Irritable bowel syndrome (IBS)
What is Irritable bowel syndrome (IBS)?
Irritable bowel syndrome (IBS) is a common disorder that affects the gut. IBS affects approximately 10-20% of people worldwide and can affect people of all ages and across both genders. The disorder can cause negative effects on one’s quality of life, affecting their lifestyle as well as bringing about psychosocial impacts.
The physical symptoms of IBS are characterised by abdominal pain, frequent bloating, flatulence, constipation, abnormal bowel movements and changes in stool consistency.
You should see an IBS doctor for three reasons.
First, to confirm the diagnosis of IBS. The symptoms of IBS overlap with many other gastrointestinal disorders and diseases. Therefore, the diagnosis must be made accurately before instituting the treatment plan.
Second, to identify the possible causative factors for the IBS. This will have implications in the overall management.
Third, to establish an IBS treatment plan.
IBS is a multifactorial condition, where genetics, the gut microbiota (the microflora mix… yes we do have bugs in our gut!), intolerances (notably to the FODMAPs) and previous severe gut infections all play a role.
Equally important is the Brain-Gut Axis. There is constant communication between the brain and the gut. Therefore, symptoms of IBS can worsen due to certain factors such as stress and hypersensitivity.
The risk factors mirror the causative factors. These would include:
- Previous enteric infection or factors that may have altered the gut microflora
- Underlying food intolerances
- Stress and an anxious personality
- Underlying functional disorders such as Fibromyalgia and Pelvic pain syndrome
- A family history of IBS
The diagnosis is based on a set of symptom criteria known as the Rome IV criteria. These includes:
- Abdominal pain and discomfort
- Associated with a change in bowel habits
- Symptoms must be chronic, for at least the past 6 months, and regularly recurring
IBS is then further subclassified into C for constipation-predominant, D for diarrhoea-predominant, M for mixed and A for alternating bowel subtypes.
Your IBS doctor will need to have also excluded other gut disorders that have similar symptoms. Your doctor will need to take a detailed history, do a thorough physical examination and may also need to perform some tests and investigations.
Treatment of IBS involves a multi-pronged approach and depends on the severity and underlying aetiology. This may involve:
- Dietary changes
- Medication for symptom relief
- Medication for control of gut hypersensitivity
- Psychological intervention
- And most importantly self-education is vital. IBS is a non-life-threatening disorder that is managed with a holistic approach