IBS – Irritable Bowel Syndrome

What IBS is not

• Bleeding (blood from the anus or in stools)
• Severe or progressive
• Weight Loss
• Loss of appetite
• Iron deficiency and/or anaemia
• Onset after 50 years of age
• Symptoms overnight
• IBS is not an IBD (Inflammatory Bowel Disorder)
• Crohns or Ulcerative Colitis
  • Crohns or Ulcerative Colitis

Causes

Irritable Bowel Syndrome is a sensitivity in the colon or large bowel. A number of things can trigger the sensitivity and active management can assist to reduce symptoms.

• Infections may trigger Irritable Bowel Syndrome – an infection such as gastroenteritis
• Diet – Fermentable food groups (FODMAP) can cause or exacerbate symptoms. 
• Intolerance – intolerance can be caused through genetic disposition or gut microbiome imbalance. Common genetic related intolerances are gluten and lactose, whilst microbiome imbalances tend to be those which appear to constantly evolve and are hard to attribute to a particular food. 
• Stress and Anxiety – this can cause hormonal and physical changes which alter the gut and can trigger IBS symptoms.
• Medications – many medications have an impact on the gut, initially because they are ingested through the gut but also because of their actions. Medications such as antibiotics can alter gut bacteria, some pain medication can alter the gut lining, antacids alter stomach acids and can cause constipation or diarrhoea.
  
• At this point, you’re probably prepared to close this tab and move on to a list citing the health benefits of chocolate.

Management / Treatment

If you are diagnosed with IBS, diet modifications (Low FODAP diet) can help to ease symptoms. In some cases, medications prescribed by a Gastroenterologist can further assist. As symptoms can be triggered through stress, stress management can play an important role in reducing symptoms. The three main treatment methods are:

• Diet modification
• Stress Management
• Medication
• Probiotics
  

These may all be necessary and your doctor will guide you through what best suits your individual needs. Whilst the symptoms of IBS are common amongst suffers, treatment does vary.

Diet

One method which appears to achieve good results is the low FODMAP Diet. FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. These are found in certain fruit and vegetables. As the body digests these foods, the sugars are poorly absorbed and therefore reach the bowel where they begin to ferment and produce gas and attract water, resulting in diarrhoea. A dietician can assist you with a plan to ensure you are getting all the necessary nutrients from your food, whilst managing your sensitivities towards these foods. Monash University also have an app which can assist you with the identification and management of these foods in your diet.

Medications

• Ones that can assist when prescribed where appropriate and administered correctly are:
• Anti-diarrheal medications – these stop the bowel from passing stools. It is important to know that these are not long-term solutions and should only be used for a maximum of two weeks.
• Constipation medication – such as fiber supplement (psyllium husk tablets or powder) or laxatives. Again, laxatives are not long-term treatments. If you are needing a laxative regularly, this is a sign you need to see a Gastroenterologist for correct diagnosis and treatment.
• Antispasmodic medication – these help the bowel to stop spasming, which may ease cramping pains.
• Antidepressants – these are sometimes prescribed to manage the pain associated with IBS, however these should only be taken if prescribed by a Gastroenterologist after diagnosis and where other treatment methods are not helping.

Stress

Stress comes in many forms; physical, emotional, mental. We all respond differently to stress, in some cases over exercising could be the cause of the stress affecting the gut, whilst for other lifestyle factors may be the trigger. As the gut produces the main stress hormone, cortisol, it is understandable that when the body is exposed to prolonged or as it is medically termed, chronic stress, the gut that will also suffer. It is important to understand our body and what we could be doing to reduce our stress, not only for our gut but for our overall wellbeing. If you feel stress may be affecting you, please consult your doctor or a mental health practitioner who specialises in this area.

Conclusion

As you can see the triggers can be varied and vast and some Irritable Bowel Syndrome symptoms are also common with other gut issues, which is why it is so important to receive proper diagnosis and get targeted treatment for you.

It is tempting to self-diagnose as there are many resources available today and whilst almost all literature is accessible, only a few are trained to identify the difference between various underlying triggers. The human digestive system is both wonderful and extremely complex. With the right diagnosis, targeted treatment can be administered and the majority of gut issues are manageable.