Irritable bowel syndrome

IBS, or irritable bowel syndrome, is a functional bowel disorder. It is called a syndrome as there is no obvious structural or biochemical cause for the symptoms, but that does not mean that the symptoms are not real. IBS has a wide range of symptoms that can have a significant effect on your life, and while there is no cure as such, Dr Ana Wilson can work with you to reduce and relieve these symptoms.

Symptoms of IBS

IBS can seem like a catch-all label for a broad spectrum of symptoms, however, these are all associated with changes in the sensitivity and function of the gut.

Typical symptoms include:

• Cramps and pain in the lower abdomen
• Swelling or bloating
• Diarrhoea or constipation
• Flatulence
• Dyspepsia (heartburn or indigestion)

IBS can also cause unpleasant changes in your bowel habit such as feeling an urgent need to go to the toilet, feeling that your bowel has not been fully evacuated when you do go, or feeling like you need to go even when you have just been.

It is unlikely that you will experience all of these symptoms, or that you will experience symptoms all the time. For most people IBS occurs in an irregular pattern of flare-ups lasting a few days at a time, although they can persist for several weeks. The nagging discomfort and the associated embarrassment of altered toilet habits, combined with the fact that there is not obvious medical cause or cure, often leads IBS sufferers to experience bouts of anxiety and depression.

Causes of IBS

The underlying cause of IBS has yet to be fully identified, although most current research points to an increased sensitivity of the gut. This increased sensitivity can change the speed at which food moves through your system, as well as making you more sensitive to abdominal pain and discomfort. If food moves too slowly, you get constipation; too fast and you get diarrhoea.

There are many schools of thought regarding what causes this increased sensitivity, including:

• Food triggers including caffeine, alcohol, fatty foods and processed food
• Psychological triggers including stress and childhood trauma
• Genetic factors – IBS may have some factors that are inherited
• Medical history – previous episodes of food poisoning may lead to IBS later in life
• Infection – some studies have suggested that IBS is related to bacterial infections, which increase sensitivity in the gut because of an exaggerated immune response

Managing IBS

Most people will have a good idea as to what triggers their IBS, be that emotional factors such as stress, or physical factors such as diet or irregular eating. Dr Wilsons’ approach to treating IBS is to help you to pinpoint these triggers and change your lifestyle to reduce or eliminate them.

For example, if you think that food may be the trigger for your IBS, then you should keep a food diary detailing what and when you ate, and what effect this had on your symptoms. This can help you to identify the changes that you need to make.

For many people, IBS is triggered by psychological factors, such as emotional situations or stress. However, that does not mean that your IBS symptoms are all in your mind, as psychological events cause very real chemical changes in the body that can trigger your IBS. Talking to a counsellor or therapist, or learning techniques to deal with stress, can make a big difference to your IBS.

Treating IBS

As well as identifying and minimising the causes of IBS, there are also a range of drug treatments that can help you deal with the symptoms themselves, such as:

• Antispasmodics – which reduce the spasms in the gut wall
• Laxatives, which relieve constipation
• Antimotility drugs, which relieve diarrhoea
• Antidepressants, which help you cope with the anxiety that IBS can cause