Irritable Bowel Syndrome
What is Irritable Bowel Syndrome?
IBS is the umbrella name given to a condition which is identified by a certain group of bowel symptoms, which are not caused by any underlying disease or disorder; it is associated with an unusual variation in the movements of the small and large bowel, which gives rise to several uncomfortable symptoms, which are listed below. It cannot be diagnosed directly - a diagnosis of IBS will involve ruling out other possible causes of the symptoms which the sufferer experiences.What are the symptoms of this condition?
The symptoms associated with IBS vary considerably from one person to another. Therefore it is difficult to give a straightforward list of symptoms that will apply to everyone, as some people may have many symptoms, and others will have fewer.The most common symptoms include:
Pain
- this
may be a sharp colic-like pain that varies considerably in
intensity and duration. It may come on while or just after
eating.
Bloating
(a
feeling that one's abdomen is over-full and distended) - often
felt in the lower part of the abdomen and occurring in the
late afternoon. Some doctors regard late afternoon bloating
as being strong indicator of IBS.
Stools
(bowel
motions) - there is no fixed pattern to the frequency or type
of bowel motions that you may suffer. There could be constipation
or there could be diarrhoea. You may have a feeling of incomplete
emptying and you might notice excess mucus being passed with
the motions. All or any of these might occur.
In addition to the above, other symptoms that might be experienced are nausea, flatus (large amounts of wind in the bowel) and bladder irritability (an urgent desire to pass water at frequent intervals).
What is the cause of this condition?
There is no underlying disease or disorder which causes IBS; it is not caused by infections, allergies or structural abnormalities in the digestive tract. There may be a dysfunction in the regulation of the bowel by the brain, causing the symptoms referred to above, but this has not been proven.There is a difference in the action of the bowel whilst digesting food, however, as mentioned above; the result of which is an alteration in the speed with which food passes through the digestive system. Propelling the food through the system are muscles located in the walls of the intestines. These muscles rhythmically expand and contract in a wave-like motion to push the parcels of digesting food along. Normally this speed is regulated to allow sufficient time for the food to be digested properly. In the person with IBS the speed regulation seems to break down. Sometimes it may be faster than normal, causing diarrhoea, or slower than normal, causing constipation.
Spasms, or powerful contractions, can also occur in the intestinal muscles. It is these muscle spasms that cause a lot of the pain.
What complications might occur?
In one sense IBS is relatively benign. Despite the unpleasant symptoms and the considerable disruption they cause to the sufferer's life, IBS does not affect life expectancy or cause any other conditions of the bowel, for example, obstruction or bowel cancer. One serious sign to watch for is the passing of blood from the back passage; bleeding in this way is not associated with IBS, but will be the result of some other condition. If this happens you should go to see your doctor without delay.What can I do to treat myself?
Once you have had IBS diagnosed by your doctor, and other bowel conditions have been ruled out, there are a number of actions you can take to relieve the discomfort.It will help to identify those factors which trigger an attack. For example, certain foods and drinks (e.g. tea, coffee, alcohol) seem capable of triggering attacks in some people, as do aspects of lifestyle and life events (e.g. stress, smoking). Everyone is different, though, and food items safe for one person to eat may bring about the symptoms of IBS in another.
A good starting point is to keep a diary of your IBS attacks. For each occasion make a careful note of what you had been eating or what you had been doing before the attack started. Over time you will be able to build up a picture of your condition and see if there is any pattern to the attacks. You may notice that IBS symptoms always follow certain foods; or that attacks are linked to stressful events occurring in your life.
Once these triggers have been identified, it may be possible to eliminate them or reduce the effect they have upon you. If coffee is linked to attacks of IBS then you may decide not to drink it or to switch to a caffeine-free brand. If stressful events provoke attacks, then you may wish to try counselling or other therapies to improve the way you respond to stress.
The bowel can be 'retrained' by adopting a fixed time for a bowel movement each day and limiting the amount of time spent in the toilet.
Fibre in the diet may help to control the symptoms, especially if constipation is a problem. Increasing the amount of fruit and vegetables you eat is a good thing in itself as well as being beneficial to the IBS; however, over-consumption of fibre could lead to diarrhoea or the symptom of 'bloating', so experimentation may be needed to work out the right amount.
Have a regular pattern to your mealtimes and do not over-eat. A normally safe meal or combination of foods may provoke an attack if taken in too large a quantity.
Episodes of pain and spasm can be relieved with hot baths, heating pads or hot compresses to the abdomen. Hot drinks may also help in some cases.
What treatments are available for me to purchase?
Trying the self-help remedies in the section above may help to reduce the frequency and the severity of your symptoms. If they prove insufficient, there are a variety of medications available from Pharmacy2U which may be of greater benefit.Antispasmodics
These are generally the most effective products to help to
reduce the colicky pain. Antispasmodics include Hyoscine,
Mebeverine and peppermint oil and products include: Buscopan,
Colofac IBS, Equilon and Colpermin.
To see the full range of antispasmodic treatments available from Pharmacy2U Click here
Bulking agents
These increase the bulk of the stools and may relieve the
pain of IBS as well as relieving constipation. They contain
ispaghula husk and are available as Fybogel Sachets. Fybogel
Mebeverine also contains an antispasmodic.
Other laxatives
If a laxative is needed, there are several available for purchase
without a prescription. Among the more common ingredients
are the following:
Lactulose
Lactulose is classed as an osmotic laxative, which means that it works by holding more water in the faeces thus making them softer and easier to pass. It may take up to 48 hours to produce an effect but is also perfectly safe to use on a regular basis, as it is not absorbed by the body at all.Senna and Bisacodyl
These are stimulant laxatives, that work by speeding up the muscular contractions in the bowel. They work faster than the bulk-forming and the osmotic laxatives, and should be taken before going to bed to produce a bowel movement the following morning. These products are only recommended to be taken for a few days at the most; over-use can actually reduce the muscle contractions of the gut, making the constipation worse. Examples of these are Senna Tablets and Dulco-Lax.Liquid Paraffin
Liquid paraffin is classed as a lubricant laxative, or a faecal softener, and works purely by coating and softening the stool to make it easier to pass and preventing the further absorption of water by the colon. However, this is no longer recommended, as it can cause problems of its own - being oily in nature, some nutrients and vitamins from food are bound by it and are prevented from being absorbed by the body; it can cause a form of pneumonia if inhaled into the lungs; and leakage from the anus can occur. Other laxatives are safer and more effective.To see the full range of laxatives available from Pharmacy2U click here
Diarrhoea treatments
These help to reduce the symptoms of diarrhoea. The most effective
anti-diarrhoeal available to buy is loperamide (contained
in Imodium, Arret and Diocalm Ultra). Loperamide helps to
slow down the passage of faeces through the large intestine
thus allowing more water to be absorbed by the body. Diocalm
Dual Action tablets contain a small dose of morphine which
acts in a similar way. Enterosan tablets also contain morphine
and include kaolin which absorbs the toxins produced by the
bacteria causing the diarrhoea; however, these are not as
fast acting as loperamide-containing products.
To see the full range of diarrhoea treatments available from Pharmacy2U click here
What treatments are available from my doctor?
If the symptoms are not being satisfactorily controlled by the self-help measures and remedies outlined above then your doctor should be consulted. He or she may choose to prescribe more powerful preparations to relieve the muscle spasm or constipation that may be occurring.What additional investigations might be needed?
There are no diagnostic tests to confirm IBS - the investigations performed are to exclude other diseases and disorders. These investigations include bowel x-rays, barium studies (e.g. barium enemas) and sigmoidoscopy (a direct examination of the lower bowel, via the anus, using a special viewing instrument). If these are negative then IBS will be a likely diagnosis.Any other information I should have?
If you are afflicted by IBS, finding an effective treatment which works for you could involve a painstaking process of trial and experimentation. Persistence is very important;if one remedy doesn't appear to work, try another. One of the main keys to success with IBS is not being afraid to experiment with different treatments and going with whatever provides most relief from the symptoms.It is important, however, that if other symptoms occur, such as weight loss, significant variation in bowel habit or loss of mucus or blood, you seek medical advice without delay.
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