Approximately 1 in 7 New Zealanders are affected by Irritable Bowel Syndrome (IBS). There are various symptoms associated with IBS – cramping and pain in the abdomen, bloating, diarrhoea, constipation, change in bowel behaviour and others. Treatment for IBS involves starts with confirmation of the diagnosis and then may involve dietary and lifestyle changes such as the use of a low-FODMAP diet or managing your stress levels. In some cases medication may be used to help manage IBS but only if advised by a health professional.
What is IBS?
An “irritable” bowel is one which does not function smoothly. The muscles of the intestine contract as they push food along the colon. In IBS those muscles are not well coordinated, meaning that food may pass too quickly or too slowly through the intestine, resulting in IBS symptoms. The term syndrome refers to the cluster of chronic symptoms experienced. IBS can cause a lot of discomfort and stress but it does not cause any permanent harm or serious disease such as cancer.
What are the symptoms of IBS?
- Crampy abdominal pain
- Diarrhoea and/or constipation
- Bloating and gassiness
- Mucus present in the stool
What causes IBS?
It is still not known what causes IBS. What we do know is that people with IBS have poorly coordinated muscle contractions of the colon (peristalsis). This means that the muscles that move food along the intestines are not well coordinated. It is a functional disorder – there is usually no visual sign of the disease when the bowel is examined. The onset of IBS may be triggered by an infection or inflammation of the gut or by injury to the gut. If the gut is irritated then it can produce a vicious cycle of gut irritation.
How is the bowel affected?
If food waste moves too slowly through the colon and if too much water is absorbed as it moves then constipation can occur. If waste moves too fast and not enough water is removed then diarrhoea can occur. Both of these problems can cause the symptoms of IBS.
Who usually gets IBS?
Anyone can develop IBS, although the symptoms usually begin in early adulthood. IBS is more common in younger people. In New Zealand about 15-20% of the population may have IBS. Women seem to be twice as likely as men to get IBS.
What can make the symptoms worse?
Some people relate flare-ups to specific stressful events or to ongoing every day stress. You may also notice that certain foods, for example spicy foods or dairy products make your symptoms worse. Also certain medications can make constipation worse.
How is IBS diagnosed?
Your specialist will ask you questions about your symptoms and how long and how often you have had these. They may also give you a physical examination and possibly send you for a colonoscopy. This is to rule out other conditions with similar symptoms.
What can I do to prevent or relieve IBS?
- Keep a diary of what you eat and drink. There may be certain foods which trigger your symptoms.
- Slowly increase the fibre in your diet. This helps to keep other food moving through the intestine; it also holds water and softens the stool to make it easier to pass. A rapid increase in your fibre intake can cause bloating and gas.
- Reduce stress. Relaxation training, meditation or stress management may help symptoms.
- Stop Smoking.
- Exercise more (this helps intestinal movement and is stress relieving).
- Respond to the urge to move your bowels. If you delay you may have to strain later.
Because IBS can occur on and off over many years, it is recommended that you visit your doctor during difficult times or if new symptoms develop. Your doctor may wish to change the way your IBS is managed.
It is important to remember that many treatable and potentially serious conditions can exhibit similar symptoms to IBS. The diagnosis of IBS is usually reached through exclusion of other problems, such as colitis, diverticulitis, tumours, ulcers, gallstones, and other illnesses. Your doctor will help determine which investigations are necessary during the diagnosis and management of your IBS.