What is IBS?
Irritable Bowel Syndrome (IBS) is a common condition which affects the digestive system. It is a long-term condition with varying degrees of severity depending on person to person. Most people have flare-ups of symptoms which can last a few days. The symptoms may then improve but not go completely. The main triggers include certain foods and stress.
The most common symptoms include:
- Abdominal pain and cramping
- Diarrhoea or constipation (or sometimes alternating between the two)
- Bloating and distended stomach
- Excessive wind (flatulence)
- Occasionally needing to urgently go to the toilet
- Feeling that you have not fully emptied your bowels
- Passing mucus from your bottom
In addition to these symptoms, people with IBS may experience some of the following:
- Lack of energy (lethargy)
- Feeling sick
- Bladder problems (i.e. feeling an urgent need to urinate or waking up at night to urinate)
- Pain during sex (dyspareunia)
The exact cause of IBS is currently unknown. Some experts have suggested the following causes:
- Problems with digestion – It is thought that the natural process of moving food through the digestive system by squeezing and relaxing the muscles in a rhythmic way is altered in IBS sufferers, causing food to either move through the digestive system too quickly (resulting in diarrhoea) or too slowly (resulting in constipation).
- Increased gut sensitivity – Some experts believe that people with IBS may be oversensitive to the digestive nerve signals. For example, mild indigestion may be barely noticeable to a non-IBS sufferer but will present itself as distressing abdominal pain in IBS sufferers.
- Psychological factors – There is evidence to suggest that psychological factors play a role in IBS. This does not mean that it is “all in the mind”. The symptoms are very real. Emotional states such as anxiety and stress can trigger chemical changes that can interfere with the normal workings of the digestive system. Some sufferers feel that their symptoms worsen when they are under stress.
- Food triggers – Certain foods and drinks can trigger the symptoms of IBS. Examples include alcohol, fried/fatty food, fizzy drinks, etc. but not everyone with IBS has the same reactions to the same foods.
There are no specific test for IBS as it does not cause any detectable abnormalities in the digestive system. In most cases, a diagnosis will be made depending on the symptoms the patient presents. A diagnosis may also be made once other conditions such as coeliac disease and inflammatory bowel disease (IBD) have been ruled out. To rule these out, the GP may order blood tests and other tests such as an endoscopy.
IBS can often be managed by changing your diet and lifestyle. The main dietary tips offered to IBS sufferers are:
- Try eating smaller meals throughout the day (i.e. 5 or 6 small meals) rather than large meals (i.e. 3 large meals)
- Don’t rush your food
- If you have diarrhoea, try to cut down on insoluble fibre (i.e. wholegrain bread, nuts, seeds, bran, etc.)
- If you have constipation, try to increase soluble fibre (i.e. oats, barley, rye, fruit such as bananas and apples, golden linseeds, root vegetables such as carrots and potatoes, etc.)
- Certain teas may have a calming effect on symptoms of IBS, i.e. peppermint tea may help with cramping and spasms while ginger tea may help nausea
- Drink plenty of fluid throughout the day i.e. water and herbal teas
- Restrict tea and coffee to a maximum of three a day
- Reduce the amount of alcohol and fizzy drinks you drink
- Some sweeteners such as sorbitol can trigger IBS symptoms. Avoid this sweetener. They are often found in some chewing gums, drinks, diabetic products and slimming products
- Limit fresh fruit to three portions a day
- If you suspect certain foods are your triggers, do an elimination diet where you completely eliminate those foods for 4 weeks then re-introduce them (one at a time if you’ve eliminated more than one food) to see if your symptoms have returned. If they return then eliminate that food again.
- Low FODMAP Diet: FODMAP stands for Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polyols. They are types of carbohydrates which are not easily broken down and absorbed by the gut. Because of this, they start to ferment in the gut quite quickly. The gases which are released during this process can cause bloating. Doctors or Dieticians sometimes recommend a Low FODMAP Diet to IBS sufferers. It involves restricting the intake of foods considered High FODMAP which include some vegetables, fruit, animal milks, wheat products and beans. This diet can be quite restrictive and may not work for everyone but some individuals may find relief of their symptoms
Many people find that regular exercise can help relieve their IBS symptoms. You should aim to do a combination of cardio (3-5 days a week for 20-90 minutes), strength/resistance training (2-3 days per week for 20-60 minutes), core stability training (no set guidelines) and flexibility training/stretching (2-3 days per week with each stretch being held for 15-60 seconds).
Some people find stress and anxiety are triggers for their symptoms so reducing stress levels can be very beneficial. Ways to reduce stress include:
- Breathing exercises
- Cognitive Behavioural Therapy (CBT)
- Colouring books
- Exercise such as running, walking or swimming
Probiotics can often be recommended by a doctor or dietician. They contain “beneficial bacteria” that can supposedly improve digestion. They can come in supplement form and can also be found in yoghurts and yoghurt drinks.
Doctors may prescribe certain medications for IBS. These include:
- Antimotility medicines
- Low-dose antidepressants
Some complementary therapies may also be useful in the treatment of IBS such as acupuncture and homeopathy.
If you suspect you have IBS or have been diagnosed with IBS and feel it is ruling your life, the first step is to go see your GP to start the process of getting to a healthier and happier state.