020 3727 0935
Dr Philip Woodland
BSc PhD MBBS MRCP
Dyspepsia and peptic ulcers
Inflammatory bowel disease
Having a gastroscopy
Having a colonoscopy
What is irritable bowel syndrome?
Irritable bowel syndrome is a condition that characterised by a change in how the
bowel is working (often resulting in constipation and/or diarrhoea), and the
presence of abdominal pain.
In addition to these 2 important features several other symptoms can also be
associated with IBS, such as abdominal bloating, a feeling of urgency to go to the
toilet and a feeling of incomplete emptying when opening bowels.
What causes IBS?
In short, we don’t yet know for certain. It is likely that IBS is an umbrella term for
a number of different causes of similar symptoms. However, we do know some
important pointers towards the causes. In some people IBS is triggered by a gut
infection, so-called “post infectious IBS". A very rare group of people have IBS symptoms caused by a defect in their bowel muscle or nerves, and there is an increasing suggestion that there may be a connective tissue problem in some (connective tissue offers a support structure around the body’s tissues and organs, including the bowel).
Many people find that certain foods can trigger their symptoms. Unfortunately the triggers are often different for different people.
As with everything in life, IBS is worse with stress. In fact, the bowel seems to react particularly sensitive to stress and anxiety (think of “butterflies in your tummy”, and how exams and interviews can affect your bowels).
What tests are needed for IBS?
As yet there is no test to positively diagnose IBS, but it is often important to exclude other problems within the bowel.
Some people may require very little testing at all (perhaps just a blood test). In others it is very important to exclude other serious conditions. Commonly this may involve a colonoscopy and perhaps gastroscopy to look directly at the stomach and large bowel. Other tests that are done can include CT or MRI scans to look at the abdomen. Occasionally breath testing for evidence of sugar malabsorption and for evidence of a bacterial imbalance within the gut (small intestinal bacterial overgrowth) can be useful.
A discussion with an expert will help the decision as to which tests need to be done.
Is IBS dangerous?
IBS does not result in a shortening of life expectancy. However, IBS can have a dramatic impact on peoples’ quality of life, and therefore needs to be taken very seriously by the doctors treating it.
How is IBS treated?
Again, there is no "one-size-fits-all" for IBS treatment. However there are a number of approaches that people can find very useful for their symptoms.
Dietary interventions can be enormously helpful in IBS since many people find their symptoms can be triggered by food. Cutting out food groups (elimination diets) can be done by trial and error. However because the food triggers are different for different people, and because tests (such as skin prick tests) to identify triggers perform very poorly, the input of a specialist dietician with experience in IBS is often extremely helpful. A dietician may also be able to help you with a low FODMAP diet. This is a relatively new diet that has been studied in good clinical trials and which is able to help many people with IBS.
Simple medications that slow the bowel down (for diarrhoea) or speed the bowel up (laxatives, for constipation) can be helpful. Some people find antispasmodic medications (such as mebeverine) useful for pain.
The interest in bowel bacteria in the production of bowel symptoms have led many people to try probiotic (“friendly” bacteria) medications, sometimes with good results.
Occasionally pain can be treated with medications that reduce the over-sensitivity of nerves within the bowel.
Obviously it is easier said than done, but reducing life stresses may have a positive impact on IBS symptoms.
Alternative therapies such as hypnotherapy and acupuncture have also been used as IBS treatment with success in some cases.
The IBS Network is the UK's national charity for IBS. Their website has plenty of advice and information on IBS.