Irritable bowel syndrome (IBS)

Patients can suffer from constipation or diarrhoea. Learn how you can manage this chronic condition.

Irritable bowel syndrome (IBS) is a chronic condition of the digestive system. It often begins in young adulthood. It affects approximately 10–20% of the general population, and women are twice as likely as men to get ​IBS. It is the most common disease to be diagnosed and one of the most common disorders seen by doctors.

Symptoms of IBS

Abdominal cramps

Usually in the lower part of the tummy or down the left hand side, the pain can be sharp, gripping or stabbing. It usually eases after passing wind or bowel movement.

Irregular bowel habits

Patients can suffer from constipation to diarrhoea. There is increased stool frequency and consistency tends to be loose. Sufferers have feeling of incomplete emptying after bowel movements. Stool tends to be loose but is never increased in bulk and water. Therefore affected people do not become dehydrated (unlike the diarrhoea in gastroenteritis).

Urgency

A feeling of urgently needing to move the bowels.

Abdominal bloating

Your stomach feels swollen, making your clothes feel tight.

Excessive wind

Less common symptoms are:

  • Generally tired or tiring easily.
  • Backache
  • Headache with sweating, flushing and fainting
  • Nausea or vomiting for no apparent reason
  • Feeling agitated or having pain when going to the toilet

Is there a test for IBS?

There is no specific tests for IBS. However, your doctor can figure out if you have IBS by asking you a few questions, and by running tests to make sure you do not have something other than IBS. Lots of medical conditions can cause the same symptoms as IBS. So it is important that your doctor checks for the other possibilities.

Managing IBS


Treatment

There are a number of different treatments and therapies for IBS. ​They are often combined to reduce the pain and other symptoms of IBS, and it may be necessary to try more than one combination to find the one that is ideal.

Treatment is usually a long-term process. During your treatment, it is important to communicate with your healthcare provider about symptoms, concerns, and any stressors or home/work/family problems that develop.


Monitoring

The first step in treating IBS is usually to monitor symptoms, daily habits, and any other factors that may affect gastrointestinal function. This can help to identify factors that worsen symptoms in some people with IBS, such as lactose or other food intolerances and stress. A daily diary can be helpful.


Dietary changes

Try eliminating foods that may aggravate IBS, although this should be done with the assistance of a healthcare provider. Eliminating foods without assistance can potentially worsen symptoms or cause new problems if important food groups are omitted.


Lactose

Many clinicians recommend temporarily eliminating milk products, since lactose intolerance is common and can aggravate IBS or cause symptoms similar to it. The greatest concentration of lactose is found in milk and ice cream, although it is present in smaller quantities in yogurt, cottage and other cheeses, and any prepared foods containing these ingredients.

All lactose-containing products should be eliminated for two weeks, with a gradual reintroduction of these products depending upon symptoms. People who avoid lactose should take a calcium supplement that contains at least 1000 mg of calcium and 400 IU of vitamin D.


Foods causing gas

Several foods are only partially digested in the small intestines. When they reach the colon (large intestine), further digestion takes place, which may cause gas and cramps. Eliminating these foods temporarily is reasonable if gas or bloating is bothersome.

The most common gas-producing foods are legumes (such as beans) and cruciferous vegetables (such as cabbage, Brussels sprouts, cauliflower, and broccoli). In addition, some patients have trouble with onions, celery, carrots, raisins, bananas, apricots, prunes, sprouts, and wheat.


Increasing dietary fibre

People with IBS may find relief by consuming foods high in dietary fibre, especially those with constipation. You can determine the amount of fibre present in the product by reading its product information. It may also be helpful in people with diarrhoea, since it can improve the consistency of stools.

A bulk-forming fibre supplement (such as psyllium or methylcellulose) may be recommended to increase fibre intake, since it is difficult to consume enough fibre. It should be started at a low dose and increased slowly over several weeks to reduce the symptoms of excessive intestinal gas, which can occur in some people commencing fibre therapy. However, fibre can make some patients with IBS more bloated and uncomfortable. If this happens, it is best to decrease fibre intake and consider other laxative treatments for constipation.


Psychosocial therapies

Stress and anxiety can worsen IBS in some people. The best approach for reducing stress and anxiety depends on the individual and the severity of symptoms. You should have an open discussion with your clinician about the role that stress and anxiety is having on your symptoms, and decide upon the best course of action.

Some will benefit from formal counseling with or without antidepressant or anti-anxiety medications. Other treatments, such as hypnosis and cognitive behavioral therapy may also be helpful. Participation in a support group can also be valuable.

Many patients find that daily exercise is helpful in maintaining a sense of well-being. Exercise can also have favorable effects on bowel action as well.


Medications

Although many drugs are available to treat the symptoms of IBS, they do not cure the condition. They are primarily used to relieve symptoms. The type of medication prescribed depends on whether a person has diarrhoea, constipation, or pain-predominant IBS. Furthermore, the effectiveness of drugs varies from one person to another. As a general rule, medications are reserved for people whose symptoms have not adequately responded to more conservative measures such as changes in diet and fiber supplements.

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