If you have an uncomfortable or painful abdomen accompanied by constipation, diarrhoea, gas and bloating, you could be suffering from irritable bowel syndrome (IBS).
Abdominal irritable bowel syndrome is a common condition where you experience symptoms related to your digestive system. This is sometimes linked to certain foods, lifestyle habits and stress levels or mood.
IBS affects around three out of every 10 people. Females are more likely than males to be affected.
Here are a couple of questions most patients in my clinic present with.
How does this problem present?
Symptoms of IBS can appear frequently or during flare-ups. In other words, you don’t always experience symptoms. Instead, symptoms may go away and you’ll have normal bowel movements while at other times, symptoms return.
These symptoms include abdominal pain or cramps, usually related to the urge to poop, excess gas and bloating, diarrhoea, constipation or alternating between the two, mucus in your poop (may look whitish) and feeling like you’re unable to empty your bowels even after relieving yourself.
What causes IBS?
While the exact cause of IBS is not clear, some common triggers include diet, stress, infection and medicines.
You may find that some foods make your symptoms worse, but these ‘trigger foods’ differ from one person to the next.
Your IBS symptoms might have started after an infection such as gastroenteritis (‘gastro’). Other triggers include a period of increased stress, or taking a medicine. Some antibiotics, antacids and pain medicines can affect your symptoms.
What does diagnosis involve?
Irritable bowel syndrome diagnosis is done by exclusion. This means that your doctor can only diagnose IBS after ruling out other conditions that could be causing your symptoms. These could include infections, inflammatory bowel disease (IBD), food allergies, and bowel cancer, among others.
Your doctor may rule out these conditions by referring you for investigations such as blood tests, stool tests and endoscopic investigations such as sigmoidoscopy or colonoscopy
If you’ve been experiencing IBS symptoms for at least six months and these tests are all normal, then your doctor may diagnose you with IBS.
Are there complications associated with IBS?
IBS is often a mild condition that can be well-managed by diet and other lifestyle modifications, but it may significantly impact your quality of life and can be stressful to manage.
Some people develop depression and anxiety, migraine, fibromyalgia and/or chronic fatigue syndrome.
If IBS is causing you to feel down, anxious or upset, there are IBS-specific psychological support services. Seek immediate medical advice.
How can I reduce IBS symptoms?
Your IBS symptoms can often be reduced by adopting healthy lifestyle habits including dietary changes.
Dietary fibre adds bulk to your stools allowing them to retain enough water to be soft and easy to pass. Your IBS symptoms may be worse if you don’t eat enough fibre or if you eat too much fibre.
Sources of dietary fibre include fruits, vegetables and high-fibre cereal. It’s best to slowly increase your dietary fibre intake up to the recommended daily intake of 25-30g per day. This is to avoid bloating and discomfort. If this is difficult for you, ask your pharmacist for a soluble fibre supplement, such as psyllium.
Some foods and drinks commonly trigger IBS, so try to reduce your intake of gas-producing foods, such as onion, cabbage, dried beans and lentils, foods with lactose (milk sugar) such as milk, ice cream and some yoghurts, alcoholic drinks, artificial sweeteners in food and drink.
A dietitian can help you identify your triggers and can work with you to create a balanced diet that suits you.
How is IBS treated?
There is no specific therapy that works for everyone, but most people with IBS can find a treatment plan that works for them.
Typical treatment options include changing the foods you eat and your routine. Medications can help, too. Behavioral health therapy may help.
Many of these treatments take time to work. They can help your symptoms, but your symptoms may not go away completely.
Dr Mwasamwaja is a Consultant Gastroenterologist at Aga Khan University Hospital, Nairobi.
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