Irritable Bowel Syndrome – more common than you think

Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder that affects 1 in 5 Australians. Many people with IBS have not been formally diagnosed and are often suffering in silence, trying various different diets or medications to help their symptoms. April is IBS Awareness month so we thought it was the perfect time to do our bit to raise awareness of this common condition and encourage you to come and talk to your GP if you think this could be you.

Symptoms of IBS
Most people with IBS have tummy symptoms that fluctuate, have been present for some time and will usually include some or all of the following:

• Abdominal pain
• Abdominal bloating or distension
• Bouts of diarrhoea or constipation
• Alternating bouts of diarrhoea AND constipation
• Excessive flatulence, or passing of wind
• Symptoms can be made worse by stress or certain foods such as spicy foods, fatty foods, alcohol or caffeine

Symptoms which may NOT be due to IBS and should be checked out straight away:

• Blood or mucous in the stool
• Anaemia
• Unintentional weight loss
• Fevers
• Severe symptoms or symptoms which are getting progressively worse
• Daily diarrhoea
• Needing to do bowel motions at night (waking from sleep)
• Family history of other bowel disease

Diagnosis of IBS
The diagnosis of IBS is usually made by your doctor based on your symptoms and physical examination. Depending on what we find, we may order some tests to rule out other conditions. 

What causes IBS?
We don’t yet know the cause of IBS. Some people can develop IBS after a bout of food poisoning or other gastro infection, and research shows that there can be different patterns of microbes in the gut (gut flora) in some people with IBS. There are certainly many triggers which can make IBS symptoms worse and these vary from person to person. Common ones are certain foods, alcohol or caffeine, some medications and stress. Identifying triggers is an important part of the management of IBS.

Management of IBS
Because there are such differing patterns of symptoms with IBS, there is no one one-size-fits-all treatment; the good news is that most people with IBS can find relief or control of their condition with targeted management strategies, some of which are:

• Dietary changes
  There are 2 things to consider here – one is identifying any foods that may be triggering acute symptoms such as spicy or fatty foods, alcohol or caffeine and reducing or avoiding those things. Sometimes keeping a food/symptom diary for a period can be helpful to see if there’s a pattern.
  The second thing is to consider whether a sensitivity or intolerance to specific components in food, such as one or more of the FODMAPs might be triggering symptoms. FODMAPs are a group of carbohydrates in various foods which ferment in the gut, causing gas production. In IBS, this can trigger the more common symptoms such as pain, bloating, diarrhoea or constipation. If certain foods seem to be triggering your symptoms, your doctor may recommend you see a dietician to try a 2–6-week low FODMAP diet to identify which (if any) of the FODMAPs is the culprit. A low FODMAP diet is not a diet for life, it is a temporary “trial and error” elimination diet which can lead to significant improvement, even complete disappearance of symptoms once the offending FODMAP is identified and removed from your diet.Many people with IBS symptoms try a gluten-free diet. Recent research, including some excellent work done at Monash University, has shown that most people with IBS do not have a gluten sensitivity, but rather a sensitivity to one of the FODMAPs. If you think gluten is causing your symptoms, it’s important to discuss this with your doctor who may recommend tests for Coeliac Disease.
• Medications
  There are several medications which can help manage IBS symptoms. These include anti-diarrhoeals, medications to help constipation or anti-spasmodics for pain. Fibre supplements can also help in some cases.
• Stress Management
  Stress or anxiety are common triggers for IBS symptoms. Stress management techniques such as yoga, meditation and breathing exercises can significantly improve IBS symptoms in many cases. There has been recent promise shown with gut-directed hypnotherapy for IBS (therapeutic hypnotherapy). Counselling or medications for depression/anxiety may also be needed.IBS is a common condition and symptoms can range from annoying to debilitating. Working with your GP to establish the diagnosis and come up with a tailored management plan can provide significant relief. Don’t suffer in silence! Come and talk to your GP to see if we can help.