A Complete Guide To Irritable Bowel Syndrome / HARTMANN Information Centre

The HARTMANN Team

Irritable Bowel Syndrome is an unpleasant condition which can have a dramatic impact on a persons life.  Being able to identify the causes and symptoms can help to reduce the distress and also help towards taking the most appropriate measures to manage the condition.

What Is Irritable Bowel Syndrome?

Irritable Bowel Syndrome is commonly referred to as IBS.  This is a medical term used to describe a collection of symptoms which are impacting the gut.  It is possible that something as simple as a dietary change can cause IBS symptoms, and often simple changes can result in positive results.

As IBS is a collective term for many gut related problems, the symptoms can vary between individuals.  Some people may suffer only minor discomfort, while others could present more severe symptoms. It is believed that some form of IBS impacts one in five adults.

Your doctor will consider IBS if symptoms include abdominal pain or discomfort, bloating, or a change in bowel habits which lasts for more than six months. People with IBS may also suffer from a noticeable difference when opening their bowels.  Alterations could include straining, increased urgency, incomplete evacuation or passing mucus when going to the toilet.  IBS can sometimes cause or increase the risk of faecal incontinence, which can have a devastating impact on a persons quality of life. If you experience faecal incontinence, HARTMANN Direct sells a variety of incontinence products that can help you manage your incontinence.

You may find that your abdomen bloats, though this is more common in women than in men.  This could be just distended, but it may also be hard to the touch.  You are likely to find that the symptoms worsen with eating. Any problem with your gut is going to result in tiredness and possibly feelings of nausea.  You could feel discomfort or pain in your back, and the problem could extend to your bladder.

If you experience unexplained weight loss, rectal bleeding, if there is a family history of bowel or ovarian cancer or if these symptoms persist for more than six weeks in a person over 60, then this should be treated as an urgent case, and immediate medical attention should be sought from your GP.

What Causes Irritable Bowel Syndrome?

The exact causes of IBS are not known.  However, factors in digestion and increased gut sensitivity include:

Muscle contraction in the intestine Your intestine is lined with a layer of muscles that contracts as food passes through your system. If contractions are stronger and last too long, then you can get gas, bloating and maybe even diarrhoea. If your muscles are weak, then the passage of stools will be slower and dryer.
Nervous system If the nerves in your digestive system are abnormal, then you will feel discomfort. It might be that signals to your brain are misfiring, causing your body to overreact to normal digestive processes.
Inflamation With an increased number of immune-system cells in the intestines, there is potential for inflammation and associated symptoms.
Infection If you suffer from a severe infection, it can leave a surplus of bacteria in the gut, known as bacterial overgrowth.
Changes to microflora Microflora is a necessary bacterium in the intestine for the processing of food. It is possible that changes to these bacteria can result in IBS symptoms.

 

How Do You Get Diagnosed With IBS?

You should visit your GP immediately if severe symptoms of bleeding or unexpected weight loss occur.  Symtpoms of IBS can be quickly relieved with some medication, which you can purchase from the pharmacy.  However, if these symptoms continue for six months, then you should report your symptoms to the GP.

Your doctor will ask for details about your symptoms, whether they come or go and how often.  They will ask for more information about the food you eat, and which foods are more likely to get a reaction.  They will also want to know how long you have dealt with these issues.  It is a good idea to write down answers to these points before you go to the surgery.  Forgetting something in a short appointment window is easy.

Your GP may then feel your stomach and check to see if there are lumps or any swelling.  There are no specific tests the doctor can request to confirm IBS.  They may ask for blood tests and a stool sample but this is to rule out any other potential causes for the symptoms, for example Coeliac Disease or Inflamatory Bowel Disease.  It is unlikely that you will need further tests at the hospital unless your doctor is concerned that the IBS symptoms are serious enough to warrant an investigation into other conditions.

How to Treat Irritable Bowel Syndrome?

Managing the symptoms of IBS requires a mixture of diet, lifestyle changes and medication. .

To improve your symptoms, you should cook meals using fresh ingredients.  You should keep a diary of foods and link these to flare-ups, avoiding that which triggers your condition.  Stress is found to be a significant trigger of IBS symptoms, therefore you should find ways to relax.  Yoga can be a good way of managing stress and improving symptoms. You should try to get plenty of exercise and try to drink probiotics for a month to see if this helps.

It would help if you did not skip meals, keeping to a routine of three meals a day at a standard time.  Try to eat slowly, as eating quickly can result in the swallowing of air that causes discomfort.  Avoid fatty and spicy foods or any food that is overly processed.  Limit your fruit intake to 3 portions of fresh fruit a day – and the same number of cups of tea or coffee.  It would be best if you did not drink alcohol or fizzy drinks.

The pharmacist can also supply medicines that relieve the symptoms, such as Buscopan, peppermint oil, Imodium, Movicol, and others.

What Triggers IBS?

Food, stress or hormones can trigger the symptoms of irritable bowel system.

Food: A food allergy will be unlikely to cause IBS, as IBS is characterised by an extended period with symptoms.  Eating a portion of food that causes you an allergic reaction will likely be limited to a short time frame.  However, symptoms of IBS can be made worse by certain foods and drinks, and it is useful to keep a record of what makes your IBS worse.

Stress: more frequent and more intense IBS can result from stress.  Although it is not the cause of IBS, stress can certainly make matters worse.

Hormones: women are twice more likely to have IBS due to hormonal changes in the body.  Many women report worse symptoms during menstruation.

You are more likely to be at risk of IBS if:

  • You are under 50
  • You are female
  • There is a family history of IBS
  • You suffer from mental health problems such as anxiety or depression.

What Food Should You Avoid If You Have IBS?

Although food is not generally the cause of IBS, it can exacerbate the symptoms.  Therefore, to avoid triggering your IBS, you should avoid:

  • Alcohol
  • Fizzy drinks
  • Chocolate
  • Caffeine-based drinks
  • Processed snacks such as crisps or biscuits
  • Fried food
  • Food with high-fat levels
  • Sweeteners that include sorbitol

It is a good idea to keep a food diary to help you identify what triggers your IBS, as it is different between individuals.

You may be encouraged to see a dietician who will recommend a low FODMAP diet.  This will involve avoiding foods that are not easily broken down such as fruit and vegetables, milk and wheat products.  You will need to replace the essential nutrients we usually get from these foodstuffs, therefore it is best to follow such a diet under the direction of a professional.

What Food Aids IBS?

Certain foods can ease the bloating, cramps and wind associated with IBS, such as:

  • Oats, such as porridge
  • A tablespoon of linseeds
  • Drinking water
  • Eating soluble fibre such as pulses, carrots, peeled potatoes
  • Probiotic yoghurts or other supplements

What Complications Can Arise From IBS?

If you suffer from constipation or diarrhoea for an extended period, then you can develop haemorrhoids.  It is also believed to result in a poor quality of life, with people worried to go out in fear of not being near a toilet.  It is also seen as a trigger-factor for mood disorders.

How to Prevent IBS?

There are choices you can make to prevent IBS.  These may be making positive changes to your diet, but many of this choices will involve managing stress related triggers.   You can:

  • Seek counselling to help modify your stress responses.
  • Undergo biofeedback, which helps to relax specific muscles and so ease symptoms.
  • Use progressive relaxation exercises, which tighten and then relax muscles. This helps you to relieve the tension that is held in your body slowly.  You should begin by tensing and releasing your feet, then your calves, and so on up your body.
  • Mindfulness training is an excellent stress-reduction technique.
  • Yoga is a relaxation technique, and many of the poses are said to aid the processing of the gut, particularly inversions.

Summary

IBS is a condition that can severely impact your life.  It is becoming more common because we live a faster-paced life, with lots of stresses and many convenience foods.  The bad news is that the symptoms can become so severe that sometimes even leaving the house becomes difficult. The good news is that there are a lot of proactive choices an individual can make that will relieve the symptoms – whether it is monitoring diet or reducing stress levels.

Further advice and help is available at the IBS network, www.theibsnetwork.org

References

Bda.uk.com. (2019). Irritable Bowel Syndrome. [online] Available at: https://www.bda.uk.com/foodfacts/irritable_bowel_syndrome [Accessed 25 Apr. 2019].

Nhsinform.scot. (2019). Irritable bowel syndrome (IBS). [online] Available at: https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/irritable-bowel-syndrome-ibs#causes-of-ibs [Accessed 25 Apr. 2019].

Mayo Clinic. (2019). Irritable bowel syndrome - Symptoms and causes. [online] Available at: https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016 [Accessed 25 Apr. 2019].

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