Irritable bowel syndrome
DEFINITION
Irritable bowel syndrome (IBS) is a chronic (long-term)
digestive disorder causing abdominal pain, diarrhoea and
constipation.
digestive disorder causing abdominal pain, diarrhoea and
constipation.
DESCRIPTION
Irritable bowel syndrome (IBS) is a common ‘functional’
digestive disorder. A functional disorder means there is a problem
with the function of a part of the body. In IBS, the function of
the digestive system is upset, but all the parts of the
gastrointestinal tract, including the bowel, look normal, even when
looked at under a microscope.
digestive disorder. A functional disorder means there is a problem
with the function of a part of the body. In IBS, the function of
the digestive system is upset, but all the parts of the
gastrointestinal tract, including the bowel, look normal, even when
looked at under a microscope.
It is estimated that up to 30% of the population may
experience symptoms of IBS at some time in their life. IBS is twice
as common in women as it is in men. The condition normally develops
in people who are between 20 and 30 years of age, but it can affect
people of any age
experience symptoms of IBS at some time in their life. IBS is twice
as common in women as it is in men. The condition normally develops
in people who are between 20 and 30 years of age, but it can affect
people of any age
CAUSE
The exact cause of IBS is unknown. It may have something to do
with overactivity of part or parts of the digestive tract or gut.
The gut is a long muscular tube that goes from the mouth to the
anus. The small and large bowel (also called the small and large
intestine) are parts of the gut inside the abdomen. Food is passed
along by regular contractions (squeezes) of the muscles in the wall
of the gut. Pain and other symptoms may develop if the contractions
become abnormal or overactive. The area of overactivity in the gut
may determine whether constipation or diarrhoea develops. One or
more of the following factors may contribute to overactivity in
parts of the gut;
with overactivity of part or parts of the digestive tract or gut.
The gut is a long muscular tube that goes from the mouth to the
anus. The small and large bowel (also called the small and large
intestine) are parts of the gut inside the abdomen. Food is passed
along by regular contractions (squeezes) of the muscles in the wall
of the gut. Pain and other symptoms may develop if the contractions
become abnormal or overactive. The area of overactivity in the gut
may determine whether constipation or diarrhoea develops. One or
more of the following factors may contribute to overactivity in
parts of the gut;
Association with gastroenteritis
In up to 25% of cases, symptoms of IBS start to occur after a
gastroenteritis infection (a gut infection which can cause
diarrhoea and vomiting). It is possible that a virus or other germ
may ‘sensitise’ or ‘trigger’ the gut in some way to cause
persisting symptoms of IBS.
gastroenteritis infection (a gut infection which can cause
diarrhoea and vomiting). It is possible that a virus or other germ
may ‘sensitise’ or ‘trigger’ the gut in some way to cause
persisting symptoms of IBS.
Altered gut sensitivity
Tests have shown that in people with IBS different parts of
the gut are extra sensitive to distension (stretching) or pain. The
cause is unknown.
the gut are extra sensitive to distension (stretching) or pain. The
cause is unknown.
Stress and anxiety
Stress may cause an overactivity of messages being sent from
the brain to the gut. About half of people with IBS can relate the
start of symptoms to a stressful event in their life. Symptoms tend
to become worse during times of stress or anxiety.
the brain to the gut. About half of people with IBS can relate the
start of symptoms to a stressful event in their life. Symptoms tend
to become worse during times of stress or anxiety.
Food intolerance
A sensitivity to certain foods may play a part in some cases.
However, this is thought to be only in a small number of
cases.
However, this is thought to be only in a small number of
cases.
Also, in some cases, symptoms get worse after taking a course
of antibiotics. Antibiotics kill certain harmless or ‘good’
bacteria in the gut which changes the balance of bacteria types in
the gut. There may also be other environmental and genetic factors
that contribute to IBS that are not yet understood.
of antibiotics. Antibiotics kill certain harmless or ‘good’
bacteria in the gut which changes the balance of bacteria types in
the gut. There may also be other environmental and genetic factors
that contribute to IBS that are not yet understood.
SIGNS AND SYMPTOMS
The symptoms of IBS are usually worse after eating. Most
people will experience a ‘flare-up’ of symptoms, lasting between
2-4 days, after which the symptoms improve, or disappear
altogether. The most common symptoms of IBS are:.
people will experience a ‘flare-up’ of symptoms, lasting between
2-4 days, after which the symptoms improve, or disappear
altogether. The most common symptoms of IBS are:.
- Abdominal pain and cramping which is often relieved by emptying
your bowel - A change in bowel habits, e.g diarrhoea or constipation or
both. - Bloating and swelling of your abdomen.
- Excessive wind (flatulence) which may have an offensive
smell. - Experiencing an urgent need to go to the toilet. If muscular
damage to the anus has occurred e.g in childbirth, faecal
incontinence may occur. - A feeling that you have not fully emptied your bowel.
TREATMENT OPTIONS
As with all medical conditions it is advisable to consult your
GP for an accurate diagnosis and treatment. There is no cure for
IBS, but symptoms can often be eased with lifestyle changes and
treatment. Once your Doctor has excluded other conditions, a
variety of therapies may be of value.
GP for an accurate diagnosis and treatment. There is no cure for
IBS, but symptoms can often be eased with lifestyle changes and
treatment. Once your Doctor has excluded other conditions, a
variety of therapies may be of value.
Lifestyle
Lifestyle changes may include stress management, introducing a
healthy diet and exercise program and/or reducing alcohol intake.
Your GP can help you to identify and then avoid the triggers for
IBS. A high-fibre diet may be helpful. See the Diet Hints section
of this topic for more information.
healthy diet and exercise program and/or reducing alcohol intake.
Your GP can help you to identify and then avoid the triggers for
IBS. A high-fibre diet may be helpful. See the Diet Hints section
of this topic for more information.
Probiotics
Some people find that taking probiotics, such as acidophilus
and bifidus, help to relieve the symptoms of IBS. Probiotics are
dietary supplements that contain healthy bacteria for your
digestive system. Probiotics may need to be taken for at least four
weeks to see if they have a beneficial effect. .
and bifidus, help to relieve the symptoms of IBS. Probiotics are
dietary supplements that contain healthy bacteria for your
digestive system. Probiotics may need to be taken for at least four
weeks to see if they have a beneficial effect. .
Medication
A number of different medications are used to help treat IBS.
These are;
These are;
- Antispasmodic medicines, which help to reduce abdominal pain
and cramping. - Laxatives, which help to treat the symptoms of
constipation. - Antimotility medicines, which help to treat the symptoms of
diarrhoea. - Tricyclic antidepressants (TCAs) may also help to reduce the
feeling of abdominal pain and cramping.
DIET HINTS
Making dietary changes can help to control the symptoms of
IBS. Each person will need to modify their diet based on their
individual situation. For example, some people may need to reduce
their intake of insoluble fibre found in wholemeal bread, cereals
and wholegrains. Other people with IBS may need additional fibre in
their diet, usually soluble fibre. This may mean taking a fibre
supplement, or eating more foods that are high in soluble fibre,
such as oats. Unprocessed bran should be avoided by people with IBS
as it can worsen the symptoms of IBS.
IBS. Each person will need to modify their diet based on their
individual situation. For example, some people may need to reduce
their intake of insoluble fibre found in wholemeal bread, cereals
and wholegrains. Other people with IBS may need additional fibre in
their diet, usually soluble fibre. This may mean taking a fibre
supplement, or eating more foods that are high in soluble fibre,
such as oats. Unprocessed bran should be avoided by people with IBS
as it can worsen the symptoms of IBS.
Your GP will be able to advise you about what your recommended
fibre intake should be. The dietary advice listed below may also
help you to control your symptoms of IBS.
fibre intake should be. The dietary advice listed below may also
help you to control your symptoms of IBS.
- Have regular meals, and take your time when eating.
- Avoid missing meals, or leaving long gaps between eating.
- Drink at least eight cups of fluid a day, particularly water,
or other non-caffeinated drinks, such as herbal teas. - Restrict tea and coffee to three cups a day.
- Reduce your intake of alcohol and fizzy drinks.
- Reduce your intake of ‘resistant starch’ (starch that resists
digestion in the small intestine and reaches the colon intact). It
is often found in processed, or re-cooked, foods. - Limit fresh fruit to three portions (80 g each) a day; a
suitable portion would be half a grapefruit, or one apple. - If you have diarrhoea, avoid sorbitol, which is an artificial
sweetener that is found in sugar-free sweets (including chewing
gum) and drinks, and in some diabetic and slimming products. - If you have wind and bloating, consider increasing your intake
of oats, for example, oat-based breakfast cereal, or porridge, and
linseeds (up to one tablespoon a day). - Do not exclude a food or food group, such as dairy, from your
diet unless you are under the supervision of a Dietician. .
See the Irritable Bowel Syndrome Diet on the Healthpoint for
more information.
more information.
VITAMINS/MINERALS/HERBS
Vitamin, mineral and herbal treatment of IBS usually requires
the advice of a qualified health professional.
the advice of a qualified health professional.
- Acidophilus such as lactobacillus acidophilus and bifidus may
assist with digestion and prevent the overgrowth of candida and
other harmful microbes. - Slippery elm consists of an abundance of mucilage with can
sooth inflammation and stop irritation of the mucous membranes
lining the stomach and intestines. - Psyllium is a soluble fibre and has a gentle bulk forming
effect on the stool. It can assist in normalizing stool consistency
and frequency in ibs and improving frequency and reduction in
abdominal distention. - Digestive enzyme may assist in promoting digestion.
- Ginger may reduce gas, bloating and diarrhea and improve
functioning of the stomach . - Peppermint oil may reduce gas and cramping and studies show it
is effective in the treatment of IBS. Enteric coated peppermint oil
capsules are recommended. - Herbal teas such as chamomile, peppermint, rosemary and lemon
balm may have anti-spasmodic activities for relief of abdominal
pain and cramping.
PHARMACIST’S ADVICE
Ask your Pharmacist for advice.
- Follow the Diet Hints
- Avoid stress by including regular exercise, rest and
relaxation. - If a fibre supplement is required, ask your Pharmacist to
recommend the most suitable type - Ask your Pharmacist for advice if you have any questions about
medication you are taking. - Smoking can increase the risk of IBS, especially following
gastroenteritis. Ask your Pharmacist for advice about quitting
smoking. - If the diet is inadequate consider some nutritional
supplements. - Probiotics may help to manage the symptoms of IBS. . Probiotic
supplements are available from your Pharmacy.