It affects almost one in five of us find out how you can kick this annoying gastrointestinal disorder into touch…
Cramping, bloating, wind, diarrhoea if you’re one of the estimated 13 million Brits who suffers from irritable bowel syndrome (IBS) you’ll know the misery it can cause from day to day.
And while there is no cure, there are ways of improving symptoms and making life more bearable if IBS blights your life. Here’s how.
Irritable bowel syndrome, or IBS, is a gastrointestinal condition that affects the bowel, and results in constipation, diarrhoea or a mix of both, as well as abdominal pain, bloating and fatigue. Incredibly, it affects around 15 in every 100 of us.
Every case is different, and people present with different issues, which is why it’s called a syndrome,’ explains Yvonne Mckenzie, clinical dietitian and specialist in gastrointestinal nutrition and IBS.
Getting personal lifestyle and dietary advice is the best way of dealing with it, as there’s no blanket treatment for all.
When food is passed along the bowel, the muscles contract. If these contractions become overactive or abnormal, it causes pain. However, part of the reason there’s currently no cure is that no one is sure why it happens.
Some people develop IBS following a bout of gastroenteritis or food poisoning,’ explains Julie Thompson from charity Guts UK. For some reason, women are more susceptible to it than men, particularly those of working age, but we don’t really know why.
It can also be down to other types of trauma including infections, or even just genetics.
There’s a link between the gut and brain function that we don’t yet fully understand, which is why stress and trauma can often exacerbate or even be the main cause of IBS,’ says Yvonne.
The trauma or stress whether in the form of an infection, food poisoning or psychological trauma can make the gut hyper-sensitive.
IBS Or Something Else?
The main symptoms of IBS include bloating, constipation, diarrhoea, wind and pain.
The main thing to notice is a change in bowel movements, explains Yvonne. Some people have diarrhoea, others have constipation, some get both.
But if you’ve suffered with bloating, diarrhoea and constipation for more than six months, it’s essential to get tested. Although doctors can’t test directly for IBS, they can test for other things in order to rule them out.
IBS is usually diagnosed by the symptom profile, but it’s also important to rule out other diseases, explains Julie.
Doctors check for symptoms such as weight loss, blood in stools and anaemia, as these aren’t commonly associated with IBS and could be something else such as coeliac disease or inflammatory bowel disease (IBD).
passing blood is not a symptom of IBS, but it could be something more serious, so make an appointment with your doctor if you notice this.
Diet is one of the main ways of tackling IBS symptoms. This is because, even though it can be caused by stress or trauma, it’s a sensitivity to food that causes the discomfort.
Start by writing a food and symptoms diary for two to four weeks. This can identify common food triggers, as well as help you discover what helps alleviate symptoms, such as exercise, or spot anything else that may help to work out a course of action.
One of the things that works for most sufferers is what’s known as a low FODMAP diet. This is the most successful evidence-based dietary treatment we have available to manage IBS-like symptoms, explains yvonne.
Scientific evidence has shown that about three in every four people gain substantial improvement in their symptoms if they follow this diet correctly.
FODMAP is an abbreviation of Fermentable Oligosaccharides Disaccharides, Monosaccharides and Polyols, which are all known as ‘short-chain carbohydrates.
Short-chain carbohydrates are poorly absorbed in the small intestine, which leads to alterations in the bacterial fermentation in the large intestine, triggering benign, often debilitating gut symptoms, explains Yvonne. Removing FODMAPs from the diet often substantially improves these symptoms.
The list of foods high in FODMAPs that need to be cut is large, and includes bread, pasta, onions, garlic, beans and many dairy products.
It’s more complex than that though, and if you try to do it yourself, you risk cutting out essential nutrients such as fibre and calcium, adds yvonne. it’s much more successful to try this under the guidance of a dietitian.
Other Diet Guidelines
Cut down on booze
Too much alcohol can exacerbate symptoms, especially diarrhoea. ‘Alcohol increases your gut permeability. We don’t fully understand the implications of this yet, but we do know that too much alcohol can make symptoms worse,’ says Yvonne.
Eat smaller portions
When there is hypersensitivity in the gut, it has more work to do, which it finds hard to handle, explains Yvonne. Smaller portions mean it has to work less hard. The same applies to snacking.
Try to eat three meals a day, and don’t snack as this increases the load on your gut.
Sprinkling a tablespoon of linseeds into your breakfast cereal, yogurt, soup or salad every day can help alleviate constipation. You may want to start with a teaspoon and work your way up.
Caffeine stimulates the colon, which can make diarrhoea worse. Try to limit caffeine to two or three cups of coffee or tea per day.
Swerve sweeteners such as sorbitol and xylitol as they’re hard to digest and can have a laxative effect.
Cut down on processed, fatty foods, which are hard to digest.
They don’t work for everyone, but they can help with digestion and reduce bloating.
Adjust your fibre intake
Fibre is a complicated issue as, depending on your symptoms, you may need to increase or decrease consumption.
Reducing insolubre such as wheat, nuts and whole grains generally helps alleviate diarrhoea, while increasing soluble fibre found in oats, fruit, vegetables, beans and pulses can help with constipation. Make changes slowly so you can see what works.
Cut down fructose
The sugar found in fruit isn’t easily absorbed, and can worsen diarrhoea, wind and bloating. Stick to no more than three pieces of fruit a day, including fruit juice.
Most importantly, give your bowels time to adjust to any changes you make. If your symptoms persist after making changes, slowly re-introduce some of the foods you have cut out.
GPs will often prescribe medication for the pain of IBS, but this doesn’t address the cause. However, for some people, it can be a lifeline while other causes are being investigated.
Antispasmodic medicines help the wall of the gut to relax, while laxatives can be prescribed for constipation.
Give peppermint oil a go for bloating as it can help with tummy pains and spasms. Try Holland and Barrett Extra Strength Oil of Peppermint Capsules, (12.49 for 120 tablets, hollandandbarrett.com)
Although changing your diet is the most successful way of reducing the symptoms of IBS, there are other methods that have had proven results, especially when tried in conjunction with lifestyle and diet changes.
A study by professor Peter Whorwell, a gastroenterologist from the University of Manchester, revealed that hypnotherapy can treat patients with severe IBS.
Before treatment, 65% of the patients had severe IBS, whereas afterwards only 25% were classed as having it, with symptoms including abdominal pain, bloating and bowel function significantly improved.
Other common symptoms including nausea, headaches, backache and lethargy had also improved.
Meditation And Yoga
Because there’s a connection between the gut and the brain, both yoga and meditation can help by relaxing the mind and body. Certain yoga poses can also directly help to relieve signs of IBS such as bloating and wind. Check out Youtube for yoga tutorials.
Cognitive behavioural therapy looks at how you think and behave. A study funded by the National Institute for Health Research showed that IBS sufferers who underwent CBT found their symptoms significaly relieved.
Exercise reduces stress, making it a great way to manage IBS symptoms. Don’t go overboard though, as it can make symptoms worse.
IBS AND COVID-19
Opinion is divided as to whether Covid-19 has made IBS worse for sufferers. Julie believes it has. Any changes to lifestyle and diet can result in a flare-up of symptoms she explains.
This is particularly true when the availability of tolerated foods during lockdown is affected, and if people are trying to juggle work responsibilities and looking after the family at the same time.
Yvonne isn’t so sure there’s no evidence to show that Covid-19 has had any affect on IBS, she says. having said that, i know people who have IBS whose anxiety levels are high at the thought that most public toilets are shut, she says. this could definitely have an impact on them.
What Is IBD?
IBD, or inflammatory bowel disease, is very different to IBS. While IBS causes pain, it is not a clinical condition. IBD, however, which includes the conditions ulcerative colitis and Crohn’s disease, is caused by inflammation of the colon (large intestine) believed to be caused by a reaction to friendly bacteria in the gut.
Symptoms are similar to IBS, such as diarrhoea and pain in the abdomen, but it can also cause bleeding from the rectum, which IBS doesn’t do. Treatment includes antiinflammatories and steroids, although severe cases can result in surgery.