Irritable bowel syndrome awareness month

April is irritable bowel syndrome awareness month and a good opportunity for me to share some information about this common disorder of the digestive system.

By Dr Sherzad Balata, Consultant Gastroenterologist

Irritable bowel syndrome (IBS) is a condition that causes stomach pain and cramps, with altered bowel habits (how often you need to poo). It comes and goes and can lead to significant distress and psychological upset.  The pain is usually in your lower abdomen, more on the left side. Other symptoms include bloating, needing to go for a poo frequently or the feeling that you cannot empty your bowels fully.

You may also have upper digestive system symptoms such as nausea, sickness, belching and indigestion.

The chronic relapsing nature of this condition (meaning it comes and goes over time) can significantly affect quality of life. At least one in ten people are estimated to have IBS, with young people more likely to be affected. Women are two to three times more likely than men to have IBS. Only a small number of people with IBS have severe symptoms (refractory IBS) and require support from secondary care.

IBS occurs in three forms

• IBS with diarrhoea (IBS-D)
• IBS with constipation (IBS-C)
• IBS with mixed diarrhoea and constipation (IBS-M)

The presence of mucous in the stool is common in IBS patients especially those with IBS-C. Sometimes an acute bacterial or viral infection of the digestive system like gastroenteritis precipitate IBS when symptoms do not resolve over months, causing psychological stress. This is called post-infective IBS.

If you think you might have IBS, see your GP. They will ask about your symptoms and examine you and may arrange laboratory tests to establish the diagnosis., which can include a blood test for coeliac disease and a stool test for inflammatory bowel disease.

Management of IBS includes

• Patient education and support to identify stressors and use avoid techniques
• Diet and lifestyle measures. The community dietitian plays an important role in this context and may recommend a Low FODMAP Diet. Gluten intolerance has been associated with IBS.
• Pharmacological treatment for your symptoms.
• Psychotherapy and antidepressants can also help ease symptoms.
• Probiotics can be used but it is unclear for which patients' probiotics are helpful.
• Colonoscopy is not required for investigation of IBS.

Diet, lifestyle and stress management are the best way to lessen the impact of IBS. Your GP can establish the diagnosis and rule out other causes of abdominal pain and change in bowel habit.

Support from The IBS Network is available. Visit The IBS Network