Irritable Bowel Syndrome (IBS) Management

Overview

Many people with IBS experience abdominal pain, bloating, alternating constipation and diarrhoea.

While the cause is unknown, research shows that environmental factors such as a change in routine, stress, infection and diet can trigger symptoms.

At the Centre for Gastrointestinal Health, we recognise the impact IBS has on quality of life for our patients and our team is up to date on the latest research and treatment options.

We take a holistic approach to IBS symptoms and causes, providing each of our patients with a comprehensive and individualised treatment plan.

What Is IBS?

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that affects around one in five Australians at some point in their lifetime.

Typical symptoms of IBS include abdominal pain, cramping, bloating, and alternating diarrhoea or constipation. While IBS can be highly uncomfortable and impact your quality of life, only a handful of people experience severe symptoms, and the disorder is not considered dangerous or life-threatening. Further, IBS does not cause long-term intestinal damage, nor is there any evidence to suggest that it leads to the development of more serious bowel conditions such as cancer or colitis.

It is also not to be confused with inflammatory bowel disease (IBD), the name given for a group of disorders that cause chronic inflammation of the digestive tract.

Women are more likely to be affected by IBS than men, and symptoms tend to first occur in early adulthood.

Changes in routine, diet, emotional stress and infection are among the leading causes of IBS, however dietary triggers in particular vary widely from person to person. It is also believed that the neurotransmitter and “happy hormone” serotonin may influence symptoms of IBS by altering the function of nerve cells in the bowel.

Managing these lifestyle factors can help many control their symptoms, whereas a more holistic approach to treatment - that may include therapy and medication - is often the best course of action for those with more severe symptoms.

Symptoms Of IBS

Among the most common symptoms of IBS are:

  • Abdominal pain, cramping or bloating - normally occurring in the lower abdomen and usually relieved by passing wind or a trip to the bathroom
  • Severe diarrhoea followed by a period of constipation which continues to alternate.
  • Altered bowel habits
  • Changes in how often you are having a bowel movement as well as in their appearance
  • Feeling that the bowels have not been fully emptied after going to the bathroom
  • Changes in the consistency of stools, or the presence of mucus
  • Nausea

  • IBS Symptoms In Women

    Women may be more affected by common IBS symptoms around the time of menstruation, and menopausal women tend to experience fewer symptoms than women who are still menstruating. Additionally, approximately one third of women report an increase in certain symptoms during pregnancy, including heartburn, nausea and bowel movements or constipation.

    The lower incidence of IBS symptoms in men has often been attributed to them being less inclined to report symptoms or seek treatment, resulting in a lack of useful data. However, some studies have suggested that due to hormonal differences, the male gut may simply be less susceptible to IBS-related symptoms.

    Causes

    While the exact cause of IBS is still unknown, there are a number of common underlying factors known to trigger symptoms in people who tend to experience IBS. These include:

  • Infection - IBS can develop following a severe bout of gastroenteritis, or 'gastro'. The bowel symptoms of gastro, most commonly diarrhoea, result from a viral or bacterial infection of the stomach and intestines, and can persist long after the virus or bacteria has been eliminated, possibly due to having affected the nerve function of the bowel.
  • Food intolerance - lactose intolerance is the most common dietary trigger for IBS whereby the body is unable to process the sugars found in many dairy foods. Other sugars believed to trigger IBS include fructose and sorbitol.
  • Diet -although many people notice that certain foods make their symptoms worse, these will not be the same for everyone and some foods will have a greater effect on you than others. That said, some IBS sufferers report worsened symptoms after eating spicy or sugary foods. Outside of food intolerances, there is little evidence to suggest low fibre diets, low carbohydrate or high protein diets exacerbate the symptoms of IBS.
  • Emotional stress - increased levels of stress and anxiety, including those from childhood events, can play a role in aggravating symptoms of IBS, particularly as the functionality of your immune and digestive systems is to a large extent controlled by your nervous system.
  • Medication - certain types of medication, namely antibiotics, antacids and pain medicines, can impact the health of the bowel and bring about symptoms such as diarrhoea or constipation.

  • Diagnosis

    If you notice a persistent change in bowel habits and suspect you have irritable bowel syndrome, it is important to seek medical advice. Your doctor may be able to diagnose IBS based on your symptoms, as well as rule out any other possible illnesses or causes for your symptoms.

    These could include coeliac disease (an immune intolerance to gluten) and lactose intolerance (a reduced ability to digest sugars in dairy products), both of which can produce similar symptoms to those of IBS.

    Your doctor may go through some of the following diagnosis methods:

  • Conduct a full medical check-up and health history review
  • Understanding of diet and lifestyle habits
  • Have blood tests done to rule out conditions such as coeliac disease or anemia
  • Collect a stool sample to rule out infection and check for the presence of problem bacteria
  • Examine the bowel lining through a sigmoidoscopy (insertion of a small tube) or colonoscopy (investigation under sedation)
  • Ask you to follow a certain diet for a period to rule out certain allergies

  • In order to form a diagnosis of IBS, your doctor will have to identify:
  • Recurrent abdominal pain for at least 6 months
  • Weekly pain (for at least 3 months) associated with bowel movements
  • Pain that is relieved by bowel movements and/or
  • A change in the frequency or appearance of bowel movements

  • Where To Get Help For IBS

    Your doctor

    Your doctor can undertake a medical health check and order initial tests to help identify potential causes of symptoms. They may refer you to a Gastroenterologist who can provide expert advice and treatment options.

    The Centre for Gastrointestinal Health

    The team at the Centre for Gastrointestinal health is highly experienced in helping patients living with IBS and the impacts on their lifestyle.

    Our Approach To IBS Treatment

    In the event of an IBS diagnosis, you may be referred to see one of our expert dieticians or gastroenterologists - specialists in diagnosing and treating patients experiencing gastrointestinal symptoms.

    We see many patients living with the symptoms of IBS and understand the impact it has on their daily living. Unlike some other conditions, IBS cannot always be cured through prescription medication. As a result, we aim to treat those struggling with IBS using a holistic approach. We consider lifestyle factors, diet factors and medical history to help find practical ways to avoid triggers.

    We also provide effective treatment solutions should symptoms arise to minimise the impact on day-to-day living. Our expert, empathetic and caring approach provides patients with the most comprehensive, self-empowering and least invasive treatment possible to suit their individual needs.

    Types Of Treatment Available

    Rather than immediately turning to long-term medications, our team of gastroenterologists, led by Dr Pran Yoganathan, approach the symptoms of IBS with a view to identify and tackle the possible underlying causes of your condition.

    In conjunction with a highly-qualified dietician, they will assess your symptoms and may recommend you keep a food diary, as well as make certain alterations to your diet and lifestyle that could include:

  • A reduction or elimination of foods causing gas and bloating, such as beans or cabbage
  • A reduction or elimination of dairy foods, should you be lactose intolerant
  • Avoiding tobacco, together with digestive stimulants such as caffeine, sugary beverages or alcohol
  • Adding fibre to reduce the effects of constipation
  • Transitioning to a low-FODMAP diet, avoiding carbohydrates that are not properly absorbed in the large intestine
  • Engaging in regular exercise

  • If dietary or lifestyle change alone is insufficient in managing your symptoms, you may be prescribed:
  • Medication to help manage diarrhoea, such as Imodium or Lomotil
  • Medication to help manage constipation
  • Antispasmodic drugs to help ease cramping
  • Stress Management

    The impact of stress on symptoms of irritable bowel syndrome cannot be understated, and whether it's rushing to work, meeting tight deadlines or dropping the kids off at school, our ultra-busy modern lifestyles often do us no favours. The mind and body - and as such, the brain and the gut - are closely intertwined, which is why it is vital to be aware of and take control of your stress levels, as this can play a significant role in reducing the symptoms of IBS. As part of your treatment, our consultants will provide strategies to better manage your stress through both physical and emotional support, and may also recommend activities such as yoga, meditation and other mind-body exercises.

    Probiotics

    Probiotics refer to live bacteria found in certain foods and supplements, similar to natural gut flora found in our own digestive systems, but which can sometimes become unbalanced. Changes to our gut flora can have a negative impact on IBS symptoms, such as inflammation, a reduction of immune function, or an increase in intestinal sensitivity to gas. Research has shown that eating common probiotic foods, such as yogurt, sauerkraut or kimchi, or indeed taking a probiotic supplement, can be an aid against IBS symptoms in a number of ways, including: Restoring balance in the digestive tract Strengthening the immune system's defence mechanisms Stopping or slowing the growth of disease-causing bacteria Slowing down bowel movements

    FAQs

    What foods trigger irritable bowel syndrome?

    While individual foods are unlikely to lead to the development of IBS, they can amplify certain symptoms. A large intake of foods such as broccoli, beans and cabbage may contribute to gas and bloating, while it's also worth looking out for a possible intolerance to dairy or gluten products, as well as not over-consuming stimulants such as caffeine and carbonated drinks, and ensuring you get enough fibre in your diet.

    Can I get rid of IBS permanently?

    There is no known cure for irritable bowel syndrome, however through effective treatment the symptoms of IBS can be reduced and even go away altogether over time.

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