Irritable Bowel Syndrome (IBS) is a persistent condition that, with the help of your GP, can significantly improve with long-term management.
This common gastrointestinal disorder mainly affects your colon – the section of your digestive tract that resorbs water from food.
ON THIS PAGE
- Symptoms of IBS
- Common causes
- How Doctors Diagnose IBS
- Available treatments
- About Dr Michael Macpherson
Doctors estimate that IBS impacts 15% of adults, mostly women, yet only a small fraction of people get diagnosed.
IBS can be inconvenient and stressful, especially not knowing when a sudden urge to race to the toilet will come.
Getting checked out by a doctor can help – especially if you struggle to control symptoms.
IBS triggers and symptoms often change, so treatment options may need to be reviewed occasionally.
Some people confuse IBS with Inflammatory Bowel Disease. IBD includes Crohn’s disease and ulcerative colitis, which are much more severe conditions that often require surgery.
If you’re experiencing any symptoms listed below, see your GP to have the more serious causes of IBD excluded.
Symptoms of Irritable Bowel Syndrome
IBS can be unpleasant and painful and can ruin your day.
Symptoms vary between people, with common complaints including:
- abdominal pain
- excess gas
- a feeling that your bowel is never empty, even after having a big poo
IBS doesn’t cause long-term damage or lead to bowel disease or colon cancer.
Causes of Irritable Bowel Syndrome
We still don’t exactly know what causes IBS. Different factors or predispositions are triggers for different people.
Food intolerances: Poor digestion of certain foods can cause fluid and gas to build up inside the bowel, stretching the bowel wall. Bloating and discomfort are common symptoms.
Stress: Although unlikely to cause IBS on its own, stress can affect the nerve function of the bowel wall, potentially worsening symptoms.
Low-fibre diets: Not eating enough daily fibre can worsen constipation and perpetuate symptoms.
Medications: Some antibiotics, painkillers, and antacids may cause changes in bowel function.
A recent bout of gastroenteritis can also spark irritable bowel symptoms, though these usually pass when the bug is out of your system and you’ve had time for your gut to recover.
How Your Doctor Diagnoses IBS
If your symptoms are typical of IBS, your GP can usually come to a diagnosis by taking a thorough your history and ordering blood or poo tests.
We use blood tests to rule out coeliac disease or nutritional deficiencies, which act as clues to other digestive problems.
A colonoscopy may be required if symptoms include bleeding from the anus, weight loss, or severe diarrhoea that wakes you overnight.
This minor procedure involves looking inside your bum with a camera.
It gives us more confidence in ruling out more serious medical conditions while diagnosing IBS.
Though we don’t yet have a cure for IBS, many treatments are available to manage symptoms.
The best remedies will depend on the pattern and triggers of your symptoms.
Patients I’ve seen have found relief from these treatments.
Dietary and lifestyle changes
Increasing fibre and water intake can work wonders in moderating your regularity.
I often recommend fibre supplements or raw fibre, such as psyllium husks, and a diet plentiful in fruit and veg.
Eating less bloating foods may help. Beans, lentils, onions, and cabbage are often to blame for excess gas.
Increasing your cardiovascular exercise can also help improve IBS symptoms.
Regular physical activity can encourage bowel movements and reduce bloating while promoting all the benefits of being in better physical and mental shape.
If being backed up is one of your symptoms, let’s consider boosting your medium-long-term fibre intake. Same with water.
For more immediate relief, laxatives will get you results. Talk with your GP about the safest and best laxatives for you.
Some laxatives can cause dependence.
With diarrhoea being such a common (and unpredictable) symptom of IBS, many sufferers have Imodium or Gastro Stop on hand to stop the runs.
Please be aware that a period of constipation typically follows after taking either.
It can be tempting to help relieve this constipation with laxatives, yet this isn’t a good idea.
If you find yourself in a vicious circle of taking constipation and anti-diarrhoea medications, we need to discuss alternative treatment plans.
Anti-spasm medications aim to reduce the severity and frequency of cramps. Buscopan is a well-known example.
Herbal remedies such as Iberogast and peppermint oil are also said to reduce cramping and bloating, though there’s little scientific evidence to support the claims.
Stress management techniques
If stress sets off your IBS, consider occupying yourself with stress-busting activities in the lead-up to tense periods.
Exercise, meditation, or just talking with someone can work wonders.
With the help of a mental health professional aligned to your needs, you might also benefit from psychological strategies to reduce IBS symptoms, including cognitive behaviour therapy and gut-directed hypnotherapy.
A Word on FODMAPs
We now believe certain carbohydrates called FODMAPs actively contribute to symptoms of IBS in many people.
FODMAPs are a group of short-chain carbohydrates your body can’t easily absorb.
Unabsorbed FODMAPs travel to your large intestine and ferment, creating gas.
This excess gas and water cause your intestines to expand and cause pain. The presence of FODMAPs also causes water build-up in your small intestine.
The pain is heightened in people with IBS as they often have very sensitive intestines.
IBS sufferers may want to consider a low-FODMAP diet.
A dietician experienced in IBS can tailor a dietary program to address your specific symptoms best while maintaining your best nutrition.
Have a look at this video for more health information on FODMAPs and IBS.
Dr Michael Macpherson is a local GP at Doctors of South Melbourne.