Irritable Bowel Syndrome (IBS)

What is Irritable Bowel Syndrome?

Irritable Bowel Syndrome (IBS) is a relatively common form of functional bowel disorder. Somewhere between 10% and 20% of people can be diagnosed with IBS symptoms. Unlike Inflammatory Bowel Disease (Colitis and Crohn’s disease), IBS causes symptoms but routine tests and examinations establish that everything is normal. It is twice as common in women than men and as the structure of the gut is normal, people suffering IBS have commonly been labeled with psychological problems, problems with food or being over-sensitive to pain.

Symptoms

Physical manifestations of Irritable Bowel Syndrome include diarrhoea, constipation, nausea, cramping and griping pains and bloating. People may also feel lethargic and tired. Any and all of these symptoms can present and can vary greatly in severity and duration. Often a feeling of urgency to go to the toilet first thing requiring several trips can signify IBS. Doctors sometimes group individuals into three main categories:

• Those with abdominal pain or discomfort, and the other symptoms are mainly bloating and constipation (IBS-C)
• Those with abdominal pain or discomfort, and the other symptoms are mainly urgency to get to the toilet, and diarrhoea (IBS-D)
• Those who alternate between constipation and diarrhoea (IBS-A)

Diagnosis

Because of the nature of the condition, there is no test which can confirm IBS. Usually, a GP will make a diagnosis based on medical history and symptoms, however, a blood test can be done to exclude other conditions with similar symptoms, for example, Colitis,  Crohn’s Disease, or Coeliac Disease.  Usually, more invasive tests such as a colonoscopy will not be done unless the person’s age (i.e. being over about 45) or range of symptoms suggests that it should be.

There is evidence to suggest that in people who exhibit the IBS-D type condition, as many as one in three may actually have bile acid malabsorption (BAM), but there is no cheap and effective test for this. The only test currently available for BAM is the SeCHAT test, but it is not widely available. For this reason, Bowel Research UK is funding research to establish a simple, convenient and cost-effective alternative.

Treatment

There is no cure for Irritable Bowel Syndrome but a range of interventions can help the symptoms, among these:

Anti-spasmodic medicines, if the GP considers that the pain being experienced is caused by muscle spasms in the gut.

Change in eating habits may help:

• Eat three meals a day; try to eat smaller meals and avoid eating late at night
• Cut down on alcohol; drink no more than two units (not glasses) and have two days each week that are completely alcohol-free
• Cut down on rich or fatty foods such as cakes, fast foods, pies, butter, cheese, creamy sauces, crisps, chocolate, biscuits, cooking oils and spreads and sausages and burgers
• Avoid manufactured food and try to cook as far as possible from fresh

Sometimes there is a particular food or drink which triggers the symptoms in individuals. If it is obvious that this makes things worse then cut down or cut out altogether.  If it can’t be pinpointed then a dietician can often help with organising an exclusion diet which will eliminate foods one by one. Although tedious, this can sometimes pinpoint certain elements of an individual’s diet which cause problems.

Further information on food and IBS can be found at the British Dietetic Association.

Most people diagnosed with IBS will have it long term. Symptoms will wax and wane and the GP will help to find the best way to manage an individual’s symptoms. Although it can be distressing and painful, Irritable Bowel Syndrome will not lead to Colitis or Crohn’s disease or bowel cancer.