Dealing with irritable bowel syndrome

Irritable bowel syndrome (IBS) affects 10-15% of the global population, and while about two in three sufferers are women, it occurs in people of all ages, even children.

Symptoms include stomach pain, bloating and excessive gas, affecting family, work life and general wellbeing.

What is IBS?

Not considered a disease, IBS is a gastrointestinal syndrome based on a common set of symptoms that are unrelated to a disease and therefore difficult to treat. The cause is unknown, says Dr Jaco Nagel, a gastroenterologist at Mediclinic Kloof in Pretoria. ‘There are many hypotheses, however, among which food intolerance and visceral hypersensitivity are most popular,’ he adds. Some scientists believe spasms and cramping are caused by faulty communication between the brain and the intestinal tract.

An underreported condition

Dr Nagel says he is seeing more patients with IBS, and this could be because it has been underreported in the past. A doctor will only confirm IBS after conducting a physical examination to rule out  medical conditions, which may entail a scope, biopsy, X-ray or stool/blood tests.

Common symptoms include:

• abdominal pain or cramping
• diarrhoea/constipation
• the feeling that a bowel movement is incomplete
• passing mucus
• bloating

Can food allergies cause IBS?

Dr Nagel says although many patients believe that diet and food sensitivities play a major role in their symptoms, proven food allergy is very rare in IBS. ‘Well-documented food intolerance via an exclusion diet is only seen in about 10 to 20% of cases. It still remains one of the major therapeutic targets in the management of IBS, although scientific evidence is lacking.’

Treatment options

Treatments include conventional medication to alleviate symptoms and recommended lifestyle changes to improve quality of life. Dr Nagel says treatment could include antispasmodics and peppermint oil for short-term relief. Antidiarrhoeals can also be prescribed, and soluble fibre or laxatives can be taken to ease constipation. Dr Nagel says antidepressants, especially the tricyclics, are also sometimes helpful.

Latest research

A study by the University of Helsinki in Finland suggests that IBS abdominal pain might be alleviated by probiotic treatment. However, Dr Nagel says enough scientific evidence is still lacking and the recommendation for routine use of probiotics in IBS is weak.

Lifestyle strategies

Adjusting your diet and managing stress may help. Remember these tips:

• Avoid coffee and alcohol, which irritate the digestive tract.
• Cut down on gas-producing foods like cabbage, onion and cauliflower.
• Too much fibre can make things worse, so monitor intake.
• Cooked vegetables are easier to digest than raw ones.
• Manage stress.
• Exercise helps with spasms, so keep active.
• Consider using medication to reduce symptoms.