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Warning:

This site gives you information NOT medical advice. You should consult your medical practitioner if you have any unexplained symptoms of illness or concerns about treatment. Do not stop a prescribed conventional treatment without consulting a doctor. Tell all the practitioners you're working with, conventional or complementary, about any medicines, remedies, herbs or supplements you are taking or considering using.

IBS

What do we mean by IBS?

Irritable bowel syndrome (IBS) is a disorder that interferes with the way the colon (large intestine) works. It causes abdominal pain, cramps, spasms, bloating, constipation and diarrhoea. The symptoms vary and they tend to come and go, without warning. They can be quite mild, but some people feel severe pain in parts of their abdomen. People who get IBS often get 'reflux indigestion' symptoms (heartburn, or acid reflux with burning feelings in middle of the chest) too.

How can we be sure that IBS is the problem?

IBS is usually diagnosed by its symptoms, after your doctor has ruled out other causes. It's normal to experience indigestion, bloating or wind, and constipation or diarrhoea occasionally. These problems could be the result of a change of diet, hurried meals or a shift in routine. But if symptoms like this continue or worsen, or if you develop any gut symptoms you have not had before, you should check with your doctor in case the problem is due to a different digestive disorder that needs treatment.

Is it curable?

Most people can control and live with the symptoms of IBS by using various prescription and over-the-counter medicines: laxatives, anti-diarrhoea medicines, antispasmodics, or tricyclic drugs. The gut is very sensitive to stress, and people often find that stress makes their IBS symptoms worse. In many cases, reducing stress can help to relieve some of the symptoms. Increasingly research suggests that what you eat can have an important effect on IBS, so making some simple dietary changes may also help.

Is it dangerous?

IBS does not damage the intestines or lead to cancer. Nor, even though some of the symptoms are similar, is it related to inflammatory bowel diseases such as Crohn's disease or ulcerative colitis.

What causes it?

Although it is not clear what causes IBS, it is one of the most common digestive problems. In England 10-20% of people have IBS at some time in their lives, and twice as many women get it as men. This may be due to the menstrual cycle, and differences in the way men and women perceive pain coming from inside the body. Many people with IBS have a more sensitive colon. This means their bowel reacts to things that might not bother other people, such as stress, big meals, wind (gas), some medicines, certain foods, caffeine or alcohol.

Something else that plays a part in IBS is called 'visceral hyper-sensitivity'. Air and other gases collect in the gut (produced by digestion but also through air-swallowing). If this stretches the intestine, this stretching may be felt as pain. Researchers have recently discovered that about half the people who get IBS feel this discomfort sooner than would be expected. This 'stretch-sensitivity' is not some sort of weakness or failure - in fact many IBS patients seem to have a greater than usual tolerance of pain in other parts of their bodies.

People therefore seem to feel internal pain in different ways. Some people are more sensitive to it, possibly because of the way the nerves in their intestines work, or perhaps because their brains are more attuned to sensing discomfort inside their bodies. It's also known that people become more sensitive to some kinds of pain when they feel stressed. And some people are more prone to feeling stressed than others.

A number of small studies have indicated that people who have experienced early physical or sexual trauma are more likely to develop IBS. Perhaps this is because, understandably, such traumatic experiences leave behind feelings of vulnerability and increased concern about pain and other feelings in the body. People who have suffered abuse may be more prone to depression and/or anxiety too, which probably make the uncertainties of an illness like IBS harder to cope with.

IBS is also linked to several other health problems that involve increased sensitivity to internal sensations. For instance, people who get IBS are more likely to get migraine, chronic fatigue, period pains and restless leg syndrome. A 2006 study, involving 125,000 people, some who had IBS and some who didn't, found that IBS sufferers were 60% more likely to have migraine, 40% more likely to experience depression, and 80% more likely to suffer from fibromyalgia.

IBS and Periods

Many women get constipation and/or diarrhoea just before their period comes on. Women who get IBS are more likely to be bothered in this way. Yet sometimes even severe IBS goes away during pregnancy. It isn't clear why: possibly because of hormonal changes, or because during pregnancy the body has to become less sensitive to things stretching inside.

Self-help Techniques:

Here are some simple tips that may ease your IBS:

  • Take regular exercise to improve your circulation and make you feel more relaxed.
  • Raise the head of your bed by 15 cm (6 inches) so that gravity can help keep digestive acids in your stomach.
  • Consider visiting a medical herbalist - caraway and peppermint oil may help.
  • A nutritionist may help you identify problem foods and recommend a simple treatment, such as a course of probiotics.
  • Eat regular, small meals and follow a healthy, fibre-rich diet.
  • Keep a food diary if you suspect that you are sensitive to certain foods.
  • Avoid highly spiced, rich or fatty foods.
  • Steam, grill or bake rather than fry.
  • Avoid raw foods and acidic foods such as vinegar and pickles.
  • Cut down on tobacco and alcohol, which increase stomach acidity; strong coffee, which irritates the stomach lining; and sodas, which cause gas.
  • Avoid eating just before going to bed.
  • Eat at a table sitting upright, rather than slumped in front of the TV.
  • Consider talking to your doctor about cognitive-behavioural therapy (CBT).
  • Keep a symptom-and-stress-trigger diary.
  • Practise relaxation and breathing techniques to help you deal with stress and anxiety. You may wish to buy a relaxation CD. Relax before and during meals and chew your food thoroughly.
  • Consider having hypnotherapy.
  • Consider visiting an acupuncturist.

What other information might be helpful

  • If you think that you might be suffering from stress or anxiety (feeling nervous or having worrying thoughts that are making you feel very tense) that are causing symptoms of IBS, you might like to see the information on STRESS AND ANXIETY first.
  • If you have general feelings of pain in several places in your body, see the information on SORE MUSCLES. If you are female and the pain in your stomach seems linked to your periods, see the information on PERIOD PROBLEMS

For more information see MindBodyDigestive or NHS Choices.