Irritable Bowel Syndrome (IBS) is a disorder that affects the muscles and nerves of the bowel. It’s the most common, yet least understood gastrointestinal disorder, affecting one in five people in Australia. IBS isn’t a disease itself, the diagnosis is often a process of ruling out other conditions. It is important to speak with your GP about your symptoms before you begin any self-investigation.
Signs and symptoms: The signs and symptoms of IBS can vary widely from person to person and often resemble those of other diseases – therefore it’s very important to speak with your doctor as soon as possible and have appropriate testing (potentially including for Coeliac disease). Note: Symptoms that indicate a more serious condition include rectal bleeding, weight loss and/or abdominal pain that progresses or lasts at night.
Symptoms can vary in severity and come and go, lasting for hours, days, weeks or months. For most people, IBS is a chronic condition, but for others it can improve or even disappear completely. Some of the more common IBS symptoms include:
Abdominal pain or cramping – often relieved by passing wind or bowel motion
Altered bowel motions such as diarrhoea or constipation (or alternating between both)
A feeling of incomplete emptying of the bowel or sudden urgency
Mucus in the bowel motion
A feeling of fullness, or bloating of the abdomen (wind)
What causes IBS? IBS can occur at any age. For many people with IBS, the bowel appears to be over-sensitive. Unfortunately the cause isn’t always known, but a variety of factors can play a role:
Foods: The role of food intolerance in IBS isn’t clearly understood, but many people have symptoms after eating certain foods. For some people too much fibre, fat or spices for example can be the culprit, but for others it can be trickier to identify. Our best option for testing more sensitive people is through the process of dietary elimination and then food challenges. Depending on symptoms, the Low FODMAPs diet or RPAH Elimination Diet have been found helpful for many people. See my page on food intolerance for more details.
Enzyme deficiencies:Some people are born with, or develop, insufficient enzymes to digest, absorb or deal with some foods. For example, a deficiency of the enzyme lactase results in lactose intolerance. Some people also benefit from supplementing the enzymes needed for fat, protein and carbohydrate breakdown.
Stress: Most people with IBS find that their symptoms worsen or are more frequent at times of increased anxiety or stress. Such strong emotions can affect the nerves in the bowel for susceptible people.
Hormones: Because women are twice as likely to have IBS, researchers believe that hormonal changes play a role in this condition. Many women find that signs and symptoms are worse during or around their menstrual periods.
Medications: Some medications (e.g. antibiotic, antacids, painkillers) and supplements (e.g. iron) can cause gut irritations and lead to constipation or diarrhoea.
Other illnesses: Sometimes another illness that affects the gut, such as an acute episode gastroenteritis, food poisoning, or too many bacteria in the intestines (bacterial overgrowth e.g. SIBO), can cause the gut to become more sensitive and trigger IBS.
Is it serious? IBS can be very distressing to those that suffer from it, but it doesn’t usually lead to a more serious condition. IBS is very different to inflammatory bowel diseases such as Crohn’s disease or Ulcerative Colitis. IBS does not cause bowel cancer.
Managing your symptoms: Most people can control their IBS symptoms with diet, stress management and prescribed medications (if required). There are a number of dietary changes we can trial to help improve your IBS symptoms. Some include reducing high fat and/or sugar foods, spicy foods, high-fibre foods, coffee, lactose and generally meal sizes; or increasing probiotics (bacteria for the gut) and prebiotics (food for gut bacteria), which may help improve digestion and keep the bowel healthy. The approach we can take will depend on the type of symptoms you have. Some people can find that they feel better within a short period of time (days) after dietary changes, but others may need a few weeks.
Investigation of symptoms: If some changes to your regular diet don’t help to improve the way you feel, you may like to investigate through a low FODMAPs or Elimination diet followed by food challenges in a systematic approach.