Irritable bowel syndrome
What is irritable bowel syndrome (IBS)？
You might have heard of irritable bowel syndrome (aka IBS) in relation to stomach issues, but are you aware of just how common it is, and the tell-tale signs to look for? Irritable bowel syndrome is a very common condition that impacts the colon (large bowel) and is used to describe a group of gut issues. Around 1 in 5 Australians experience the unpleasant symptoms of IBS at some point in their lifetime, and it impacts women more frequently than men. Despite IBS being uncomfortable and painful at times, it is not considered dangerous or a cause of any long-term colon or digestive damage#. You can help manage the condition by avoiding common triggers, and often making some lifestyle changes.
What causes IBS？
The exact cause of IBS is unclear, however health professionals have identified several triggers that appear to relate to those living with IBS flare-ups. Some of those triggers include:
diet
stress
infection
medication
certain foods – however this varies with each person
Symptoms of IBS
Symptoms can vary from person to person, but some common symptoms of IBS to look out for include:
Abdominal pain or cramping that is often relieved by the passing of wind or faeces
Alternating bowel habits from constipation to diarrhoea, or suffering with just one
Feeling like the bowels are not fully empty after going to the toilet
Abdominal bloating
Whiteish mucus presented in your faeces
Nausea
If you’re experiencing any of these symptoms, or if your symptoms are worsening, it is important to consult your doctor. A GP will be able to help identify if you are experiencing IBS, or if the symptoms may indicate another underlying health condition.
How is IBS diagnosed？
If you suspect you have IBS, it’s important to speak to a doctor to rule out your symptoms being caused by anything more serious. Your doctor is usually able to diagnose IBS by asking you some key questions about your symptoms.
For IBS to be diagnosed, a criterial called ‘Rome IV’ must be met, which include recurrent ‘abdominal pain’ (a required symptom), along with at least two other key symptoms. These symptoms include:
Required Symptom
(Abdominal Pain - Recurrent, at least 1 day a week within the last 3 months)
+
Any of the two other symptoms below:
Pain experienced during bowel movements
Gas and bloating
A change in frequency of bowel motion
A change in consistency or appearance of your stools
If you are over the age of 40, if you have a family history of bowel cancer, or if a doctor suspects the symptoms relate to something else, it’s likely you’ll be referred for more testing to rule out other inflammatory bowel conditions such as Coeliac Disease>, or anything more serious. It’s important to remember symptoms can vary between people, and change over time.
How to treat IBS
While IBS cannot be cured, there are many ways to help manage and reduce the impact of symptoms. Depending on your triggers and whether your IBS tends to be more diarrhoea or constipation, there are a wide range of approaches people can take including prescribed medication, holistic approaches and lifestyle changes that may help. Health professionals will take into consideration all symptoms before recommending something. Common approaches to treat or manage irritable bowel syndrome include:
Prescription medication (e.g. antispasmodics, antidiarrhoeals, antidepressants or antibiotics)
Over-the-counter (OTC) products such as pain relief medication, constipation medication and probiotics may help settle or relieve symptoms
Behavioural or psychological therapies
Reducing stress (e.g. meditation, yoga, swimming, walks outdoors, or reading – anything that will help relax you)
Dietary changes (e.g. increase fibre intake and avoid gas-producing foods)
Creating regular eating routines
Peppermint oil
Increase water intake.
How can I reduce the symptoms of irritable bowel syndrome?
Along with some of the medication and lifestyle changes suggested, dietary changes can often successfully improve or reduce symptoms by excluding foods that trigger IBS. However, this should be performed with the guidance of a nutritionist or GP to ensure a balanced diet is maintained and carefully monitored to assess the impact.
Some foods to avoid whilst trying to get IBS symptoms under control could include:
Gas-producing foods, such as onion, cabbage, Brussels sprouts, dried beans, lentils and cauliflower
Lactose-rich (milk sugar) or dairy substances such as milk, ice-cream, and some yoghurts
Alcoholic drinks
Artificial sweeteners in food and drink, such as aspartame, sorbitol and mannitol
Low FODMAP diet
In some instances, people resort to a low FODMAP diet which eliminates certain foods from your diet to ease abdominal pain. FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols.
These are the chemical names of several sugars that are poorly absorbed in the small intestine. A FODMAP diet is designed to help people with IBS by reintroducing foods slowly, which can help to figure out what foods are problematic and assist in controlling symptoms.
A range of foods that are high in FODMAPs and should be avoided are as follows:
Garlic
Onions
Apples
Green peas
Some marinated meats
Dairy products (e.g. milk, yoghurt)
Chickpeas
Wheat, barley and rye-based bread
People who have symptoms of IBS may find it helpful to avoid high FODMAP foods and instead, to eat a diet containing a low volume of FODMAPs. Low FODMAP foods include:
Red capsicum
Oranges
Grapes
Eggs
Plain cooked meat
Oats
Rice
Dark chocolate
Peanuts
For a list of high and low FODMAP foods, visit the Monash University FODMAP website.
As with everything diet related, you should consult a registered nutritionist or dietician to ensure your diet still provides you with everything you need to function healthily. Please note, a low FODMAP diet is recommended for 2 to 6 weeks before reintroducing certain foods back in your diet. It’s not a long-term solution or a lifelong diet, but more an indication as to certain foods that trigger symptoms.
Increasing fibre
Fibre intake is something to consider, as low-fibre diets can make constipation worse. One tip that may help you reduce your symptoms is to simply increase your intake of high-fibre foods. The current recommendation for adults is to eat at least 25g to 30g of fibre each day. In a typical day, you might achieve your fibre intake through a high-fibre breakfast, such as eggs with wholegrain toast, oats, porridge and some cereals. Always try and follow this up by eating at least 2 servings of fruit and 5 servings of vegetables per day. A list of high fibre fruit and veg can be found here.
This might sound like a lot to balance and achieve each day, so fibre supplements are always available to supplement in your diet, following a chat with your pharmacist or GP about what may be right for you.
Before cutting out certain foods altogether, it’s important to work with a GP or dietician to figure out the best route for you with food management.
Should I see my doctor about irritable bowel syndrome symptoms?
If you have experienced IBS symptoms for 6 months or longer, it’s recommended you seek help as soon as possible#. Although IBS does not cause any long-term damage to the colon or digestive system, it can be painful and uncomfortable to live with. This can influence your mental health and overall quality of life. It’s important to also rule out that the symptoms you’re experiencing are not related to any other serious health condition.
It is reassuring to know that symptoms can usually be reduced with certain medicines, lifestyle and dietary changes
If you live with IBS, our friendly pharmacists are here to support you with expert advice and steps you can take towards a more comfortable life. Ask your local MediADVICE pharmacist today for more information.