What is Irritable Bowel Syndrome?
A syndrome is a group of symptoms that occur together, indicating a particular abnormality or condition. In the case of IBS, that can include abdominal cramps, persistent diarrhoea, constipation or a fluctuation between the two.
The disease is classified into three main types, based on the dominant symptom:
- Constipation or IBS-C. The person fluctuated between normal bowel function and constipation, often experiencing pain and cramping after eating
- Diarrhoea or IBS-D. Unformed stools are passed on waking or after eating. The urge to go is urgent and faecal incontinence can be an issue
- Mixed IBS or IBS-M. Describes the alternation between the above two types
The condition itself occurs when the large intestines or colon, are either over or underactive. In normal function, the colon removes water and salt from the waste product delivered to it from the stomach. The walls of this nearly two-meter-long organ are lined with thick mucus and contract in waves to push waste through to the small intestines. If the progress is too fast, insufficient water is removed, and the result is diarrhoea; if the progress is too slow, too much water is absorbed, causing constipation. Further, the large intestines can spasm, causing sharp abdominal pain or become inflamed, which will create a dull ache.
It’s important to note that although IBS can be a painful and annoying condition, it doesn’t cause lasting damage. Nor does it lead to more serious bowel diseases like cancer or colitis.
Symptoms of Irritable Bowel Syndrome
Symptoms can vary from person to person and even within the same person; coming and going, as well as being more and less severe.
That said, typical symptoms include:
- Excessive gas
- Abdominal pain and cramping that is often relieved with a bowel movement
- Alternating diarrhoea and constipation
- Mucus in the stool
When to see the doctor
The symptoms of Irritable Bowel Syndrome are not exclusive to the condition and can also be indicators of other, more serious diseases. This is especially the case if you’re also experiencing any of the following:
- Rectal bleeding or blood in your stool
- Unintended weight loss
- Anaemia (iron deficiency, often indicated by paleness and fatigue)
- Unexplained vomiting
- Diarrhoea during the night
- Abdominal pain that’s not relieved by a bowel movement
Abdominal pain and cramping can also be caused by endometritis, Chron’s disease, colitis (or Inflammatory Bowel Disease), polyps, Coeliac disease, lactose intolerance or other food intolerances.
The nature of IBS symptoms is that they are common and don’t pose any long-term health issues However, it’s still wise to consult with your doctor to rule out other possible causes.
How is IBS diagnosed?
Diagnosis can include:
- A discussion of your symptoms, including diet and bowel habits. In preparation for this, keep a diary of symptoms, food and drink consumed, time of bowel motions and consistency
(using the universal Bristol Stool chart)
- A physical examination
- Blood tests
- Stool test
- Investigation of the state of the bowel lining with a sigmoidoscopy (a small tube with a light used in a procedure similar to a colonoscopy)
- In some cases, a colonoscopy
If the doctor suspects something other than IBS, additional tests may be required.
While IBS can affect anyone, some risk factors increase the likelihood of having the condition.
- Gender. Women are more likely to experience IBS than men, with oestrogen thought to be a trigger. That’s because there is a correlation with IBS episodes and having your menstrual period, as well as an increased incidence among women on HRT (Hormone Replacement Therapy).
- Age. Many sufferers first experience IBS in early adulthood. It’s uncommon for it to appear over the age of forty, so if you are older and experiencing symptoms, make an appointment with your doctor.
- Family history. IBS can run in the family, suggesting a genetic predisposition can be a factor.
- Mental health. There is a strong correlation between depression and anxiety and IBS. A traumatic childhood where sexual, physical or emotional abuse has occurred may also increase the likelihood of experiencing IBS.
The precise cause of IBS is unknown, but ‘triggers’ have been identified and include:
- Infection. Following gastroenteritis caused by a virus or bacteria, some people experience long-term changes in their bowel function. It’s thought the infection might have adversely affected the nerves, resulting in faster, slower or irregular contractions
- Food intolerance. This can vary from person to person, but lactose is probably the most common culprit. Fructose, a naturally occurring sugar found in plants, including fruit and cane sugar, is intolerant for some people’s digestive system. It’s found in high quantity in many processed foods, so check the labels.
- Diet. Doctors disagree on the impact of an overall diet and IBS. However, a diet low in fresh vegetable, fruit and grain can also be low in fibre, leading to constipation and abdominal pain, with or without IBS. For that reason, choose a high-fibre diet. There are also certain foods that individuals can identify that trigger their IBS, including spicy or sugary foods.
- Emotional stress. The relationship between emotions and the gut are still being understood, but there’s no doubt the connection exists. Stress, depression and anxiety can all induce an episode of IBS.
How is IBS treated?
Although a small number of medications have been developed to treat IBS, safety concerns have led to them to being withdrawn from the Australian market. Currently, there are no approved medications to treat the condition. Acquiring such medicine, for example, over the internet, is NOT recommended.
Acceptable treatments include:
- Investigation of food intolerances, such as lactose and fructose
- Treating constipation with diet, hydration, exercise and medication
- Treating diarrhoea with medication
- Adjusting your diet to avoid gas-producing foods, like beans and cauliflower, and any identified intolerances or trigger food
- A strict eating routine that avoids abrupt changes
- Anti-spasming drugs
- Pain killers
- Stress management through mindfulness, relaxation and other techniques
- Antidepressants and other mental health medication
If you’d like to explore dietary options, ask your doctor for a referral to a dietician who’ll be able to assist with a tailored program.
Incontinence and IBS
Urinary and faecal (or bowel) incontinence can be experienced with IBS. While IBS itself isn’t the cause, constipation is. When the bowel is full of hard, dry stool, it can press on the bladder, reducing its capacity and increasing the need to void more frequently.
Further, frequent straining when passing a bowel motion weakens and damage the pelvic floor muscle. This muscle plays a significant role in bowel and bladder function, particularly the ability to ‘hold on’ when experiencing the urge to urinate or defecate. A weak pelvic floor can lead to faecal incontinence, from staining amounts when passing wind, liquid leaks or full stools. Similarly, an inability to ‘hold on’ can cause a small leakage of urine through to the complete loss of a full bladder (because the flow can’t be stopped once started).
Constipation can present with misleading diarrhoea-like symptoms. This is when the bowel is impacted with hard matter, and only liquid waste can pass to be expelled.
If you are experiencing incontinence, don’t put up with it. Find out more in these articles:
- Improving Urinary and Faecal Incontinence with Fibre
- Pelvic Floor Exercises
- Food and Drinks to Avoid
TENA has a range of products suitable to help with the management of both urinary and faecal incontinence. For small leaks, TENA Liners may be sufficient to protect your underwear. For more significant urine leaks, check out the extensive range of TENA Pads and TENA Pants.
Faecal incontinence needs to be changed immediately to avoid skin irritation. If you’re suffering from both urinary and faecal incontinence, TENA Duo Protective Layer has been designed as a top layer for urinary incontinence products. This allows the faecal matter to be swiftly removed without soiling the product underneath.
Deciding on the right product can be challenging. If you’re still uncertain, try TENA’s Product Finder Tool where you can also order free samples.
Asaleo Care makes no warranties or representations regarding the completeness or accuracy of the information. This information should be used only as a guide and should not be relied upon as a substitute for professional, medical or other health professional advice.