Irritable bowel syndrome (IBS) is a condition that affects the digestive system. It often appears between the ages of 20-30 years and affects women more than men. The symptoms are usually bouts of painful stomach cramps, diarrhea, bloating and constipation. If you have been diagnosed with IBS, you may experience constant symptoms, or you may only have a few flare-ups per year. It is a very unpredictable condition, which is not life-threatening.
While there is currently no known reason for developing IBS, specialists in the field, called gastroenterologists, believe it is caused by several different factors.
Normally, food moves through your digestive system in a slow, rhythmic way, the squeezing and relaxing of intestinal muscles (peristalsis) gently pushing it along. In IBS, this movement changes, either becoming too fast or too slow and creating discomfort. If the food moves too slowly, you get constipation, as too much water gets absorbed by your body. If the food moves too quickly, not enough water will be absorbed, giving you diarrhea.
Stress, previous food-related illness and certain food types seem to trigger flare-ups of IBS. Other potential causes may be:
There are many nerve receptors in your digestive system that tell your brain if you are full, in pain or need to go to the toilet. There is thought to be a link between IBS and a change in how these nerves work. Serotonin, a chemical produced in your gut, may be overproduced or underproduced in IBS. This may explain the increased sensitivity to abdominal pain and bowel movements.
It is considered normal for emotional stress to cause changes in bowel movements; both diarrhea and constipation are common side effects to stress in our lives. Our bodies constantly send signals back and forward between our bowels and our brains. During stress, these signals increase, causing more intestinal contractions and sensitivity. This appears to occur in IBS.
Certain foods appear to trigger flare-ups of IBS, such as:
Quite often you may experience ongoing bowel symptoms long after you have recovered from an episode of food poisoning or gastroenteritis. The bacteria in our bowels may be affected in the long-term by digestive system infections, causing abnormal bowel symptoms well into the future.
Some medications can give you diarrhea or constipation, which may trigger IBS attacks. Pain-relief medications, antacids and antibiotics are all known to have this effect.
Microscopic, single-celled organisms with DNA but no definite nucleus. Bacteria are the cause of many human diseases.
A type of sugar found in honey and sweet fruits.
One or more fibers that transmit signals of sensation and motion between the brain or spinal cord and other parts of the body.
A chemical messenger within the brain that is thought to play a role in mood and behavior. Many antidepressant medications act by increasing the amount of serotonin in the brain.
The word ‘stress’ can have a variety of meanings, but generally describes the physical and mental responses of the body to a demand placed upon it. Often used to describe conditions where the demand is high or unable to be resolved and creates anxiety and tension.
Relating to the abdomen, the middle portion of the trunk which contains organs such as the intestines, stomach and liver.
There are three main types of irritable bowel syndrome:
This type of IBS normally alternates between diarrhea and normal bowel movements. Diarrhea often occurs first thing in the morning or just after food. The urge to go to the bathroom is often immediate and very urgent, which can lead to embarrassing incontinence incidents.
This is when you mainly experience constipation together with painful cramps in the abdomen, often just after eating.
This is when you experience both constipation and diarrhea, often having normal bowel movements in between attacks.
The part of the body that lies between the chest and the pelvis.
The uncontrollable loss, small or large, of bladder or bowel control, resulting in leakage of their contents.
Risk factors for IBS include:
IBS symptoms tend to come and go, often getting worse after you have eaten. Passing wind or going to the toilet often relieves the pain. The severity of symptoms can vary between people, depending on the type of IBS you have been diagnosed with. Flare-ups tend to last for between 2-4 days, often after a time of change or stress in your life, then gradually improve. Bowel movements can change between hard, pellet-like stools to explosive, urgent diarrhea. Some women find their symptoms get worse around their menstrual cycle. Other common IBS symptoms include:
Irritable bowel syndrome can cause indigestion and bloating of the abdomen.
The part of the body that lies between the chest and the pelvis.
Stomach pain or discomfort caused by difficulties digesting food.
A thick, viscous liquid that is secreted for lubrication and to form a protective lining over certain tissues.
The word ‘stress’ can have a variety of meanings, but generally describes the physical and mental responses of the body to a demand placed upon it. Often used to describe conditions where the demand is high or unable to be resolved and creates anxiety and tension.
There are several other conditions that have similar symptoms to IBS, such as coeliac disease, Crohn's disease, diverticulitis and intolerances to lactose and fructose. Your doctor may want to discuss your symptoms in detail, to make sure you do not have one of these other bowel conditions. There is no single test for IBS, but the following tests may be suggested:
Your doctor may check for any abnormalities in your abdomen or rectum.
There is no blood test that diagnoses IBS, but it is important to exclude other conditions. Therefore, blood tests can check for antibodies, iron levels and signs of other bowel conditions.
A colonoscopy is used to examine the entire length of the bowel. Before the procedure, the bowel may need to be cleansed using an oral laxative solution or an enema. You may also be asked to not eat, but to drink plenty of clear fluids in the 12-24 hours prior to the procedure. During the colonoscopy a thin, flexible tube with a camera is passed through the bowel, via the anus. Air is usually pumped through the bowel to allow your doctor to properly view the inside lining for abnormal lesions.
There are usually no specific findings on colonoscopy to help diagnose IBS. It is mainly performed to exclude other serious conditions that may mimic IBS.
Your doctor may suggest a colonoscopy to help investigate IBS.
A stool test can check for any abnormal bacteria in your stools. This involves collecting a small sample of your stool in a special container, which is sent away for testing, avoiding any embarrassment. Stool tests can also assess for mucus and blood, which may be present in conditions that can mimic IBS.
The part of the body that lies between the chest and the pelvis.
A protein molecule produced by the immune system. Antibodies bind specifically to foreign substances to neutralize them or target them for destruction.
The opening at the end of the anal canal, between the buttocks, through which fecal matter and intestinal gas exits the body.
Microscopic, single-celled organisms with DNA but no definite nucleus. Bacteria are the cause of many human diseases.
A procedure in which fluid or gas is injected into the rectum for cleansing, diagnostic or therapeutic purposes.
A type of sugar found in honey and sweet fruits.
An essential mineral required by the body. Iron is part of a protein in the blood called hemoglobin, which carries oxygen around the body.
A thick, viscous liquid that is secreted for lubrication and to form a protective lining over certain tissues.
The final part of the large intestine, leading to the anus.
There is no known cure for IBS, so the focus of treatment is to avoid triggering for your symptoms.
There are many dietary measures you can take to control IBS, including the following:
Stress and anxiety appear to play a big role in triggering IBS symptoms. Finding ways to relax and reduce your stress levels may help lessen the severity and number of flare-ups. Relaxation techniques, such as deep breathing, meditation or practicing yoga, may help.
Exercise may help with many of the symptoms of IBS, potentially by reducing anxiety and relaxing you. Your doctor will help advise you on what will suit you best. Taking a regular walk, swimming, running, and gentle exercises such as tai chi, may all help reduce symptoms.
There are a range of medications that can help you control your symptoms of IBS, including:
A feeling of tension, nervousness and dread about future events. It can trigger physical symptoms such as a rapid pulse or breathing difficulties.
The word ‘stress’ can have a variety of meanings, but generally describes the physical and mental responses of the body to a demand placed upon it. Often used to describe conditions where the demand is high or unable to be resolved and creates anxiety and tension.
A sweet-tasting compound that may be used as a substitute for cane sugar, as it is absorbed more slowly.
IBS is not a life-threatening condition, but it can have a serious impact on your lifestyle and ability to work. The discomfort and embarrassment of the symptoms can lead to anxiety and depression.
A feeling of tension, nervousness and dread about future events. It can trigger physical symptoms such as a rapid pulse or breathing difficulties.
If you have IBS, you will have to manage your symptoms for the rest of your life. You may experience disabling symptoms on a daily basis, or you may be relatively symptom-free; each case is different. While there are no particular medicines that can cure IBS, some medications can help with managing symptoms. Identifying what causes your flare-ups is key to this.
If you have had an infectious bowel condition, or food poisoning, ask your doctor for advice on keeping your bowels healthy. Consider taking a probiotic supplement to maintain the healthy bacteria that are usually present in your bowel. Try to follow a healthy diet and avoid foods that upset your bowels, such as drinking too many caffeinated drinks. Also, exercise regularly and make time to relax each day.
Microscopic, single-celled organisms with DNA but no definite nucleus. Bacteria are the cause of many human diseases.
Bacteria that have health benefits to the human body, such as Lactobacillus bacteria, which is added to yoghurt to improve digestion.