals and grains.

Lifestyle

Stress seems to be a common factor when it comes to IBS. Try to reduce the stress in your life, or if you can’t, try and increase the relaxation and exercise instead. Try meditation, yoga, walking, bike riding or joining a gym. Exercise increases the production of endorphins which helps to relieve stress and increases blood supply to major organs. A colon cleanse may also be helpful.

Medication

Different medications may be prescribed for the different aspects of IBS:

Abdominal Pain

Anticholinergic Medications to reduce bowel spasms such as Colofac, Buscopan or Arobel. Peppermin oil can help with bloating and abdominal pain.

Constipation

Fibre supplements such as Metamucil, Normafibre or Fybogel: soften the stool and provide bulk.

Diarrhoea

Anti diarrhoea medication such as Imodium, Loperamide or codeine phosphate.

IBS Prognosis

IBS is a chronic condition, so you may have flare ups then remissions. Sometimes it goes away all by itself and sometimes it doesn’t. However, with changes to your diet and stress levels combined with the medications available today you should be able to make your Irritable Bowel condition at least manageable.

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