Roughly 20% of people will suffer from IBS. It most often first appears during a person’s 20s. Most people with IBS will experience episodes throughout their life, though for some it will gradually improve over many years.
IBS is twice as common among women as it is for men.
IBS is thought to occur due to an abnormal sensitivity within the digestive system. The specific cause, however, is unknown.
This sensitivity can lead to a number of varying symptoms. In some cases, food is digested too slowly, leading to constipation. Conversely, for some people food passes through the digestive tract too quickly, leading to diarrhoea. In either case, people with IBS are more susceptible to pain associated with the digestive process.
Antispasmodics like Mebeverine help to ease the symptoms of IBS by relaxing the muscles involved in digestion. It is also available in peppermint oil capsules such as Colpermin – do not take these if the capsules are broken, as peppermint oil can irritate the tissues of the mouth.
Antispasmodics tend to have few serious side effects, though peppermint oil can sometimes cause heartburn or skin irritation.
If your IBS is causing constipation, you will likely be advised to take laxatives. These soften the stool, making it easier for the body to pass. Remember to regularly drink water while on laxatives, to prevent the medicines from obstructing the digestive tract.
Some people experience bloating and wind as a side effect of laxatives. You can reduce your likelihood of developing these side effects if you begin on a very low dose and increase it every few days. Once you have one or two normal soft stools every one or two days, stop increasing your dosage.
Importantly, you should not take laxatives immediately before going to sleep.
If IBS is causing you to have diarrhoea, you will likely be advised to take antimotility medicines such as loperamide.
Antimotility drugs reduce how quickly food is passed by slowing down the action of digestive muscles. This allows for waste to solidify to a normal consistency.
Loperamide’s side effects include bloating, stomach cramps, fatigue, dizziness and skin irritation.
A tricyclic antidepressant such as amitriptyline might be prescribed for IBS if the antispasmodic medication has been ineffective. TCAs reduce the activity of the nerves within the digestive tract, which helps to ease the feeling of pain and cramping.
It takes three to four weeks for the body to adjust to a tricyclic antidepressant, so the medication will only take effect after this period of time. TCAs can lead to constipation, blurred vision, dry mouth and fatigue, though these tend to improve after the first few days of treatment. If these side effects persist, contact your GP to see if an alternative is available.
One such alternative is a selective serotonin reuptake inhibitor (SSRI), such as fluoxetine, citalopram or paroxetine. These have similar common side effects to TCAs.
The doses of antidepressants used to treat IBS are much lower than the recommended dose for depression itself. So, you should not infer that you have a psychological disorder if you are prescribed TCAs or SSRIs for IBS.
You should consult a GP if you have IBS symptoms coupled with sudden unintentional weight loss, rectal bleeding, or a family history of cancer of the bowel or ovary.
You should also talk to your GP if you are over 60 and notice a change in your digestive patterns and stool which lasts for more than six weeks.
Your GP may refer you to a specialist for some additional tests to check for other conditions.
You will likely be given additional tests only if your symptoms are abnormal or especially severe. Because some IBS symptoms are also associated with more serious conditions, your GP may refer you to a specialist for certain tests if they see cause for concern, such as if you are suffering from a combination of diarrhoea and constipation. This may vary depending on your age, health and symptoms.
If you are over the age of 50 and have not yet been screened for colon polyps and cancer, you will likely be given a colon exam. You may also be advised to undergo a colon exam if you are younger but exhibit possible indications of inflammatory bowel disease or other more serious conditions.
If you are suffering from persistent diarrhoea, your colon exam will include a biopsy, whereby samples of tissue are removed from the body and examined. This will allow the doctor to diagnose an inflamed colon or microscopic colitis, which have similar symptoms to IBS but are treated differently.
Another condition that causes similar symptoms to IBS is coeliac disease. This is a genetic disorder that causes an intolerance to gluten, the type of proteins found in wheat and other grains. The small intestine does not properly absorb nutrients, leading to digestive problems. Coeliac disease is diagnosed with a blood test and then confirmed with a biopsy of the small intestine.
Lactose intolerance can also cause symptoms similar to IBS. This can be diagnosed with a lactose breath test.
Each of these diagnoses can exist alongside IBS, so the doctor will decide whether to treat both or to give the other condition priority in treatment over IBS.
IBS is not linked to any further complications. So, once you are diagnosed with IBS, you will not be required to have extra preventive checkups.
Consider limiting your alcohol and caffeine intake if you are suffering from IBS symptoms. You should consume no more than two alcoholic units per day, and give yourself two or more days each week without alcohol.
It may help your symptoms to eat slightly smaller meals, but do not remove any of your daily meals from your diet. Have three normal meals each day, and do not eat late at night.
Mild exercise can help keep the digestive muscles healthy, which will regulate their contractions. This is particularly important if you are suffering from constipation.
If you are suffering from diarrhoea, ensure you replace your fluids by regularly drinking water.
There are some small changes that can help with certain IBS symptoms. For example, if you are suffering from bloating, you might reduce your consumption of gas-producing foods such as beans and other pulses. It may also be helpful to limit your intake of dairy or gluten if you think your symptoms may be due to an intolerance.
The most important aspect of your diet with regard to digestion is your soluble fibre intake. Soluble fibre softens buildups in the colon and makes it easier for digestive muscles to contract. Also, since it is soluble, it absorbs excess water in the digestive tract, solidifying liquid waste. So, it normalises the activity of the digestive tract, which is important for both diarrhoea and constipation.
You can increase your intake with foods high in soluble fibre or with supplements. Helpful foods include linseeds, white rice, oats, dry corn or rice cereals, pasta, and peeled vegetables. Continue drinking plenty of water to allow your soluble fibre intake to be fully effective.
Foods with high-fat content have the opposite impact of fibre on digestion, so consider restricting your intake of fatty foods.
Artificial sweeteners can cause a number of digestive side effects, including IBS. Popular sweeteners include aspartame, saccharine, sorbitol, xylitol and sucralose. Consider removing these from your diet.
However, it is important not to make any substantial changes to your diet without first consulting your GP or a dietician. They can assist you in identifying which foods might be affecting your symptoms.
Food allergies do not cause IBS. If you think you have digestive problems due to an allergy, consult your GP – they may refer you to a specialist.
Most people will suffer from IBS symptoms for just a few days at a time. However, in some cases, the symptoms will not completely disappear.
IBS is a functional disorder – this means that digestion does not occur properly, but no disease is present. As a result, IBS will not cause any structural damage such as bleeding, inflammation or cancer. Bloody stool may be a symptom of other inflammatory bowel diseases like ulcerative colitis.
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