Irritable bowel syndrome (IBS)

Irritable bowel syndrome (IBS), also called spastic colon, is a chronic condition that affects the large intestine.

IBS is a common gastrointestinal disorder, the exact causes for which are unknown. One theory is that this condition is the result of a disordered communication between the gastrointestinal system and the nervous system, causing an overreaction in the body to normal digestive processes.

Risk factors for developing IBS are thought to include a family history of the disease, age (it’s more common in those under 45), anxiety or depression. Acute gastrointestinal infection is also thought to be a possible trigger.

The condition is more common in women than in men.

What are its symptoms?

Although a chronic disease, irritable bowel syndrome symptoms are not always present – there are times at which they are worse and others at which they may seem to completely disappear. Triggers, such as certain foods or stress, can bring them on.

Signs of irritable bowel syndrome include:

  • Abdominal pain
  • Cramps
  • Bloating
  • Constipation or diarrhoea, or alternating constipation and diarrhoea
  • Excess flatulence
  • Mucous in the stool
  • A change in bowel habits
  • Pain associated with a change in stool appearance or consistency
  • Anxiety or depression (present in the majority of cases)
  • Lack of energy (a symptom of the associated depression)
  • Sexual dysfunction (a symptom of the associated depression)

How is it diagnosed?

As the symptoms are common to many conditions, including lactose intolerance, coeliac disease and some gastrointestinal infections, often an irritable bowel syndrome diagnosis comes down to excluding any other condition that could be causing the symptoms.

A variety of tests, such as blood or imaging tests or colonoscopy, may be used to rule out other diseases or disorders.

A healthcare provider may also diagnose irritable bowel syndrome according to specific criteria and guidelines, namely the Rome criteria and the Manning criteria, which require the presence of abdominal pain for three days in a month within the most recent three months, or the presence of certain prescribed symptoms.

What are your treatment options?

Much remains to be understood about the disease, which is why irritable bowel syndrome treatment focuses on management rather than cure.

In many cases, diet and lifestyle changes are recommended. These may focus on foods to avoid that may trigger irritable bowel syndrome symptoms, like high-gas foods, gluten or carbohydrates called FODMAPs (fermentable oligo-, di-, and monosaccharides and polyols), or learning stress reduction techniques to manage stress.

Medication can be used to treat the symptoms, such as antispasmodics, anti-diarrhoeal drugs or fibre supplements/laxatives for treating constipation.

Studies also show that tricyclic antidepressants can be useful in combating irritable bowel syndrome symptoms.

Can it be prevented?

While its causes remain unknown, it may not be possible to prevent developing irritable bowel syndrome, but there are techniques to help lessen the severity of symptoms or to avoid flare-ups.

Being aware of your irritable bowel syndrome triggers can go a long way towards reducing the severity and frequency of symptoms, if these triggers are under control or avoided. A healthy, balanced lifestyle is key.

The accuracy of this information was checked and approved by physician Dr Thomas Blake in May 2015