Irritable Bowel Syndrome

2021-06-09

Irritable Bowel Syndrome (IBS) is a common condition causing abdominal discomfort and affects the large bowel. It is known as a functional bowel disorder due to the fact there is no physiological or structural issue detected. It affects as many as 3 in every 10 people, with the presentation being more prevalent in women than men.  Most people first present with IBS in their late teens or early twenties. 

IBS is usually diagnosed by your GP asking you specific questions and ruling out bowel or other disease that may have a similar presentation. Symptoms that may be associated with IBS are constipation, diarrhoea, bloating, passing of wind and abdominal cramping and pain. Often symptoms of pain and discomfort are relieved by defecation. 

IBS has also been shown to be associated with anxiety. The cause of IBS is
not completely understood. There are however associated triggers. Some
things that are known to trigger IBS are periods of stress in a person’s life,
certain foods, medications such as antacids, anti-biotics and pain
medications, and after having a stomach infection.  

While there is no specific medication to treat IBS, your GP may prescribe you
with certain medicines to help manage your symptoms. These may include
antispasmodics, antidiarrheal's, antidepressants, antibiotics and mild doses
of certain types of anti-depressants, which besides helping depression have
also been shown to help people with chronic pain. Supplements such as peppermint oil may also be suggested as studies have shown them to be helpful in the management of IBS (1).

IBS often presents earlier in life, so if symptoms associated with IBS present for the first time, especially  after the age of 40, it vital that you see your GP. This is because the symptoms may potentially be an indication of another condition.  It is also particularly important if you have any history of bowel disease in your family.  Regardless, it is always helpful to see your GP when you have any change in bowel habits no matter what age you are so that you can get the correct diagnosis to enable you to receive the right treatment. 

Your GP may also refer you to a dietician to help you devise a diet plan specific to you. Nutritionists and naturopaths can also help you with diet and lifestyle modifications. Seeing a professional to help with your diet can be important so that they can ensure that when eliminating specific food groups you are still getting all the nutrients you require and give you an informed treatment plan.  Additionally, therapies such as cognitive behavioural Therapy (CBT) have also been shown to help people manage their symptoms of IBS (2, 3).

Some other alternative treatments that people have found helpful and which studies have shown potential for, have been acupuncture and visceral osteopathy (4-6). 

Additionally, learning to manage stress can be important (7).  Some people find activities like meditation, yoga and Tai Chi helpful. The most important thing however, is to make time for yourself every day, even if it is only 10 minutes.  It isn’t so important what you do in that time but that you disconnect from work, technology and other people.  It could be as simple as writing in a journal, drawing or painting, listening to soothing music, taking a bath or walking in nature.  Diaphragmatic breathing exercises may also be helpful. 

If sleeping is a problem for you this is one especially important issue you should try to address.  Good quality sleep is vital for all our body systems to be functioning properly along with our well-being.  Studies have shown that poor sleep can affect our digestion and our ability to cope with stress (8-9).  Good sleep habits include going to bed at the same time and waking at the same time daily, avoiding screen time and stimulation at least an hour before bed, and creating a room that is dark, quiet and clutter free.

References and further reading

1.       Alammar, N., Wang, L., Saberi, B. et al. The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data. BMC Complement Altern Med. 2019;19(1):21.

2.       Lackner JM, Jaccard J, Radziwon CD, et al. Durability and Decay of Treatment Benefit of Cognitive Behavioral Therapy for Irritable Bowel Syndrome: 12-Month Follow-Up. Am J Gastroenterol. 2019;114(2):330-38.

3.       Everitt HA, Landau S, O’Reilly G on behalf of ACTIB trial group, et al. Assessing telephone-delivered cognitive–behavioural therapy (CBT) and web-delivered CBT versus treatment as usual in irritable bowel syndrome (ACTIB): a multicentre randomised trial. Gut. 2019;68:1613-1623.

4.       Haizhen Zheng, Rixin Chen, et al. Comparison between the Effects of Acupuncture Relative to Other Controls on Irritable Bowel Syndrome: A Meta-Analysis. Pain Research and Management, 2019, 13 pages.

5.       Florance BM, Frin G, Dainese R, Nébot-Vivinus MH, Marine Barjoan E, Marjoux S, Laurens JP, Payrouse JL, Hébuterne X, Piche T. Osteopathy improves the severity of irritable bowel syndrome: a pilot randomized sham-controlled study. Eur J Gastroenterol Hepatol. 2012;24(8):944-9.

6.       Piche T, Pishvaie D, Tirouvaziam D, Filippi J, Dainese R, Tonohouhan M, DeGalleani L, Nébot-Vivinus MH, Payrouse JL, Hébuterne X. Osteopathy decreases the severity of IBS-like symptoms associated with Crohn's disease in patients in remission. Eur J Gastroenterol Hepatol. 2014 Dec;26(12):1392-8.

7.       Qin HY, Cheng CW, Tang XD, Bian ZX. Impact of psychological stress on irritable bowel syndrome. World J Gastroenterol. 2014;20(39):14126-31.

8.       Hyun, M., Baek, Y. & Lee, S. Association between digestive symptoms and sleep disturbance: a cross-sectional community-based study. BMC Gastroenterol. 2019;19(1):34

9.       Abdullah I. Almojali, Sami A. Almalki, et al. The prevalence and association of stress with sleep quality among medical students. J Epidemiol Glob Health. 2017;7(3):169-74.


https://www.healthdirect.gov.au/irritable-bowel-syndrome-ibs

http://www.ibis-australia.org/

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/irritable-bowel-syndrome-ibs

 

IBS, Visceral Manipulation, abdominal massage, visceral osteopathy Sydney