Irritable Bowel Syndrome

Alphabet I Irritable Bowel Syndrome (IBS) is verging on being a pandemic. Nearly half of all referrals to gastroenterologists are for IBS, and it is second only to the common cold in terms of workplace absenteeism
IBSIBS

On the other hand, nobody dies from it. It can be painful, embarrassing, debilitating and antisocial, but it doesn't develop into cancer or any other serious bowel disease.

Symptoms

While this is positive news, there are still problems: the symptoms can vary wildly from person to person.

Most people who've never had IBS think it entails continuous diarrhoea, but symptoms can include abdominal pain or cramps; feeling 'full' or bloated; alternating constipation and diarrhoea; production of mucus; wind; nausea; feelings of inadequate emptying of the bowel; and women sometimes experience pain during sexual intercourse.

However, IBS never causes bleeding, so if this affects you, see your doctor. It may well be caused by something simple like haemorrhoids, but it should always be checked.

Triggers

What triggers the symptoms also varies widely - from relationship upsets to eating apples. So pinpointing your particular bugbear may not be straightforward.

Professor Nick Read, a consultant gastroenterologist and analytical psychotherapist at Sheffield's Northern General Hospital, who runs a specialist IBS clinic, firmly believes that IBS is "the visceral expression of unresolved emotional tension", and many experts agree.

However, IBS does have purely physical triggers in some people. Recent US research shows that intolerance of fructose (a simple sugar found in honey, most fruits and some manufactured foods) may explain some symptoms.

Other common triggers are

  • alcohol
  • spicy food
  • too much or too little fibre
  • caffeine
  • smoking
  • Some patients seem to have "super-sensitive" bowels that react differently from those of healthy people.

Theories

There are many theories about what causes IBS, but none has yet been proved nor debunked. Until the last decade or so, thousands of patients who suffered symptoms of IBS often struggled to get a diagnosis from their doctor and were even accused of malingering.

Today at least that has changed and the symptoms are taken seriously by the medical profession. But while the condition can't be cured, there are various drugs which your GP might prescribe to alleviate specific symptoms. For example:

  • Loperamide (Imodium) helps with diarrhoea attacks.
  • Bulking agents like psyllium, ispaghula husk or methylcellulose can ease constipation.
  • Antispasmodic drugs like atropine (Lomotil), merbentyl (Diarrest), mebeverine (Colofac) and hyoscine (Buscopan) all help to relieve abdominal cramps and diarrhoea.
  • Antidepressants can calm the bowel as well as relieving depression.
  • You will probably also need to experiment with lifestyle changes to alleviate stress and help control your symptoms.

Keeping a food diary may enable you to identify specific foods that upset you. Everyone's solution will differ, but with a combination of medication and self-help, it should be possible to prevent the condition interfering with normal living.

Written by Stephanie Zinser

The Good Gut Guide, by Stephanie Zinser (Thorsons)

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