Irritable bowel syndrome

What is irritable bowel syndrome?

Irritable bowel syndrome (IBS) is a very common problem affecting the gastrointestinal (digestive) system. It is also sometimes called irritable colon, spastic colon and mucous colitis. It is a chronic (prolonged), intermittent condition characterised by abdominal pains and disturbed bowel movements in the absence of any detectable abnormality of the bowel tissues. It is, therefore, a collection of symptoms rather than a single disease and can only be diagnosed once other diseases such as gastroenteritis or inflammatory bowel disease have been excluded. However, it is a real and unpleasant condition.
What are the causes of irritable bowel syndrome and who is at risk?

For many people IBS is a condition of unknown cause. Some people with IBS also have psychiatric symptoms and stress. Emotional states can affect the function of the digestive tract and IBS is a symptom of depression in some people. IBS may also be caused by abnormal function of the muscles of the intestine (also known as the bowel), which may occur spontaneously or be triggered by stress.
What are the common symptoms and complications of irritable bowel syndrome?

IBS is a relapsing and remitting condition, that is to say it comes and goes. The most common problem is periods of passing frequent small stools that alternate with periods of constipation. Other common symptoms are: sensation of incompletely emptying the bowels,

passage of mucus with stools,

crampy abdominal pain,

bloating,

excessive flatulence (passing of wind).



If the stools contain blood, any diarrhoea is prolonged or other more serious symptoms such as weight loss occur, the person is unlikely to have IBS.
The doctor may also want to carry out some tests, such as:

blood tests,

ultrasound scans of the abdomen,

endoscopy (passing a fibre-optic tube into the digestive tract and directly observing the inside of the bowel),

barium studies (X-rays of the digestive tract after a barium solution has been placed into the bowel).



The purpose of these tests is to exclude other conditions. It may be better to see the doctor on a few occasions over a period of time and have only simple tests performed, rather than to have a whole battery of tests at the first appointment. This will also check that symptoms do not indicate any more serious disease of the digestive tract.


What is the treatment for irritable bowel syndrome?

Self-care action plan

As the cause of IBS is unknown, no therapy is specific. Although responses to change in diet vary between individuals, some people benefit from eating bran (this must be coarse bran from a health food shop, not the fine bran typically found in breakfast cereals), and others find that a reduction in sugar and fat intake helps. It may also be useful to keep to strict meal and toilet times, to help regulate the bowel. Peppermint in tea or in oils is said to have a calming effect on the digestive tract, and so may also be of help.
Complementary therapy

Many herbal and homoeopathic remedies are available for IBS, but (as with the therapies discussed above) little if any evidence shows that they are of benefit. The effects of herbal remedies tend to have been investigated less carefully than those of conventional medicines. Consequently, these preparations may contain compounds with quite powerful effects on the body that have not been rigorously tested for safety. As mentioned above, herbal teas may be of help.
Therapies that reduce stress and promote a sense of well being, including the Alexander technique and yoga is often beneficial.