ON THE COVER Dr Sarah Jarvis

My Weekly’s favourite GP from TV and radio writes for you

Irritable bowel syndrome is a “functional” bowel disorder – there’s no specific problem with one part of the gut, but the various elements don’t work smoothly together.

Lifestyle changes and sometimes medication can go a long way towards keeping symptoms controlled.

Doctors aren’t sure what causes IBS, which affects 1 in 5 people at some time and a higher proportion of women. Causes include oversensitivity of the muscles or nerves of the gut; overgrowth of the wrong type of bacteria in the large bowel; a gut which is unusually sensitive to being stretched; and in some cases food intolerance. Bacterial infection isn’t the cause of IBS, but a tummy bug may trigger oversensitivity.

Symptoms include colicky tummy pain, which may be eased when you open your bowels; bloating and wind, which come and go; and a change in your bowel habit. Some people are more troubled by constipation, others by diarrhoea, and others still alternate. You may have to rush to the loo, then feel you haven’t completely emptied your bowels.

IBS is a gut disorder, but can cause a remarkable number of non-gut related symptoms – tiredness, backache, headache and muscle pain. Sometimes you may also develop irritable bladder, where you need to wee very often and lose control of your bladder. IBS can severely affect your quality of life, and this can affect your mood.

There are no specific tests to diagnose IBS – it’s based on

SOME PROBIOTICS SUCH AS SYMPROVE AND VSL#3, OR PREBIOTICS SUCH AS BIMUNO, HELP TOP UP YOUR ‘GOOD’ GUT BACTERIA AND CAN HELP A LOT

symptoms. Sometimes these can overlap with other conditions and your GP may recommend tests to rule out: Ovarian Cancer: Bloating (not the kind that comes and goes), feeling full quickly on eating, low tummy or pelvic pain and needing to wee more often. A blood test and sometimes an ultrasound picks this up. Coeliac Disease: An autoimmune condition where the gut lining is inflamed on contact with gluten in food. Symptoms include tummy pain, wind, diarrhoea and bloating. Some people develop mouth ulcers and an itchy rash. A blood test can usually exclude it. Inflammatory Bowel Disease (Crohn’s disease or ulcerative colitis): A poo sample can show evidence of these conditions, which tend to cause diarrhoea, often with blood, tummy pain and weight loss. Anaemia: Using a full blood count blood test. Several gut and other conditions, but not IBS, lead to anaemia.

Diet is key in IBS. In a minority, food intolerance may be at the root. For many others, bloating and pain are brought on when gas-forming bacteria in your gut feed on “fermentable” foods, known as high FODMAPS foods. Many people report great success on a low FODMAP diet. High FODMAPS foods include garlic, pulses, beans, onions, cauliflower, apples, pears, wheat and rye. Alternatives include oat and rice products, gluten-free bread, bananas, citrus fruit and berries.

It’s well worth keeping a food diary to find triggers. Common culprits include alcohol, caffeine, fizzy drinks and resistant starches, common in ready meals. Sitting down to regular meals and eating slower can help.

IBS can be triggered or worsened by stress. Using relaxation techniques and trying to avoid upset may prevent flare-ups. Next week: Help! I’m having an allergic reaction

ANTISPASMODIC TABLETS FROM YOUR GP CAN HELP WITH COLICKY PAINS, WHILE PEPPERMINT OIL CAPSULES MAY RELIEVE WIND AND BLOATING

IT’S WELL WORTH KEEPING A FOOD DIARY AND TRYING TO TEASE OUT YOUR TRIGGERS’’