It affects as many as one in five people in the UK with a catalogue of debilitating symptoms from abdominal pain to bloating, constipation, nausea, heartburn and fatigue.
In fact, Irritable Bowel Syndrome (IBS) is second only to the common cold as a major cause of absenteeism from work.
Yet, despite the misery the condition can cause, research shows many people remain undiagnosed and unaware they’re even suffering from a medical disorder.
But this month is IBS Awareness Month and experts are keen to stress the message to sufferers: “You are not alone – don’t suffer in silence.”
Campaign organiser The International Foundation for Functional Gastrointestinal Disorders (IFFGD) points out: “Although IBS is not typically associated with an increased risk for life-threatening illness, it… can severely compromise a person’s quality of life. Receiving a proper diagnosis and treatment is key.”
So how can you identify Irritable Bowel Syndrome – and are there any steps you can take to alleviate its sometimes extreme discomfort?
The condition is probably best described as a functional disorder of the gut. While the gut itself has no abnormalities with IBS, the way it functions is impaired.
Symptoms, while variable, include:
*Pain and discomfort in different parts of the abdomen – often described as a “spasm” – which tends to come and go
*Pain often eases when the sufferer passes stools or wind
*Bloating and swelling of the abdomen, from time to time, with increased passing of wind
*Diarrhoea or constipation
*A sensation of not having emptied your rectum after going to the toilet
*Some people have an urgent need to go to the toilet – often several times in the morning, and commonly during and after breakfast
Occasionally IBS can cause nausea, headache, belching, poor appetite, tiredness, backache, muscle pain, feeling full quickly after eating, heartburn and bladder symptoms.
Where some people have infrequent and mild symptoms, others can suffer unpleasant effects for long periods of time.
IBS most commonly first develops in young adults, although it can occur at any age, and it is twice as common in women as men. Its causes are not known, although it may be related to an overactivity of part of the gut – and there is no cure, as such.
With IBS, the gut appears to be over-sensitive to certain triggers, leading to symptoms. Sometimes stress can be pinpointed as a trigger or an intolerance to certain foods. In others, IBS has developed after an infection. Identifying the triggers and treatment can often dramatically ease the symptoms.
The first step, however, is to receive a proper diagnosis from a doctor and rule out any other illness. While there is no ‘test’, often a blood sample is taken to discount the likes of ulcers, colitis or coeliac disease and a diagnosis is then made based on the description of the symptoms.
In many cases, diagnosis can ease anxiety and lead to an improvement in symptoms. But if discomfort is troublesome or frequent, there are steps you can take to ease them. They include:
Increase your intake of soluble fibre
There is some confusion about whether increasing fibre in your diet can improve or worsen IBS. In fact, it now appears that the type of fibre you eat is important: so-called “soluble fibre” (which dissolves in water) is recommended, while it is advised to cut down on “insoluble fibre”.
Soluble fibres include oats, fibre supplement ispaghula (psyllium), and some fruit and vegetables, such as bananas, strawberries, apples, pulses, carrots and potatoes. Insoluble fibre is chiefly found in corn (maize) bran, wheat bran, brown rice and wholegrain bread. Avoid bran as a fibre supplement.
Change your eating habits
Even aspects of a normal healthy diet can trigger symptoms of IBS. Experts advise:
*Have regular meals and take time to eat at a leisurely pace
*Drink at least eight cups of fluid, especially water, per day
*Restrict tea and coffee to three cups per day
*Keep the amount of fizzy drinks that you have to a minimum
*Don’t drink too much alcohol
*Limit fresh fruit to three portions (of 80 g each) per day
*If you have diarrhoea avoid sorbitol, an artificial sweetener
*If you have a lot of wind and bloating, consider increasing your intake of oats and linseeds (up to one tablespoon per day)
Check for intolerance
If you suspect a particular food is causing you problems, you may have a food intolerance. See your GP to discuss the best course of action. He or she may refer you to a dietician who can advise on an exclusion diet and the best way to pinpoint a ‘trigger’ food.
They’re more than just an advertising fad: probiotics containing so-called “good bacteria” may help. You can take them in capsule from pharmacies or some yoghurts, cheeses and milk drinks contain probiotic bacteria. It may not work for everyone, however, so keep to one brand for at least four weeks to monitor the effect. If the first fails to work, you could try a different one.
Regular exercise can help alleviate symptoms. It may also reduce stress, which can be a factor.
Keep a lifestyle diary
Record everything you do and eat for three or four weeks to help identify potential triggers (for example food, alcohol, lack of exercise or emotional stresses)
Cognitive behavioural therapy
Because stress, family problems, work issues and other emotional upset can trigger IBS, cognitive behavioural therapy – where you learn coping mechanisms to deal with anxiety and stress – may help. Stress counselling, relaxation techniques and hypnotherapy may also be useful. Again, ask your GP for a referral to an accredited practitioner.
If symptoms persist there are medications that can help. Antispasmodics relax the muscles in the wall of the gut and your doctor may suggest them if you have spasm-like pains. There are different types, so you may need to experiment with a few.
Alternatively, some tricyclic antidepressants have been used to treat IBS where pain and diarrhoea are the main symptoms. But these are only advised if you have persistent symptoms, or frequent bad flare-ups that have not been helped by other treatments. In the event that you feel you may need medication, always consult first with your GP.