Irritable bowel syndrome

Dr I G Quigley
IBS is a common problem affecting most people at some time in their life.
Some people are disturbed by it throughout most of their life.
 
What are the symptoms ?
Diarrhoea, constipation, stomach pain, wind, bloating. These symptoms may 
alternate or there may just be one. They  tend to start in young people
in their teens, twenties or thirties. Symptoms starting after the age of 40 
or associated with weight loss or blood in the stool are not likely to be due
to IBS and need to be investigated by the doctor.

What causes IBS ?
IBS is caused by the bowel working inefficiently. Often we don't discover a 
reason but it  can be due to a poor diet or emotional problems. Scientists 
think some IBS sufferers feel pain because the nerves telling them what is 
going on in the stomach are more sensitive than usual.


What causes the symptoms ?

Pain and bloating; 
The gut is a tube leading from the mouth to the anus.It contains muscle in 
it's lining to propel food from one end to the other. Usually the muscle works 
in a coordinated fashion sending waves of contractions down the gut. 
These force food along in the same way as you would squeeze the last 
drops out of a toothpaste tube. In IBS the muscles contract out of  'synch' . 
Imagine squeezing a sausage shaped balloon at each end. The bit in the
middle becomes distended. This can happen in the bowel. The bit that gets
distended hurts and makes you feel bloated.
Constipation; 
The bowel needs fibre to allow these waves of contraction to get a grip on 
the food. If your diet is low in fibre you may find yourself passing faeces
resembling rabbit pellets. 
Diarrhoea; 
If the muscles of the bowel start working overtime this can cause loose
bowel motions. This can often be made worse by feelings of anxiety 
eg before exams or a driving test. 

How can it be treated ?
The treatment depends on which symptoms are most troublesome. 
The first part of the treatment is getting used to the idea that, although 
uncomfortable, IBS is an extension of the tummy aches and pains we 
all experience. It will not harm your health in the long run.
Pain and bloating ;
These symptoms can be relieved by increasing the fibre in the diet. 
Sometimes fibre makes them worse. Mebeverine ( Colofac ) is a tablet 
which helps to relieve the muscle spasm and helps pain and bloating. 
Buscopan, Spasmonal and Merbentyl are similar drugs. Peppermint 
extracts can be helpful ( Colpermin capsules )
Constipation
Fibre is found in fresh fruit and vegetables, bran and laxatives such as 
Fybogel and Regulan.It is not absorbed by your body. It is got rid of 
when you open your bowels. Increasing the fibre in your diet helps to 
retrain the muscles of the bowel. It is the best treatment for constipation.
Training any muscle causes pain. The bowel is no exception. Taking 
large amounts of fibre immediately can cause pain, bloating and wind. 
You need to start with small amounts and increase it gradually over several 
weeks. You are taking enough when it allows you to pass a bulky well
formed stool each day.
Diarrhoea  
 Antispasmodic drugs like Merbentyl may help. If this does not help
antidiarrhoeal drugs like Imodium may be the answer.