Your guide to causes, treatment and symptoms of irritable bowel syndrome.
Irritable bowel syndrome (IBS) is a long-term condition that affects the normal functioning of the bowel and causes pain and discomfort in the abdomen. This painful, and sometimes embarrassing, condition affects as many as one in five Australians and can develop at any point in life.
What is IBS?
IBS is a functional disorder that prevents the bowel from acting as it should. While it causes a change in how your digestive system functions, no change in structure is evident when your bowel is examined using biopsies and X-rays. As a result, the exact cause of IBS is unknown.
People who suffer from IBS experience altered bowel habits, such as chronic diarrhoea or constipation, and pain or discomfort in the abdomen. The best way to relieve those symptoms is to pass wind or faeces, while the condition can also cause uncomfortable stomach bloating.
The symptoms of IBS can be embarrassing, inconvenient and often painful, but the good news is that it doesn’t cause any permanent damage to the bowel nor lead to any other diseases.
IBS will affect about one in every five Australians at some time throughout their lives. Women are around twice as likely as men to suffer from the condition and experience more severe symptoms. While it can develop at any age, many people experience their first symptoms during early adulthood.
What are the symptoms of IBS?
For many people with IBS, the symptoms they experience are little more than an occasional inconvenience and do not force them to see a doctor. However, IBS can have a severe impact on the quality of life of some sufferers and can cause the following symptoms:
- Abdominal pain and cramps. This pain can range from mild to severe and eating can often make the pain worse. You can often relieve the pain by passing wind or faeces. Some sufferers find that pain occurs at a particular time of day, and many women find that the ups and downs of the pain cycle are linked to their menstrual cycle.
- Changes in bowel habits. Recurring episodes of diarrhoea or constipation commonly affect IBS sufferers, often alternating between one and then the other. The consistency of faeces can also vary from hard pellets to soft, watery stool. Sometimes you may pass mucus in your faeces, and you may feel that you have not fully emptied your bowels after going to the toilet.
The following are some of the other common symptoms caused by IBS:
- Stomach bloating
- Nausea and indigestion
- Abdominal pain or discomfort that can be reduced by passing wind or faeces
- Bladder problems
Symptoms are usually worse in women than in men and can be more severe at times of stress or around the time of menstruation. These symptoms are not unique to IBS, and they could be signs of coeliac disease or arrange of other conditions. It’s important to see a doctor for a proper diagnosis.
How is IBS diagnosed?
Anyone with IBS symptoms should seek medical attention to have their condition assessed and diagnosed. Lactose intolerance, coeliac disease, diverticulitis and a range of other health problems can cause similar symptoms, so your doctor will be able to rule out any other conditions.
There is no medical test that can definitively determine whether you have IBS. Instead, a doctor will make a diagnosis based on your symptoms and medical history.
Your doctor will give you a check-up and may also ask you to undergo blood tests to rule out other conditions. In some cases, your doctor may refer you for a colonoscopy or an X-ray of your abdomen in order to check for other underlying health problems.
Your GP will also ask for details regarding your symptoms, such as when you experience them, what they are, whether they’re more severe at particular times, and how often you have bowel movements, before giving a diagnosis of IBS.
What causes IBS?
Experts do not know the exact cause of IBS and research is continuing into what causes the onset of this embarrassing condition. However, the following factors can trigger IBS attacks and symptoms in sufferers:
- Emotional stress. Anxiety or stress can affect the nerves in the bowels of people susceptible to IBS. This could be stress about work, a school exam or even relationship problems.
- Genetics. Researchers believe that if you have a close relative who suffers from IBS, your chances of suffering from the condition are slightly increased.
- Infection. A bout of gastroenteritis can sometimes result in bowel-related symptoms that persist long after you’ve seen off the virus. Some experts believe this may cause changes to the nerve function of the bowel or to the number of bacteria in the bowel.
- Food intolerance. Your symptoms may get worse after eating certain foods or drinking specific fluids. For example, some researchers think lactose, fructose and other sugars may trigger IBS.
- Diet. Diets low in fibre can cause constipation, while spicy and sugary foods can cause diarrhoea. As a result, some experts have suggested that general diet can exacerbate the symptoms of IBS.
- Medication. Some antibiotics and painkillers can cause constipation or diarrhoea.
What treatment options are available?
While there is no known cure for IBS, there are several treatment options to help relieve symptoms and manage the condition. Using a variety of these treatments is typically the best way to control IBS, and your GP will be able to help you work out the best approach for your symptoms.
Treatment options include the following:
- Regular exercise. Not only will exercise improve your general health and wellbeing, it will also reduce your stress levels and help keep your bowel movements regular.
- Stress management. If stress triggers your IBS, you could consider using a range of relaxation and stress-management techniques to control the condition.
- Keep a diary. You can keep a diary of your IBS symptoms so that you can link them with life events, foods eaten, medications taken etc. and then avoid any potential triggers in the future.
- Anti-diarrhoea medication. Medications such as Imodium or lomotil can help relieve the pain, discomfort and inconvenience of diarrhoea brought on by IBS.
- Anti-constipation medication. On the flipside, medication to relieve the pain and symptoms of constipation and bloating can also be beneficial. You may also benefit from the use of antispasmodic drugs to prevent cramping.
- Antidepressants. Tricyclic antidepressants can also help treat the pain of IBS.
- Painkillers. Codeine and other painkillers can provide effective relief from the pain caused by IBS.
Finally, dietary changes are also an important tool when treating IBS.
Changing your diet
Changing your diet is crucial to the treatment of IBS. Although the impact of diet on IBS differs from one person to the next, making some simple changes to the food you eat can make a huge change to your quality of life. By keeping a food diary for a few weeks and monitoring how what you eat affects your IBS, you can identify trigger foods and make some simple dietary changes to relieve your symptoms.
Some commonly recommended dietary changes include the following:
- Slightly increase your dietary fibre to relieve constipation.
- Eat regular meals. Consuming six small meals throughout the day may be more beneficial than eating two or three large meals.
- Drink plenty of water.
- Cut down on beans, cabbage and other foods that produce gas.
- Cut down on dairy foods if lactose intolerance triggers your IBS symptoms.
- Limit the number of caffeinated drinks (tea, coffee, energy drinks) you consume.
- Eat a maximum of three portions of fruit a day.
- Cut sorbitol, an artificial sweetener, out of your diet to reduce diarrhoea symptoms.
- Consume psyllium supplements to relieve constipation.
- Eat plenty of oats to help reduce bloating.
- Eat meals slowly rather than rushing through them.
Finally, research from Monash University in Melbourne has shown that eating a diet low in specific types of carbohydrates helped to reduce IBS symptoms in 75% of patients. These carbohydrates, known as FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols), are not well digested or absorbed by people with IBS. For advice on how to follow a low-FODMAP diet, consult an accredited dietitian.