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Constipation, Health information, IBS

Irritable Bowel Syndrome

More common than you’d imagine

Irritable bowel syndrome (IBS) is a common disorder characterised by episodes of cramping tummy pain, bloating and passing wind, plus diarrhoea or constipation (or both). It is a long-term condition that fluctuates in severity.

Most people can control their symptoms adequately by carefully managing their diet, lifestyle and levels of stress. A minority need medicines and counselling.

IBS affects between 10-20% of people, most commonly those between 20 and 30 years. It’s twice as common in women as men. It doesn’t increase the likelihood of getting bowel cancer.

Symptoms

Although these vary between people, typical symptoms include:

  • Cramping tummy pain and bloating – sometimes relieved by going to the toilet.
  • Excess wind
  • Diarrhoea or constipation — sometimes alternating
  • Mucus in the stool

Diagnosis

There’s no specific test for IBS, although it’s important to rule out other conditions before making the diagnosis. There are various screening tools which use a combination of symptoms, signs and tests to predict the likelihood of your problem being IBS, such as the Kruis, Manning or Rome Scoring Systems.

Investigations to rule out other conditions include blood tests, breath and stool samples (to test for bacteria), ultrasound or CT scans and endoscopies (inserting a fine tube through the mouth or bottom to look at the upper or lower part of the bowel).

Treatment

There’s no cure for IBS at present. Treatment is focused on relief of symptoms. Initially, it’s worth trying a combination of:

  • Eating regular meals without skipping them.
  • Increasing intake of soluble fibre such as oats, linseeds, pulses, peeled potatoes
  • Avoiding insoluble fibre (eg: bran) and foods that appear to trigger episodes including artificial sweeteners
  • Drinking plenty of fluids (at least 8 cups daily) and reduce caffeine and alcohol
  • Regular exercise
  • Plenty of sleep

There’s also pretty good evidence that Peppermint Oil is very effective at reducing the symptoms of IBS.

A high fibre diet can make things worse for some IBS sufferers. Some people advocate avoiding food and drink that generates lots of gas such as fizzy drinks, raw fruit and certain types of vegetables. Avoiding gluten (in wheat, rye and barley) helps some people (even if they don’t have coeliac disease). It’s also worth avoiding so-called FODMAPs: these are Fermentable Oligo-, Di-, and Monosaccharides And Polyols (quite a mouthful for anyone). They’re found in certain grains, vegetables, fruit and dairy products.

If none of these provide sufficient relief, then you may need to see a doctor who may advise the use of medicines such as:

  • Antispasmodics to reduce cramping and bloating
  • Laxatives (but not lactulose)
  • Anti-motility drugs to reduce diarrhoea such as loperamide
  • Antidepressants and counselling if depression starts to make it harder to cope with the symptoms

More specialised medicines are used in people with symptoms that are particularly difficult to control. These include Eluxadoline, Lubiprostone and Linaclotide that reduce fluid secretion into the gut and hence diarrhoea. Rifaximin is an antibiotic that is poorly absorbed from the gut, so works locally to reduce bacterial overgrowth and diarrhoea.

Contact Bluezone if:

… the nature of your IBS has changed, especially if you experience:

  • Weight loss
  • Fever
  • Diarrhoea at night
  • Blood mixed in with poo
  • Anaemia
  • Unexplained or repeated vomiting
  • Difficulty swallowing
  • Persistent pain that isn’t relieved by passing wind or going to the toilet

You should also see a doctor if your symptoms started after you were 50 years old.

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