What is Irritable bowel syndrome?

An estimated 10-20% of the UK population are proposed to suffer with irritable bowel syndrome (IBS) (1). You’ve probably heard the term ‘IBS’ thrown about before, but what is it? IBS is a chronic functional gastrointestinal disorder which includes symptoms such as abdominal pain, changes in bowel movements and bloating (1,2).

Unfortunately, there isn’t a specific cause – making diagnosis difficult! However, there are links between symptoms and potential causes. Our gut microbiome (i.e. the bacteria in our gut) is suggested to largely influence our health, particularly our digestive health. We have trillions of gut bacteria – and they aren’t all ‘bad’! However, these bacteria can be impacted by multiple factors, including our diet, medication (such as antibiotics) and stress (3). This is linked to the brain-gut axis (4) (this is the connection between the brain and gut). Ultimately, this connection is crucial to ensure our digestive system is functioning properly. However, IBS sufferers may experience adverse alterations causing negative outcomes, such as changes in bowel movements. There are also suggestions that genetics may play a role, such that you may be at increased risk if you have a family history of IBS (4). The key point to take away from this is that the cause differs in everyone!

Symptoms

Symptoms may differ between sufferers but the main symptoms a healthcare professional may consider when assessing IBS includes abdominal pain, bloating and changes in bowel habits (1). Changes in bowel habits simply means you may now suffer from constipation or diarrhoea when previously you didn’t, or you may alternate between the two. Sufferers may also experience urgency, incomplete evacuation, mucus, fatigue, nausea, backache and symptoms linked to their bladder(1).

Diagnosis

IBS diagnosis isn’t necessarily a ‘true’ diagnosis. Rather, it is diagnosed through eliminating other health conditions, such as coeliac disease. This may involve undergoing investigations and tests, such as stool and blood samples.

Management

IBS is not curable; therefore a ‘treatment’ doesn’t exist. Instead, the condition must be managed, primarily through lifestyle.

Many healthcare providers (particularly those in the UK) are likely to follow the National Institute for Health and Care Excellence (NICE) recommendations when providing IBS management support (1). This may include recommendations to have regular meals involving mindful eating (i.e. taking time to eat), drinking plenty of fluids and monitoring your fibre intake particularly the balance between insoluble and soluble fibre(1).

Probiotics may also be recommended. Probiotics contain live bacteria and their aim is to help restore the diversity of bacteria in the gut (5) (we want to aim for a greater diversity of bacteria to promote better gut health). However, not all probiotics are equal, and some won’t reach your gut ‘alive’. Therefore, some people may find probiotics help whilst others may not find much of a difference. Regardless, NICE suggest if you take probiotics to try them for at least 4 weeks.

A low FODMAP diet is another method to aid IBS symptoms (1). FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. A low FODMAP diet is an ‘investigation’ which involves eliminating FODMAPs for a short time period (NOTE: this is NOT a long-term lifestyle plan!) to determine whether symptoms improve. One by one the FODMAPs are reintroduced, and symptoms are monitored. The final stage involves deciding which foods you can and cannot tolerate. It is crucial, however, that if you follow a low FODMAP diet, that you receive support from a qualified registered dietitian or registered nutritionist… it really can be tough!

Conclusion

IBS is a condition affecting a relatively large proportion of the population, yet not enough awareness is raised! However, given that diagnosis isn’t straightforward, this may deter people from seeking help and support. Fortunately, IBS research is ever evolving meaning we know more than ever before! If you think you may be suffering, please make sure to visit your GP or a registered dietitian/nutritionist to ensure you receive the correct support.



References

1. https://www.nice.org.uk/guidance/cg61/resources/irritable-bowel-syndrome-in-adults-diagnosis-and-management-pdf-975562917829

2. https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039952/

4. https://aboutibs.org/what-is-ibs/what-causes-ibs/

5. https://www.nhs.uk/conditions/probiotics/

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