Irritable Bowel Syndrome (IBS) - Fact Sheet

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LTB 871/09 - Irritable Bowel Syndrome (IBS) - Fact Sheet


No. 871/09
Ref P23
Date: 5 October 2009

To: All Branches

Dear Colleagues

Irritable Bowel Syndrome (IBS) - Fact Sheet

Irritable bowel syndrome (IBS) causes a variety of unpleasant abdominal symptoms.

What is IBS?
IBS is the most common gut condition and affects about one in ten people at some time. It is most common among people aged between 25 and 45 but can cause problems at any age. Women are more often affected than men.

Symptoms
Symptoms of IBS include:

* Abdominal pain, bloating and wind
* Diarrhoea or constipation, or episodes of both
* Passing mucus when you open your bowels
* A feeling of incomplete emptying of the rectum
* Nausea and vomiting
* Depression, anxiety and stress

Other possible symptoms that aren't related to the gut include backache, tiredness, headaches, and urinary or gynaecological symptoms.
About one third of those with IBS predominantly have problems with diarrhoea while another third are mostly troubled by constipation, and the remainder have both loose and hard motions, and others switch between types.
While IBS can cause huge disruption and destroy the quality of life for those severely affected, it's important to know that IBS is not linked to life-threatening diseases and doesn't develop into bowel cancer, for example.

Causes and risk factors
Although the exact cause is unknown, and it isn't possible to prevent IBS from developing, there are certain things that trigger attacks and so should be avoided, including stress, certain foods (different in every individual), irregular mealtimes and, in some cases, a lack of dietary fibre.
What research is starting to show is that people with IBS seem to have a colon (also called the large bowel) that is super-sensitive.
This is supported by the fact that some people develop IBS following gut infections and food poisoning, suggesting that these illnesses have somehow changed the gut and made it more sensitive.
The whole length of the bowel is controlled by a nervous system, which carries signals back and forward between the gut and the brain, controlling factors such as how fast food is pushed through the intestines. Some experts believe this 'enteric' nervous system is faulty in people with IBS.
In IBS, the bowel responds with powerful contractions or spasms to stimuli that wouldn't bother other people, for example, simply eating food. The fact that many women with IBS find it's particularly bad just before or during their period has led researchers to suggest that female hormones may play a part too.

Treatment and recovery
There isn't a cure for IBS, but the following actions will help:
Watch your diet
Make a food diary. Try to work out how your diet relates to your symptoms, by comparing what you have eaten with bad attacks.
The gut normally responds to food by contracting, and the strength of the response seems to be linked to the amount of fat in the meal. So try to cut down on the fat in your diet. Avoid fat-rich food, such as dairy food, ensure your milk is skimmed or semi-skimmed, and cook with minimal fat by baking or steaming food rather than frying or roasting.
Avoid large meals as they can trigger spasms. Instead, eat small amounts more often.
Make sure that you rule out lactose intolerance as a cause of your symptoms - this condition is often mistaken for IBS. As many as one in ten people in the UK - and more among those of African or Asian descent - has lactose intolerance, as they lack the enzyme necessary to digest lactose (the sugar found in milk and used in many manufactured food products). Lactose from foods passes undigested to the large bowel, where it is fermented by the gut bacteria, resulting in cramps and gas production. Lactose intolerance can cause symptoms very similar to IBS. Cut down on dairy products and see if your symptoms improve. You can also try supplements of lactase -the enzyme that digests lactose.
Eat soluble fibre
Fibre can help to reduce IBS symptoms and prevent spasms. But be careful what type of fibre you eat and how much you consume because people can react very differently. In diarrhoea, fibre may firm up and slow down the passage of stools, but some people with IBS also get constipation and then fibre can bulk up and soften stools, making them easier to pass.
But fibre can aggravate both constipation and diarrhoea. Current thinking is that soluble fibre is probably most helpful for people with IBS. High levels of soluble fibre are found in vegetables, such as potatoes, and some fruits (apples and citrus), dried beans, oats and barley.
Insoluble fibre may also be helpful for constipation. Good sources include wheat bran, whole grains, cereals, seeds and the skins of many fruits and vegetables.

Fibre supplements may be worth a try, too. You may find an increase in gas and bloating at first, but this will soon calm down.
Tackle stress
Try to get as much sleep as you need, ensure there's at least one set period each week when you can have some time exclusively for yourself (ideally, you should do this at least once a day) and take up some relaxation therapies.
Get expert help
There are drugs that can help reduce spasms in IBS. Talk to your doctor or pharmacist, especially if things get really bad.
A couple of words of warning. Occasionally, chronic gastrointestinal infections can lead to IBS symptoms, so it's important you see your doctor to confirm the diagnosis is IBS.
Second, if you pass blood when you open your bowels, get checked by your doctor as this isn't normal, even in IBS.
Other treatments
Peppermint oil and antispasmodic medication relieve abdominal pain. Anti-diarrhoea medication will stop diarrhoea. If constipation is a problem then increasing fluid, fibre, activity, as well as taking a gentle laxative may be recommended.
More recent research has shown that improving the natural gut flora or friendly bacteria found within the gut can reduce symptoms. You can do this either by taking prebiotics (special "foods" which increase the levels of your own bacteria), probiotics (extra supplements of gut bacteria themselves) or a combination of both.
The most natural source of probiotics are foods such as washed but unpeeled root vegetables, but it is difficult to get enough this way. You can use probiotic yoghurts and drinks but the best way to be sure to get good concentrations of the friendly bacteria into the gut may be to take specific probiotic supplements (ask in the pharmacy or at your health store).
Studies have shown that these treatments may help reduce symptoms such as bloating and flatulence. Friendly bacteria to look out for include Lactobacillus rhamnosus plantarum, VSL#3 (a mixture of lactobacilli), and bifidobacteria.

Advice and support
The Gut Trust
The Gut Trust is the largest national patient-led charity for people with Irritable Bowel Syndrome in the United Kingdom. They support sufferers, who are coping day to day with IBS; a condition that is misunderstood, often stigmatised and which can chronically affect everyday life.
The Gut Trust supports people with Irritable Bowel Syndrome in several ways. For members, they offer a telephone helpline staffed by medical and nursing specialists and on-line medical advice and consultation, fact sheets on all aspects of IBS, online support, can't wait cards and travel cards to facilitate access to toilets at home and abroad, a quarterly magazine, and an interactive and frequently updated website that includes a unique fully comprehensive Self Management Programme to help people live life to the full with IBS.
Questions about Irritable Bowel Syndrome, methods of coping etc are answered by the Charity's medical advisor Professor Nick Read.
The Gut Trust works in the public arena, raising the profile of people with Irritable Bowel Syndrome through advertising and media appearances, as well as providing advocacy for people with Irritable Bowel Syndrome at a national level, within government, the National Health Service and the medical profession.
Membership is £34 a year.
The Gut Trust
Helpline: 0114 272 3253
Email: info@theguttrust
Website: http://www.theguttrust.rg" onclick="window.open(this.href);return false;
Core
Core is the only charity in the UK that funds research into the entire range of gut, liver, intestinal and bowel illnesses. The Chartity is called Core because the digestive system is at the core of the body and a good digestive system is the core of good health.
Core
Tel: 020 7486 0341
Email: info@corecharity.org.uk
Website: http://www.corecharity.org.uk" onclick="window.open(this.href);return false;
Yours Sincerely

Dave Joyce
National Health, Safety & Environment Officer