Overview
IBS (irritable bowel syndrome) is a disorder of the digestive system and consists of a variety of symptoms. The most common of these are pain in the abdominal area and abnormal bowel habits. Symptoms can vary amongst individuals in their frequency and severity. IBS is the most common digestive system disorder and is believed to affect around one third of the population, most commonly between the ages of twenty and forty. It is slightly more common in women than it is in men and it’s believed that around sixty percent of people with IBS will also have some form of anxiety, stress or depression.
There is no cure for the condition and it can be very challenging to cope with as it can have a negative effect on a person’s daily life, particularly on their social lives. Whilst there is no cure, it is possible to manage the symptoms which is important, given that you might have frequent flare-ups, although you will also have days when symptoms are milder and easier to cope with.
There are four types of irritable bowel syndrome:
· IBS with constipation known as IBS-C
· IBS with diarrhoea known as IBS-D
· Mixed IBS with constipation and diarrhoea IBS-M
· Unsubtyped IBS (for cases that don’t fit the other three types) known as IBS-U
Potential causes of IBS
The exact cause of IBS remains unknown but it is believed that a variety of factors could contribute to its development and these include:
Bacteria
An increase in either the type or amount of bacteria in the small intestine.
Certain foods
Foods such as alcohol, caffeine, fatty or spicey foods are believed to trigger symptoms for as many as ninety percent of people who have the condition.
Genetics
Studies within families have shown that if you have a parent, sibling or child with IBS you are more likely to develop the condition.
Gut microbes
Changes in bacteria, fungus, or infections in the intestines are believed to play a role in a person’s overall health. Research has indicated that these microbes may differ between a person who has IBS and someone that does not.
Infections or inflammation
The condition can occur as a result of gastroenteritis, a severe form of diarrhoea caused by either bacteria or a virus. A viral, bacterial, or protozoal infection of the digestive tract, or inflammation in the gastrointestinal tract which could be caused by inflammatory bowel disease.
Medications
It’s believed that some medications such as antibiotics, antacids, and some blood pressure medications could trigger IBS.
Muscle contractions
The walls of our intestines are lined with muscles which contract as food moves through our digestive tract. If their movement is weak it can slow down the passage of food which can lead to dry, hard stools. If they are to strong, or last longer, it can result in gas, bloating, and diarrhoea.
Nervous system
It’s possible that problems with the nerves in our digestive system could cause discomfort in the abdomen as it expands due to gas or stool. If the signals between the brain and intestines are poorly coordinated it’s possible that the body could have an overreaction, resulting in pain, or either diarrhoea or constipation.
Stress
Anxiety, depression, or stress can all make symptoms worse and people who suffered stressful events, particularly in their childhood can be more at risk of developing IBS.
Symptoms of IBS
Symptoms may vary depending on the type of IBS you have but are more than likely to include a combination of, but are not necessarily limited to the following:
Physical symptoms
· Diarrhoea which can often be described as violent or occurring without any prior warning. This can result in an urgent need to use the toilet, and incontinence if unable to do so.
· Constipation which can result in straining in an attempt to empty your bowels which can be painful. Feeling like you still need to empty your bowels even after a bowel movement.
· Mucus in your stool or feeling like you are passing mucus from your rectum. Feeling like your bladder is still full even after you have emptied it or having to pass water frequently.
· Feeling bloated in your stomach which can cause feelings of discomfort, feeling nauseous having trapped wind or passing wind frequently.
· Having stomach cramps or discomfort which can be worse after eating but improve when you empty your bowels.
· Harder or looser bowel movements that can alternate or bowel movements that look like pellets or ribbons
· Intolerance to certain foods
· Feeling lethargic or having headaches
· Indigestion or heartburn
Psychological symptoms
People who have IBS can either have previously suffered from, or develop the following conditions as a result of developing IBS:
· Anxiety
· Depression
· Stress
They can also find themselves withdrawing from social situations, because they feel embarrassed or self-conscious about their IBS, and this resulting stress and anxiety can aggravate their symptoms.
Whilst IBS is not life threatening and it does not lead to other conditions such as colon cancer, Chron’s disease or ulcerative colitis, you should seek medical advice if you suffer any of the following symptoms:
· Passing blood from your rectum
· Unexpected weight loss of two kilograms or more in a short period of time
· Have a fever
· Unexplained vomiting
· Diarrhoea that wakes you from your sleep
· Iron deficiency anaemia
· Pain that is not relived by either passing wind or stool
Also if you have a persistent change in your bowel habits, lasting for four weeks or more and you are over the age of forty, as they could all be a sign of other serious health conditions.
Diagnosing IBS
Your doctor will make a diagnosis usually based on your symptoms, but they may want to do some tests to rule out any other possible causes. If you are taking medication that could be the cause of your symptoms they can look at changing your prescription. They could also run blood tests to check on the following:
· Liver and kidney functions
· For signs of anaemia
· If you have signs of coeliac
· For signs of inflammation in the bowel
They may also take a stool sample to perform a faecal calprotectin test which is used to check for inflammation to rule out any form of bowel disease and confirm their diagnosis of IBS. Further tests could include x-rays, an upper endoscopy if you suffer from indigestion or heartburn, or a flexible sigmoidoscopy or colonoscopy to check for signs of inflammation or a blockage in the intestines.
Treatments for IBS
You can work with your doctor to find out which treatments work the best for your particular symptoms, and this will depend not only on what symptoms you have, but their severity and frequency.
Lifestyle changes
Symptoms can start to ease if you implement just a few simple changes, you could try the following to see which are the most beneficial:
· If you smoke try stopping
· Avoid caffeine and carbonated drinks
· Eat smaller meals more often rather than eating large meals
· Eat slowly and ensure you chew properly to aid digestion
· Don’t be tempted to miss meals try and keep a regular meal schedule as this should help you to keep your bowel movements regular as well
· Try to get between seven and nine hours sleep a night as this should help manage stress levels which can trigger symptoms
· Ensure you take regular exercise
· Drink eight glasses of water a day to stay hydrated and help avoid constipation
You might also find it helpful to keep a food diary which could help you to identify any foods that trigger your IBS. Anything that can reduce symptoms of stress, anxiety or depression such as breathing exercises, mindfulness, meditation or yoga could also prove useful in managing symptoms.
Medications
IBS can be treated with a variety of medications or supplements these can include:
· Antibiotics can change the amount of bacteria in your intestines which can control symptoms for as long as six months
· Antidepressants can be prescribed for people suffering with depression
· Bulking agents can help to slow the movement of food through the digestive system
· Probiotics contain live yeasts and bacteria that is good for the health and digestive system. They can be found in foods such as yoghurts, cottage cheese or kombucha or are available as a supplement
· Prescribed or over the counter medications for constipation or diarrhoea
FODMAP diet
Your doctor might discuss going on a FODMAP diet which stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols, which cuts down on hard to digest carbohydrates.
You will start, by going on an elimination diet to see which of these high FODMAP foods causes a reaction and triggers your symptoms. You do this by removing them, and then slowly reintroducing them back into your diet.
Therapy
Anxiety, stress, and depression are often associated with IBS and managing those conditions will help you to better cope with your IBS symptoms. Your doctor may refer you to a therapist, or you can choose to see one privately and they could use a combination of therapies to help you, such as:
· Hypnotherapy and relaxation therapies can prove helpful for some people in managing their symptoms or reducing flare-ups
· CBT (cognitive behavioural therapy) can help to reduce anxiety and depression. It teaches you how to recognise negative thoughts and behaviours and how they can affect your physical symptoms
There are plenty of self help and support groups on-line, who can help you by sharing support and information from people who also have IBS and are willing to share information on what treatments or lifestyle changes they found worked well. Written by Jan, Jeana and Wendy at Barnsley Hypnosis and Counselling (UK). For more free Information click above link.