Irritable Bowel Syndrome
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.
It is estimated that 10-20% of the UK's population is affected by IBS at any one time, although this figure may be higher because many people with the condition do not report their symptoms to their GP.
It 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 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.
- have mental health problems — anxiety, depression, personality disorders and a history of childhood sexual abuse are all risk factors. Additionally, women who have suffered domestic abuse may be at risk also.
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.
- bladder problems.
With some IBS symptoms you don’t need to visit your doctor. But if your symptoms seriously affect your lifestyle, or you find it quite difficult to cope with the symptoms, talk to your doctor.
Important, please note that not all the above symptoms are specific to IBS. They may be attributed to other conditions, including coeliac disease which can damage the lining of your 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 gets worse 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 diarrhoea.
But sometimes the opposite is true. Weak intestinal contractions slow the passage of food and leads to hard, dry stools.
Abnormalities in your gastrointestinal nervous system may cause you to experience greater than normal discomfort when your abdomen stretches due to gas or stools.
Sometimes the coordination between the brain and the intestines can make your body overreact to the normal digestive process — which in turn causes pain, diarrhoea or constipation.
Irritable bowel syndrome is another condition where there doesn’t seem to be a definitive cause. But there are some things that can trigger an attack 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 it.
- General diet — low fibre diets can lead to constipation which is predominant in IBS. Some people find foods such as chocolate, spices, fats, fruit, 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, antacids and painkillers can bring about constipation or diarrhoea.
- 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/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. Go 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 sigmoidoscopy or 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 may be concerned, is if you have any of these 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
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 fibre, 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-diarrhoea medication, such as Imodium or Lomotil can be an essential part of management in those with diarrhoea-predominant IBS
- pain relief medication including opiates such as codeine can provide effective pain relief. A common side effect is constipation, which may also help if you have diarrhoea-predominant IBS
- constipation treatments
- antispasmodics (to ease cramping)
- anti-depressants (which are used to treat pain and depression).
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 deal with these issues and cope with IBS.
Kimberly-Clark makes no warranties or representations regarding the completeness or accuracy of the information. This information should be used only as a guide and should not be relied upon as a substitute for professional medical or other health professional advice.
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