What?
A condition affecting the bowels with a variety of symptoms. There is abdominal pain or bloating, belching and associated altered bowel habit. This may be constipation, diarrhoea, or both (even on the same day!)
People may notice that pain is worse with stress and dependent on mood. The pain may improve with passing a motion.
Who?
Anyone can be affected, and it is estimated that 10-20% of the population have this, to varying severities.
Why?
There are lots of theories as to why some people have it, some people don’t – and why suddenly you may develop symptoms one day, when previously you didn’t have them.
Some of these include:
1) Triggered by an infection (often a gastroenteritis causing diarrhoea and vomiting).
2) Overactive and oversensitive nerves to the bowels. Therefore, even normal amounts of gas or movement are painful. Stress can play a part.
3) Too fast or too slow digestion.
4) Unbalanced gut microbiome More information on the gut microbiome
Tests?
Because it is so common, and many of the symptoms of IBS mimic other more serious bowel conditions, it is vital that through a series of tests, including blood tests, stool tests and colonoscopy and/or gastroscopy, these conditions are ruled out.
What now? Treatments?
This depends on what your symptoms are. There are lots of different avenues to pursue. This includes:
- Dietary laxatives – simple things can help to move the bowels along, especially if you may be having hard stools (constipation). Green kiwifruit, prunes and dates are a great start.
- Fibre – Metamucil (purchased from the supermarket) can be an excellent source of fibre to help to bulk and smooth stools.
- Diet changes to see if there are food triggers: in particular FODMAP (see patient information on this) which may be easier to digest, cause less fermentation and less bloating.
- Medicines such as:
- Laxatives (if you are predominately constipated) and the natural diets are not enough.
- Anti-spasmodics (these will help to calm the spasms and muscular drive of the bowel).
- Peppermint oil tablets (over the counter from the pharmacy).
- Mindfulness and relaxation techniques
- Gut-brain neuromodulation medicines – such as Amitriptyline or Nortriptyline.
Prognosis:
My goal in treating patients with IBS is to be thorough and ensure we are not missing another condition that should be treated with other therapy. Over time, less than 5% of people will be diagnosed with another gastrointestinal condition.
Following this, I aim that patients should be able to live a happy, healthy, normal life not limited by their gut symptoms.
Additional information and reading: