There’s some new guidance on treating IBS symptoms, says Woman’s Weekly GP Melanie Wynne-Jones
Irritable bowel syndrome (IBS) means your bowel doesn’t function as smoothly it should, and this can lead to uncomfortable symptoms.
The cause isn’t known, although it could be linked to disturbances in the nerves that control regular onward movement of waste in the colon and relay pain or discomfort to the brain.
It affects up to one in five people (and more women than men) and usually starts in early adulthood.
Stress or lifestyle can make IBS worse, or it may be triggered by bowel infections or bacterial ‘overgrowth’ – a disturbance of the small bowel’s normal low bacteria count or pattern.
NICE (National Institute for Health and Care Excellence), which advises on NHS treatments, has recently issued new guidelines for ruling out other conditions, and listed treatments.
IBS often causes abdominal pain or discomfort, bloating or a change in bowel habit (ABC symptoms) for at least six months.
Symptoms can be made worse by eating, and you may strain to open your bowels, rush to the loo, feel you haven’t ‘been’ properly, suffer incontinence or pass mucus. Stools may be loose, hard or vary between the two.
IBS can also cause nausea, backache, bladder symptoms, fatigue, anxiety or depression, as it often affects wellbeing, work and social activities.
Many of these symptoms can also be caused by bowel, ovarian or other abdominal cancers, coeliac disease (gluten sensitivity) and inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis.
So, if symptoms are severe, last more than three weeks or you have ‘red flag’ symptoms (such as unintentional weight loss, feeling easily full, a tummy lump, loose stools for six weeks or bleeding from the bowel or vagina) see your GP straightaway.
There’s no actual test for IBS but your GP will need to examine you, and may suggest checks to rule out other conditions.
These include blood tests for things such as inflammation, anaemia, coeliac disease and thyroid disorders.
She may refer you to hospital for other tests, including an ultrasound, CT and/or MR scan of your tummy. You may also be referred for a bowel X-ray (barium enema) or colonoscopy (telescope examination of your bottom and bowel).
This can be uncomfortable so you’ll be given a sedative.
You may also be asked to provide a stool sample and/or breath test for lactose intolerance, infections and bacterial overgrowth.
Your GP can help you to tailor this to your symptoms, and some products are also available from your pharmacist.
Taking laxatives can regulate your bowel and ease pain and bloating, as can antispasmodics including mebeverine and peppermint oil capsules. NICE now recommends a prescription antispasmodic called linaclotide.
Loperamide relieves diarrhoea and urgency, while small doses of antidepressants, such as amitriptyline, can help the nerves that control the bowel.
Your GP may also suggest psychological therapy or medical hypnotherapy.
9 ways to help IBS symptoms
1 Keep a diary to see what helps or makes symptoms worse. Smartphone apps, such as Patient IBS, are great.
2 Eat at regular intervals and don’t rush meals.
3 Take daily exercise, and try relaxation techniques or mindfulness.
4 Experiment with your fibre intake. Soluble fibre (found in oats) may suit you better than wholegrains.
5 Have at least eight drinks of water or herbal tea a day. Restrict tea and coffee to no more than three cups.
6 Reduce alcohol intake and fizzy drinks, and avoid sorbitol sweeteners.
7 Try probiotic yogurts. You’ll need to eat them for at least four weeks for them to start working.
8 Seek medical advice before permanently excluding any food groups from your diet.