Managing IBS

IBS involves episodes of abdominal pain and changes to pattern of bowel movements. It is a syndrome, and so it is a collection of associated symptoms, as opposed to a specific disease. Symptoms vary from person to person in both type and severity. However, in addition to abdominal pain, they may include:

• Diarrhoea
• Constipation
• Distension
• Straining during a bowel movement
• A sensation of incomplete bowel-emptying
• Urge to visit the bathroom suddenly
• Mucus seen with the stools
• Symptoms made worse by eating

Bloating is another commonly reported symptom, but it is not mandatory for the diagnosis of IBS.

There are some risk factors that can increase your likelihood of developing IBS, such as diet, and infection like gastroenteritis, anxiety, stress or depression, and even past childhood trauma.

However, IBS isn’t merely about what is going on inside our gut. The biggest step change in the diagnosis of IBS in recent years has been in our understanding of what is known as the gut-brain axis. This is the interaction between the central nervous system (CNS) and the enteric – or gut – nervous system (ENS), which is known as our ‘second brain’. Our main brain and gut are hard-wired to communicate with each other, and when a glitch occurs in the system, it can lead to the troublesome symptoms of IBS.

Sadly, studies show it can take up to four years on average for people with IBS to be diagnosed. In fact, it is not uncommon for my patients to have consulted three or four doctors before they see me.

Because IBS is a disorder of function (the way the GI tract works), rather than a structural or biological cause, blood tests, stool examinations, imaging scans and more invasive camera investigations, such as endoscopy or colonoscopy, can all return ‘normal’ results. Historically, patients with functional symptoms (that is, symptoms with no physical cause) have traditionally been given short shrift as a result: they will have their symptoms investigated, but when the tests come back as normal, they are given little help to better understand or manage their condition.