A B C D E F G H I J K L M N O P R S T U V W

IRRITABLE BOWEL SYNDROME

What is Irritable Bowel Syndrome ?

Irritable bowel syndrome (IBS) is the commonest bowel disorder. The typical features are of variable bowel habit, often alternating between constipation and diarrhoea and passing stool of variable consistency as well. There is often associated abdominal pain, which is usually poorly localised, and may be altered by having the bowels open. Many patients have troublesome bloating and distension of the abdomen which can be quite distressing. There is often a sense of urgency and having to rush to the toilet. Although mucus may be passed from the rectum (back passage) there is never frank bleeding due to an irritable bowel. Irritable bowel is common in young adults and more frequent in women than men. Many people have a mild form of the condition and are never seen by a doctor. The severity of symptoms for an individual usually vary over time.

How does Irritable Bowel Syndrome occur ?

There is increased sensitivity within the bowel, particularly to distension and stretch of the bowel. In about a third of affected individuals the syndrome may develop following recovery from an episode of gastroenteritis.

Why does Irritable Bowel Syndrome occur ?

The cause is unknown. It is not hereditary. Although many individual with an irritable bowel are stressed there is no evidence that stress is responsible. Some people have intolerance to specific foods which may trigger the symptoms whilst true allergy is rarely responsible.

Treatment Involved for Irritable Bowel Syndrome

The doctor may carry out blood and stool tests. This is to be sure that no other disease is causing the symptoms. He may want to perform a sigmoidoscopy; using a narrow telescope to look into the rectum. It is uncommon for these tests to show another cause. Constipation is treated by increasing fibre in the diet (especially fibrous fruits). Sometimes fibre supplements (such as bran or Isogel) can be used. They should be added slowly until stools are passed without effort. Abdominal pain is treated by anti-spasmodic drugs such as mebeverine. Diarrhoea, if severe, may justify the use of drugs such as codeine phosphate or imodium. Food intolerance may be a factor and it worthwhile experimenting with the diet. Typically, a trial of avoiding milk products or wheat may help. Other foods such as alcohol or caffeine can also precipitate the symptoms and are worthwhile avoiding for a time. If there is associated stress then anything that reduces this may help. Different strategies may help different individuals. For example, regular exercise or relaxation therapy can be helpful. Antidepressant medication is sometimes used both to treat any associated depression but also because these types of medication have a direct affect on the bowel as well. Assessment from a psychologist can be helpful and hypnotherapy has also been shown to help.

During Treatment for Irritable Bowel Syndrome

Fibre supplements may help constipation but can cause increased wind, bloating, and sometimes pain. Anti-spasmodics, (such as mebeverine), can cause dry mouth, difficulty passing urine, blurred vision and constipation. Too much medication given for diarrhoea can actually cause constipation. Antidepressants have a variety of potential side effects and these should be discussed with the doctor. It is important to understand that this group of drugs may take several weeks to show any benefit.

If Irritable Bowel Syndrome is Left Untreated

IBS can be disabling but does not lead to other serious disease. There is no association with cancer. Many people need only explanation and reassurance rather than treatment.