Irritable Bowel Syndrome

What is Irritable Bowel Syndrome (IBS)?

Irritable Bowel Syndrome (IBS) is a common digestive disorder that affects the large intestine (colon).  It is characterised by symptoms that may include abdominal pain, bloating, constipation, diarrhoea, and changes in bowel habits. These symptoms may come and go and can vary in severity.

How Does IBS Impact Your Anatomy and Health?

The exact cause of IBS is still unknown, but it is believed to be caused by a combination of factors, including genetics, diet, stress, and the gut microbiome. IBS can impact your anatomy and health in several ways, including:

• Changes in bowel movements can result in either constipation or diarrhoea.
• Bloating and abdominal pain can be quite severe.
• Anxiety and depression due to the chronic nature of the condition.
• Malnutrition and weight loss due to the inability to absorb nutrients from food properly.

Types of Irritable Bowel Syndrome (IBS)

IBS can be further classified into the following three types based on the predominant symptom:

• IBS with constipation (IBS-C): This type of IBS is characterised by constipation, hard stools, and infrequent bowel movements.
• IBS with diarrhoea (IBS-D): This type of IBS is characterised by diarrhoea, loose stools, and frequent bowel movements.
• Mixed IBS (IBS-M): This type of IBS is characterised by constipation and diarrhoea.

Who Does Irritable Bowel Syndrome (IBS) Affect?

IBS can affect anyone, but some people are more at risk than others. Women are twice as likely to develop IBS as men, which is more common in people under 50.

Other risk factors include:

• Family history of IBS
• Mental health conditions, such as anxiety and depression
• Gastrointestinal infections
• Inflammatory bowel disease
• Food intolerances and sensitivities

Why Does Irritable Bowel Syndrome (IBS) Occur?

IBS results due to an irritation of the gut. 

The digestive tract alternates between very fast muscular contractions, which result in diarrhoea, bloating, and abdominal pain, and weaker than regular muscular contractions, which can cause constipation. 

Causes of Irritable Bowel Syndrome (IBS)

The exact causes of IBS are unknown, but research suggests that it may be caused by a combination of factors, including:

• Abnormalities in the gastrointestinal muscles that cause spasms and cramping.
• Nervous system abnormalities affect the signals between the brain and the gut.
• Inflammation and infections in the gut.
• Abnormalities in the gut microbiome can affect digestion and absorption of nutrients.

Symptoms of Irritable Bowel Syndrome (IBS)

IBS symptoms vary from person to person and can change over time. The most common symptoms of IBS include:

• Abdominal pain or discomfort that is often relieved by a bowel movement
• Changes in bowel movements, including constipation, diarrhoea, or alternating between the two
• Bloating and abdominal distension
• Mucus in the stool
• Feeling like you still need to finish a bowel movement
• The urgency to have a bowel movement

Stages of Irritable Bowel Syndrome (IBS)

There are no stages in IBS. The disease progresses in intensity with increased stress and other causative factors.

How is Irritable Bowel Syndrome (IBS) Diagnosed?

IBS is determined after excluding other diseases (Diagnosis of exclusion). 

Your doctor begins by taking a complete history and a thorough physical examination. The Rome Criteria is used to determine if the diagnosis is IBS. 

Your doctor may run the following tests to rule out other diseases and inflammation:

• Blood tests to identify associated anaemia and nutritional deficits
• A stool culture rules out any bacterial infection, such as Campylobacter, C. difficile, Salmonella, Shigella, E. coli and amoebae.
• Faecal blood test. 
• Faecal calprotectin.
• Colonoscopy to collect tissue samples and visually examine the intestines for inflammation

How is Irritable Bowel Syndrome (IBS) Treated?

Treatment aims to control symptoms and improve the quality of life for the patient. 

Lifestyle changes such as:

• avoiding ‘trigger foods’,
• adding high-fibre foods to the diet and
• exercise and optimising mental health are essential. 

Trigger foods are unique to each individual and include food items that exacerbate the condition. While people with mild disease can lead almost normal lives with diet changes, more severe cases of IBS require medication and counselling. 

Your doctor decides the best approach on a case-by-case basis and the severity of the symptoms. 

It is also recommended to reduce stress, which can worsen the symptoms. This is achieved by regular exercise and breathing exercises.

In drug therapy, your doctor may have to try different medications before one works for the patient. Some of the drugs used include:

• Anticholinergics relax muscle spasms and treat abdominal cramping and diarrhoea.
• Antidiarrheals may be prescribed to slow down bowel movements. 
• Sometimes, antidepressants such as SSRIs and Tricyclic antidepressants may also be prescribed to reduce the symptoms.

What If Irritable Bowel Syndrome (IBS) Is Untreated?

IBS, if left untreated, can result in haemorrhoids due to chronic diarrhoea and constipation. The patients experience a poor quality of life and experience depression and anxiety, which can further exacerbate the symptoms of the disease.

It is essential to seek medical help if you suspect you have IBS or are experiencing chronic gastrointestinal symptoms. An early diagnosis can help you manage the condition effectively and reduce the risk of developing complications.