Dr Sarah Jarvis
My Weekly’s favourite GP from TV and radio writes for you
Your tummy is swollen, you’re crippled with colicky pain and you keep having to run to the loo. Many people, women in particular, suffer the debilitating symptoms of Irritable Bowel Syndrome, or IBS, every day.
IBS can’t be cured, although there are lots of treatments and lifestyle changes that help. But how do you know if your symptoms are down to IBS or something else?
I see patients regularly who feel fobbed off – with conditions like cancer and Crohn’s disease ruled out, they are made to feel they should be grateful it’s “only” IBS.
Yet IBS can have a huge impact on your quality of life. It’s a “functional” gut disorder. There’s nothing abnormal about the structure of your bowel, but the different elements don’t work smoothly together. Normally, food is propelled into your stomach via waves of muscle motion in your gullet when you swallow. The process of digestion starts, and it’s swept through your small and then large bowel.
The walls of your small and large bowel are surrounded by rings of muscle, which contract in co-ordinated waves to squeeze the food along. If these contractions are too vigorous, they can lead to pain, which is often colicky. Tummy pain which comes and goes is a major feature of IBS – it’s often relieved by opening your bowels. So too are wind, bloating and a change in bowel habit: some women have bouts of diarrhoea, some are constipated, others alternate. Some folk feel a sudden urge to get to the loo, especially in the morning. IBS can leave you feeling tired,
sick, achy and off your food.
No-one is certain why IBS, which affects up to 1 in 5 adults (mostly women) happens. Oversensitive gut muscles or an imbalance in nerve signals to and from the brain may play a part. Food intolerance is a factor for some. But in recent years, interest has focused on the balance of gut bacteria.
We all need “friendly” bacteria to help digest our food. Some produce more gas than others – this can lead to bloating, wind and stretching of the gut, causing pain.
There’s no single test for IBS, but symptoms often point to the diagnosis. Your doctor will probably want to exclude conditions like tummy bugs and coeliac disease, where your body reacts to gluten.
Inflammatory bowel diseases Crohn’s disease and ulcerative colitis can cause similar symptoms – although you’re more likely to be feverish, have blood in your poo, diarrhoea and pain.
Ovarian cancer, while uncommon, can also lead to tummy pain and bloating. The bloating tends to be persistent rather than coming and going, often linked to feeling full quickly or waterworks issues.
This should always be excluded if you develop IBS-type symptoms over 40 (sometimes before this). A blood test called Ca 125, along with an ultrasound scan, should reassure.
If you’re diagnosed with IBS, a food and symptom diary can often pinpoint foods that trigger symptoms. Cutting down on caffeine, alcohol and fizzy drinks, eating regularly and chewing well should help.
Probiotic and prebiotic food supplements have been found to relieve symptoms of IBS. These either bolster your body’s natural supply of “good” bacteria, or provide food for them. They include Bimuno, Symprove and VSL#3 – your pharmacist can advise. Next week: How does your GP keep fit?