Irritable bowel syndrome, also known as IBS, is a common condition that affects the digestive system. As many as one in five UK adults suffer with IBS at any one time. It can cause bouts of stomach cramps, bloating, diarrhoea and constipation and can be painful and debilitating. Stress and eating certain foods are the main triggers for IBS. IBS can be unpredictable and a sufferer may go for many months without any symptoms before a flare-up.
The symptoms of IBS tend to first appear between the ages of 20 and 30 years. Thereafter, they come and go in bouts, although obviously symptoms vary between individuals. Normally sufferers of IBS can expect painful stomach cramps with either diarrhoea or constipation, or occasionally bouts of both. The bouts will vary in their severity and the sufferer may also notice mucus in their stools. The cramps will ease once the bowels have been opened.
Other symptoms include:
- Needing to pass urine more often
- Fatigue and tiredness and sleep disturbance
- Loss of appetite
- Feelings of depression or anxiety are common in about a third of patients.
What Causes IBS?
While it is currently unknown exactly what causes IBS, most researchers and experts are in agreement that IBS is related to an increased sensitivity of the entire gut. This sensitivity may or may not be linked to a prior food-related illness, such as a previous episode of food poisoning. If the nerves have been damaged during previous illnesses, they will be over sensitive and prone to increased pain in the future.
IBS may be due to a change in the body's ability to move food through the digestive system, as well as increased sensitivity to pain in the gut. The body normally moves food through the digestive system rhythmically. The muscles of the intestines are squeezed and relaxed and the food moves through in this way. However, in IBS the food is moved through the intestine either too quickly or too slowly and this causes discomfort and pain.
If the food moves through the intestines too fast, the result is diarrhoea as the digestive system does not have enough time to absorb water from the food. Conversely, food that moves too slowly causes constipation because too much water is absorbed. Stools then become hard and these are difficult to pass.
What is known for certain is that psychological factors, such as stress, play a part in IBS. Researchers have found that there is an increase in levels of a chemical called 5-hydroxytryptamine (5-HT), which can occur after eating certain foods or during times of stress, and this affects the gut. Intense emotions of stress and anxiety can trigger chemical fluctuations that impede the ordinary mechanisms of the digestive system. This can happen to anyone regardless of whether they have IBS or not. Many people when faced with sudden danger will feel the need to visit the toilet suddenly.
Traumatic experiences in the past are common among patients with IBS, such as neglect, abuse, bereavement or serious injury or illnesses.
Triggers for IBS
Known foods and drinks can trigger the symptoms of IBS. These will obviously vary between patients but the most common include:
- Sugary foods and drinks such as chocolate and fizzy drinks
- Drinks that contain caffeine – coffee, tea, cola
- Processed foods and snacks – such as patties, pastries, crisps, pies and biscuits
- Fatty food
- Fried food
If you suspect you may have IBS you should pay a visit to your GP. They will want to rule out that you have any other illness such as coeliac disease or chronic inflammation of the gut. You may be asked to keep a food diary to identify whether there are any specific triggers. Your doctor will also look for evidence of unexplained weight loss, any swellings or lumps in your stomach or back passage, and anaemia.
They may perform further tests such as a gastroscopy - where the oesophagus, stomach and small intestine are examined with a camera on the end of a long thin tube (an endoscope); or an ultrasound; a barium study that X-rays the stomach and intestines; or a colonoscopy – an examination of the large intestine with an endoscope.
Treatment for IBS
Sadly, there is no cure for IBS, but you will be encouraged to manage the symptoms by introducing lifestyle and diet changes. IBS can be a distressing condition, but rest assured that it never causes bowel cancer; however, first-time symptoms of IBS in a person over the age of 40 should be assessed by a doctor. Antispasmodic medicine can help with the stomach cramps, or laxatives may be prescribed for constipation.
Certain strategies can help you to improve your IBS.
- Drink lots of water
- Eat a high-fibre diet
- Avoid known triggers
- Avoid strong spices and foods that give you wind.
- Avoid large meals
- Limit your alcohol intake.
You should also note that physical activity and exercise will improve digestion and simultaneously reduce stress. You can also consider relaxation and meditation techniques.
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