IRRITABLE bowel syndrome (IBS) is a condition that affects the digestive system. Symptoms include abdominal pain, bloating, diarrhoea and or constipation.
A lot of people who suffer from the condition often times don’t seek medical attention, possibly due to fobbing it off as a ‘weak stomach’ or maybe due to embarrassment, but there is help available.
IBS can be a debilitating illness and is a common cause of absenteeism from work. It is one of the most common reasons for referral to a gastroenterologist.
It is estimated that around 20,000 people in Ireland are affected by it, but that figure could well be much higher as many people suffer in silence when it comes to IBS.
Who does IBS affect?
IBS affects about 10-15% of the population. It’s more common in women than men.
What are the symptoms?
Crampy abdominal pain is common for IBS sufferers. It’s often made worse by some food triggers or emotional stress.
It may or may not be relieved by passing a bowel motion.
Bloating is also a bothersome symptom. Some patients report diarrhoea. It typically occurs after meals. Mucus may also be present in the stool.
Blood is not associated with IBS. Whilst some patients may suffer from diarrhoea predominant IBS, some may suffer from constipation predominance. Some will alter between the two. A feeling of incomplete emptying may also occur.
Is there a test for IBS?
There is no specific test. IBS is a ‘diagnosis of exclusion’. This means that all other causes of abdominal symptoms are ruled out first, i.e. conditions like Coeliac Disease, Crohn’s Disease and Ulcerative Colitis.
When you go to your doctor to report your symptoms a detailed history will be taken, paying attention to family history, stool frequency and consistency (normal topic of conversation for doctors!) and identifying important symptoms like passing blood or weight loss.
What causes it?
The exact cause of IBS is not very well known but it is thought to be due to a ‘hypersensitive’ bowel that overreacts to certain foods.
What is the treatment?
Keep a diary
It’s important in IBS to identify your triggers, whether it’s stress or certain food types. Keep a diary of your diet, lifestyle and bowel symptoms can be useful in identifying your triggers and thus knowing what to avoid.
Keeping active is important for overall physical and mental health and plays a key role in the management of IBS.
Psychological stress can have very real physical manifestations and can undoubtedly cause IBS to worsen. Again, exercise is a good stress reliever. Over the counter remedies like Zenflore can also help.
These play an important role in IBS. Alflorex is one of the top probiotics prescribed by gastroenterologists for IBS management.
Common dietary triggers include gas-producing foods like beans, onions, celery, and carrots. Lactose can be difficult for IBS sufferers to tolerate. Gluten can also be bothersome, even for people who don’t have coeliac disease and ‘non coeliac gluten sensitivity’ is now being recognised amongst gastroenterologists.
A low FODMAP diet can also be very beneficial for symptomatic relief. FODMAPs are carbohydrates that are found in some foods. High FODMAP foods include apples and pears.
Talk to your GP about a dietician referral for more information about FODMAPs.
Case Study 1: Dr Doireann O’Leary’s IBS story
A doctor working in general practice, it took Dr O’Leary a long time to really identify that she had IBS and in turn to treat it.
She said that she has always been a fussy eater and she struggled to maintain a healthy lifestyle, especially when she was working as a junior doctor.
“I was admitted to hospital a few times with extreme abdominal pain and had a number of investigations done over the course of a few years,” said Dr O’Leary. “But it wasn’t until I was about 30 that we realised it was IBS.
“My main symptoms were bloating and abdominal pain. There came a stage where my IBS was so bad I was actually terrified about going away for a weekend or going on holiday in case I’d get a flare-up. I think some people don’t realise how debilitating IBS can be.”
Changing her lifestyle worked very well for Doireann and key for her has been getting regular exercise, staying hydrated, following a predominantly low FODMAP diet. She also takes a daily probiotic called Alflorex.
“I am delighted to say that now that I have identified my triggers, I know how to manage my IBS.
“I would say to anyone who thinks that they might have IBS to go and talk to your GP about your symptoms and ask to speak to a dietitian.”
Case Study 2: Vivienne McCarthy, Cork mother of two young boys
Vivienne is a well-known model in Cork but despite the glam of the fashion world she has been suffering with IBS since she was around 14.
“I would get really bad cramps and severe bloating so I decided to go look for help, but struggled to find some answers,” Vivienne said.
“IBS was a very general term, and diet or supplements were never discussed when I first started looking for help.
“Initially, I was put on the contraception pill as my stomach would get so bad near my period but over the years I have learned what triggers my symptoms.”
Vivienne cut out foods like wheat, dairy and some vegetables including broccoli and she also found fatty foods and too much sugar will cause a flare-up.
She added: “Probiotics have been my saving grace and at the moment my IBS is very much under control but there was a time it took over my life.”