Irritable Bowel Syndrome
A diagnosis if IBS should be considered if someone has had the following symptoms for at least 6 months:
Abdominal pain or
Bloating or
Change in bowel habit
Typically, abdominal pain is relieved by defecation or may be associated with diarrhoea, constipation or a change in bowel frequency.
Symptoms may be worse after eating and associated with lethargy, nausea, backache and bladder symptoms. Everyone presenting with the above symptoms should seek medical advice in order to exclude a serious illness such as inflammatory bowel disease and bowel cancer.
IBS is a diagnosis of exclusion – this means that other health conditions have to be ruled out before the diagnosis of IBS is given.
Abdominal pain or
Bloating or
Change in bowel habit
Typically, abdominal pain is relieved by defecation or may be associated with diarrhoea, constipation or a change in bowel frequency.
Symptoms may be worse after eating and associated with lethargy, nausea, backache and bladder symptoms. Everyone presenting with the above symptoms should seek medical advice in order to exclude a serious illness such as inflammatory bowel disease and bowel cancer.
IBS is a diagnosis of exclusion – this means that other health conditions have to be ruled out before the diagnosis of IBS is given.
Symptoms
People with IBS often have multiple factors which are contributing to their symptoms.Things to consider include:
Chronic stress
Food intolerances or a poor diet
Small intestinal bacterial overgrowth (SIBO)
Previous history of antibiotic use
Environmental toxicity including mycotoxins
Hormonal imbalances such as thyroid disorders and chronic stress
Bacterial or viral infections
A history of traumatic brain injury
Previous abdominal surgery or a history of endometriosis
Treatments
Dietary interventionsSpecific food exclusion diets may be helpful. For example, the low FODMAP diet which is low in fermentable carbohydrates.
Fibre intake may have to be adjusted to include foods that are higher in soluble fibre (such as oats) rather than insoluble fibre (such as bran).
Eat meals regularly and take time to chew food properly.
Drink at least 8 cups of fluid a day. Caffeine exacerbates symptoms for some people.
Stress management
It is common to find that stress exacerbates IBS symptoms. This is due to the constant interaction between the gut and the brain – also known as the ‘gut-brain axis’.
Relaxation techniques, such as deep breathing, meditation and yoga have been shown to be useful in some people with IBS.
Psychological therapy may be appropriate for those who do not respond to conventional treatments
Probiotics are beneficial bacterial that live in your gut. They may provide benefit for people who have an imbalance of good and bad bacteria living in their gut (also known as dysbiosis).
Medications can be used to treat constipation or diarrhoea. Anti-spasmodics may be helpful for those with abdominal discomfort. Antidepressant therapy may be given for those who have not responded to the medications above.
You may want to work with a doctor who is trained in Functional Medicine, alongside your GP, if you want to identify specific triggers for IBS.
To find your nearest practitioner:
https://www.ifm.org/find-a-practitioner/
References
Chang, L., Lembo, A. and and Sultan, S. (2014) American Gastroenterological Association Institute Technical review on the pharmacological management of irritable bowel syndrome. Gastroenterology 147(5), 1149-1172D'Silva A, MacQueen G, Nasser Y, Taylor LM, Vallance JK, Raman M. Yoga as a Therapy for Irritable Bowel Syndrome. Dig Dis Sci. 2020 Sep;65(9):2503-2514. doi: 10.1007/s10620-019-05989-6. Epub 2019 Dec 12. PMID: 31832970.
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Schumann D, Anheyer D, Lauche R, Dobos G, Langhorst J, Cramer H. Effect of Yoga in the Therapy of Irritable Bowel Syndrome: A Systematic Review. Clin Gastroenterol Hepatol. 2016 Dec;14(12):1720-1731. doi: 10.1016/j.cgh.2016.04.026. Epub 2016 Apr 22. PMID: 27112106.
Spiller R, Lam C. An Update on Post-infectious Irritable Bowel Syndrome: Role of Genetics, Immune Activation, Serotonin and Altered Microbiome. J Neurogastroenterol Motil. 2012 Jul;18(3):258-68. doi: 10.5056/jnm.2012.18.3.258. Epub 2012 Jul 10. PMID: 22837873; PMCID: PMC3400813.
Syndrome. CNS Neurosci Ther. 2016 Feb;22(2):102-17. doi: 10.1111/cns.12490. Epub 2015 Dec 10. PMID: 26662472; PMCID: PMC6492884.
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