Irritable Bowel Syndrome: Three words that use to make Michael*, a healthy 28 year-old journalist from St Kilda, break out in a cold sweat before each date.
The first time his condition got in the way of his love life still haunts him. Around two years ago, he finally got up the courage to ask Amy* out to a Saturday night movie. “I’d love to!” was her answer.
All was going well until that all-familiar pain stabbed at Michael’s abdomen. Knowing this meant a bout of diarrhoea was only moments away, he dashed to the toilet to avoid humiliation. It was a bad episode which, to his horror, seemed to last forever.
With Michael’s unexplained absence, Amy felt like she was being ignored and booked an Uber home. Too embarrassed to talk later with Amy about his IBS, their relationship ground to a halt before it even began.
Michael eventually spoke with his GP who offered some great tips for minimising the impact of IBS on his social life. He’s now in a wonderful relationship with a partner who empathises with his condition and accepts him warts and all.
IBS Treatment, Symptoms, Causes and Diagnosis
Before we dive into the tips offered by Michael’s GP, let’s quickly look at some facts on IBS.
Irritable Bowel Syndrome is a condition that affects your colon – the section of digestive tract that stores poo. It’s estimated to affect up to 15% of adults. Surprisingly, only a small fraction gets diagnosed by a GP or gastroenterologist.
Irritable Bowel Syndrome Symptoms
IBS can be unpleasant, painful and can have a huge impact on 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
- occasional white mucus in your poo.
Rest assured, the condition doesn’t cause long-term damage to your colon or lead to bowel cancer.
What Causes IBS?
We still don’t exactly know what causes IBS. Different factors or predispositions are triggers for different people, such as:
- Food intolerances: This can cause fluid and gas to build up inside the bowel, stretching of the bowel wall which results in discomfort and bloating.
- 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.
- Medications: Some antibiotics, painkillers and antacids may cause changes in bowel function.
- Infection: A spell of gastro can cause prolonged bowel symptoms.
How is IBS Diagnosed?
If your symptoms are typical of IBS, your GP can often make the diagnosis by taking a thorough history and ordering simple blood tests. Blood tests are used to rule out coeliac disease or nutritional deficiencies which may be clues of other digestive problems.
If symptoms include bleeding from the anus, weight loss or severe diarrhoea that wakes you overnight, a colonoscopy may be required. This minor procedure, involving looking inside your bowel with a camera, is effective in ruling out other medical conditions. It also gives us more confidence in diagnosing irritable bowel syndrome.
IBS Treatment and Management
We can’t yet cure IBS. However, there are many different ways to manage symptoms. The best treatment will depend on the symptom pattern and triggers. Typical treatments may involve:
- increasing the amount of fibre and water throughout your day
- constipation medications if being backed-up is a common symptom
- anti-diarrhoea medication if diarrhoea is a recurring symptom
- anti-spasm medications to help with cramping
- stress management techniques if symptoms worsen with emotional distress.
Five Tips for Dating With an Irritable Bowel
Don’t eat or drink anything that sparks your IBS in the hours or days before your date. You may want to avoid spicy dishes, caffeine and FODMAPs (see below for more info). Knowing that you’ve eaten right can help you relax and reduce stress – which may also be a trigger factor for you.
If stress sets off your IBS, occupy yourself with healthy stress-reducing activities in the lead-up. These may include exercise, meditation or just talking with someone you trust. There are also many relaxation exercises for IBS. Avoid taking medication for stress unless prescribed by your GP.
3. Location & Time
Choose the locale and time of your date well. This could be a venue at which you’re familiar with the toilets, or bar with a bit of noise to hide belly gurgles and farts. If eating tends to trigger your IBS, organise the date outside of typical meal times. Mini-golf on a Sunday afternoon sounds ideal.
Most people love humour and react positively to modest self-deprecation. If you feel your date will respond well, why not joke about your IBS? Imperfection and vulnerability can be attractive traits in a person. Who knows, you might be pleasantly surprised by your date’s reaction – and even learn a little secret about them in return.
A Note 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 which your body can’t easily absorb. Unabsorbed FODMAPs travel to your large intestine and ferment, creating gas. The presence of FODMAPs also causes water build-up in your small intestine.
This excess gas and water cause your intestines to expand and cause pain. The pain is heightened in people with IBS as they often have very sensitive intestines.
IBS sufferers may consider a low-FODMAP diet. An IBS-experienced dietician should guide this to avoid patients being burdened with overly restricted diets.
We want you to be able to enjoy as many foods as possible!
Have a look at this video for more info on FODMAPs and IBS.
* Not their real names