Most of us have heard of Irritable Bowel Syndrome, or IBS, and many of us know someone who suffers from it. Also known as spastic colon, irritable colon, or colitis, the disorder is possibly – after the common cold – the most frequently-diagnosed condition of our times. It is estimated that one in three people will be affected at some point in their lives, with a significantly higher incidence in women than in men. Onset is usually around the age of 20, and almost always before the age of 35.
What is IBS?
IBS is a syndrome rather than a disease, meaning that it presents as an individualised collection of signs and symptoms. There is no specific diagnostic test, though the doctor may perform procedures such as X-rays, blood tests and a colonoscopy in order to rule out more serious diseases.
In some cases symptoms subside for a while then return, in others there seems to be a steady worsening over time. If not controlled, IBS can significantly affect quality of life. Sufferers experience abdominal discomfort and pain, cramping, bloating, and unpredictable bowel habits – constipation or diarrhoea or sometimes both, alternating. One of the distinguishing characteristics of the condition is that abdominal pain is always relieved by a bowel movement.
It is a functional rather than a structural disorder – the intestines are structurally healthy but don’t function as they should. In IBS the colon is unusually sensitive and the normal gentle ‘wave-like’ movements it makes during the digestive process become irregular, squeezing either too hard or not hard enough. Specific causes are uncertain – there may be a genetic tendency to IBS, there appears to be some connection to stress and anxiety, the immune system may be involved, and there certainly seems to be a link with intolerances to particular foods.
Distressing and debilitating though it is for sufferers, it’s helpful to remember that IBS is NOT:
• A life-threatening illness
• An indication of Crohn’s disease or colon cancer
• A contagious disease
• An infection
• A rare condition
• A temporary problem
• ‘All in the head’.
The most common triggers for IBS are wheat, rye, barley, dairy products, onions, caffeine (in tea, coffee and fizzy drinks), alcohol and nicotine. Avoiding or limiting consumption of each of these, one by one – and observing the effect on your symptoms – could go a long way to managing the condition.
Curing and controlling IBS
Although there is no cure for the condition, there are many options for controlling symptoms and improving quality of life. Experts suggest that you work with your doctor, and possibly with a qualified dietician, to find the approach which suits you best. Once you have begun implementing your individualised plan you may well find you need to refine and change it as time goes by.
1. To start with, you could try keeping a food and lifestyle diary for two to four weeks, to keep track of your symptoms and the activities linked to them. Note everything you eat and drink, how you feel under different circumstances, times you’re especially anxious or stressed, and what exercise you take. This could identify what triggers your symptoms – specific foods, alcohol, emotional stresses – and whether exercise helps ease or prevent them.
2. Experts suggest moderate regular meals, eaten at a leisurely pace, without too long a gap between them. You should drink at least eight glasses of fluid a day, especially water or non-caffeinated drinks like herbal teas. Restrict tea and coffee to three cups a day, limit alcohol consumption, and try to avoid fizzy drinks altogether. Stick to three portions a day of fresh fruit, and consider carefully the role of fibre – soluble fibre as found in oats, isphaghula, nuts and seeds is better than the insoluble fibre in bran and some fruits and vegetables.
3. Gentle regular exercise such as walking, yoga or swimming can be helpful, and reducing or managing stress has significant beneficial effects. In much the same way that many of us experience cramps or ‘butterflies’ when we’re nervous or excited, feeling tense, angry, anxious or overwhelmed can stimulate colon spasms in people who suffer from IBS. Relaxation therapies, stress reduction training, professional counselling or cognitive-behavioural therapy, and joining a support group, have all been found to help. You should try, of course, to identify and remove the cause of stress, but even getting enough sleep makes a difference to how we cope emotionally.
4. The doctor may prescribe specific medications to deal with constipation or diarrhoea, and you could be advised to take antispasmodics or antidepressants to help regularise colon function.
Apart from conventional medicine, a multi-strain probiotic supplement can restore and balance gastrointestinal processes, reducing gas and improving bowel regularity.
Some IBS sufferers have experienced relief with peppermint tea or oil (in the form of capsules), marshmallow root, and aloe vera juice, all obtainable at a good health food shop.
IBS is a highly individual disorder, manifesting differently in everyone, and it is important that you work with your doctor to find the best combination of diet, counselling, support, medication and supplements for you. You can learn to self-manage the condition by controlling what triggers your symptoms, and your quality of life could be dramatically improved. Remember to make changes gradually, observing what works – and try to stay positive! One simple change could be the one that makes all the difference in the world.