What is IBS?
IBS is a disorder of the way the bowel functions. Food gets from the mouth to the anus being propelled along by muscular contractions in the bowel wall. When I was at Medical School, there was much debate around whether IBS sufferers had stronger than normal contractions or were simply more tuned into normal contractions. I suspect both theories play a role. It is a very common condition affecting as many as one in three of us at some point.
What are the symptoms of IBS?
IBS is a very individual disease. Some people have mild and occasional symptoms, whilst others find their lives totally ruled by the condition. Some people will get diarrhoea with an attack, others tend more to constipation and some people will have a mixture of both diarrhoea and constipation. Most sufferers describe crampy abdominal pain, bloating and excess wind. Some people notice slime or mucus in the motions, but IBS should never cause bleeding from the back passage, so this must always be checked out. Another common symptom is a feeling of incomplete emptying after opening the bowels. This is called tenesmus.
What causes IBS?
We don’t yet fully understand what causes IBS. We know it is much more common in women and flares are often linked to menstrual cycle, so we know hormones play a role. Stress is also a common trigger, and some foods may also be a cause symptoms to flare.
How is IBS diagnosed?
We don’t currently have a specific test to diagnose IBS. The diagnosis is made mainly on the history, so if you are thinking of seeing your GP querying a diagnosis, spend some time really thinking about when your symptoms flare. I am a huge fan of symptom diaries. If foods trigger IBS, it may not be within hours, sometimes it can be a day or more later, so keeping a food and symptom diary for two or three weeks can really help to show if there is a pattern. IBS is a disease of the way the bowel works so it looks normal, meaning scans, blood tests and looking inside with a camera will all appear normal.
A couple of years ago, I filmed a documentary on IBS and was lucky enough to interview researchers doing some exciting work. I met one team who has identified a particular chemical in the stool of IBS sufferers. It is early days yet, but this could be the beginning of developing a specific test to diagnose IBS.
How is IBS treated?
Treatment will depend very much on severity of symptoms and the impact of lifestyle factors. If you have identified a particular food group that flares your symptoms, simply omitting this food may be all you need to do, but I would advise anyone considering eliminating any food group from their diet long-term, to consult a qualified dietician to ensure they are replacing those lost nutrients.
Stress management is really important in IBS. Many years ago, I worked with a specialist in IBS and he had the foresight to employ a hypnotherapist alongside him in his clinic. I was so impressed with the results that I have often recommended hypnotherapy to help my IBS patients. There are also lots of medicines, some available over the counter and some on prescription to help with the condition.
What about the low-FODMAP diet?
FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. The low-FODMAP diet means cutting out foods containing these and then gradually reintroducing them. It is a difficult diet to follow and really should only be tried with the help of a dietician.
Do probiotics help?
I am a fan of taking a daily probiotic for anyone with gut health issues. Probiotics contain good bacteria that help us digest our food. Each one of us has 2kilos of good bacteria in our gut and topping those up with a probiotic can be helpful in alleviating IBS symptoms.