Irritable bowel syndrome (IBS) is a disorder of the large bowel (colon) in which the bowel overreacts to a mild stimulus – such as eating or the presence of gas – by going into spasm. It is also known as spastic colon. IBS is characterised by abdominal pain, bloating and irregular bowel habits – including alternating diarrhoea and constipation.
IBS is extremely common, affecting as many as one in five of our population. It is most common in people in their 20s and 30s, and affects more women than men. In some people irritable bowel syndrome is a mild annoyance, while in others it can have a tremendously debilitating effect.
- Abdominal pain which can be quite severe – pain may be relieved following a bowel movement
- Unusual bowel movements – intermittent diarrhoea, constipation, or an alternating combination of both
- Crampy urge to move bowels but inability to do so
- Bloating sensation
- Excessive belching and flatulence
- Stool may have mucous and be small in size.
- Occasionally heartburn, nausea and vomiting also occur.
IBS appears to be due to an abnormal, exaggerated response of the muscles of the intestinal walls; however, it is not known exactly why some people develop the disorder. It can sometimes develop after a gastrointestinal infection, and there are also a number of factors that may set it off – including dietary, psychological, hormonal and genetic factors. Stress and depression are known to contribute to flare-ups.
There are no specific tests for irritable bowl syndrome, and so your doctor will normally make a diagnosis on the basis of your symptoms and after ruling out various other disorders – such as colon cancer and Crohn’s disease. Diagnostic tests that may be carried out to rule out these other disorders include blood tests, stool analysis, x-ray and endoscopy of the bowel.
How is IBS treated?
Treatment for IBS will depend on the degree of your symptoms. The first step is to find out as much information on the condition as you can. This often helps people to feel more in control of their symptoms.
Some people may find particular foods set off their IBS. Making changes to the diet can help to control symptoms for many people with IBS. This may include:
- Implementing a high-fibre diet, including more fruit and vegetables, whole-grain breads and cereals – this helps by softening stools and relieving constipation
- Avoiding tea and coffee and swapping for herbal teas such as peppermint and chamomile
- Drinking more water (6-8 glasses a day is recommended)
- Cutting out vegetables that produce gas, such as beans
- Cutting out spicy and fatty foods
- Cutting out artificial sweeteners.
As stress can often set off flare-ups of IBS, stress management can be a useful part of treatment. This can entail counselling and support, stress reduction and relaxation therapies, and ensuring you are getting enough exercise and adequate sleep.
For some, lifestyle changes may not be enough to manage symptoms and medical treatment may also be necessary. Anti-spasmodic drugs may be prescribed to reduce the involuntary muscular contractions associated with the condition. This will help to stop diarrhoea and pain. The doctor may advise you to take mild laxatives (particularly the bulking or stool softening types) if you are suffering from constipation.
Antidepressants may also be prescribed, even if you are not depressed – as these drugs can block the brain’s perception of pain in the gut. Painkillers or sedative drugs may be prescribed if indicated.