What is IBS?

Irritable bowel syndrome (IBS) means that your gut (bowel) is not working properly, so you feel pain and get a lot of gas. You can have trouble going to the toilet (constipation), or have very loose bowel motions or stools (diarrhoea). It is very common: about one person in 100 has it.

How did I get IBS?

The exact cause of IBS is still not certain. IBS may stem from a problem with the nerves that control the bowels. These nerves tell the bowels how fast to remove the waste. They also control pain by sending pain signals to the brain. Nerves that are too active can cause the bowels to remove waste too quickly (diarrhoea). Nerves that aren't active enough can allow waste to stay in the bowels too long (constipation). Very sensitive nerves may send too many pain signals to the brain, causing increased pain.

What triggers IBS?

Stress can bring on (trigger) IBS symptoms. So can certain foods, drinks and medications. Some women get symptoms of IBS during their period, or just before. Keeping a record of your symptoms may help you learn what triggers your IBS.

Common triggers include: caffeine, alcohol, fat, dairy products, preserved food, smoking and medications.

How is it diagnosed?

Your doctor will usually make a diagnosis from your symptoms. If there is uncertainty about whether you have more serious problems or an infection you may have one or more of the following tests; sigmoidoscopy, colonoscopy or barium enema.

What are the symptoms?

• cramps and bloating in your lower tummy that may be worse on your left side. It usually feels better after you go to the toilet or pass wind
• constipation; not going to the toilet enough, having small, hard stools that might be hard to push out, feeling that you have not finished
• diarrhoea; going too often and having very loose stools
• constipation some times, diarrhoea others, then be fine for a while
• flatulence or bloating
• mucous in the stools.

What you can do

You can make some lifestyle changes to help control IBS. Try to eat more fibre and drink more fluids. Learn to avoid symptom triggers, reduce stress, and be more active. If lifestyle changes are not enough, your health care provider may prescribe medication.

• learning how to handle stress; counselling, yoga, breathing exercises, meditation, relaxation tapes and classes and acupuncture may help
• exercise; being more active helps digestion
• eating well, eat plenty of vegetables, fibre (cereals, brans, etc) and water. Add fibre to your diet slowly and early in the day; it may make things worse at first. Write down what you have been eating, doing and feeling when your gut gets upset and see if there is anything that is always the same and try to avoid it in future. Note: Increased fibre is not for everyone. If eating more fibre gives you gas or cramps, talk to your health care provider
• avoid symptom triggers. If a certain activity or food seems to trigger your symptoms avoid it. Your health care provider may suggest that you remove certain foods from your diet for a few weeks. If your symptoms improve, you may need to consider avoiding the trigger forever
• take medication as directed by your doctor. If diet and lifestyle changes do not help, medication may be used to treat IBS. Medication may be used for any of the following; regulating the movement of the digestive muscles, reducing diarrhoea, constipation and gas, relieving abdominal pain, reducing symptoms of stress.

What happens if IBS is not treated?

Irritable bowel syndrome is usually a big nuisance, but harmless. Many people worry about cancer, but there is no need. Ask your doctor to do a check if you are concerned.

For further information and support a dietitian in your area may be able to help you work out a diet that suits you better.

Written by Anna Mickell RCpN. Source material Living with Irritable Bowel Syndrome, Staywell/Krames publications. Reviewed by everybody.