Irritable Bowel Syndrome

Irritable bowel syndrome, or IBS, is a disorder that affects the large intestine (colon).

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Irritable bowel syndrome (IBS) is a condition also known as “'sensitive gut”, “spastic colon” or “nervous colon”. In Singapore, it affects about 10 percent of people. IBS tends to affect more women than men and occurs most frequently in the 30s and 40s. IBS is not life-threatening despite its uncomfortable signs and symptoms. It does not cause permanent damage to the colon, nor does it develop into cancer.

Causes of Irritable Bowel Syndrome 

The exact cause of IBS is not known. People with IBS appear to have extra-sensitive muscles and nerves in the bowel. These muscles may contract too much during eating, causing abdominal cramps. In some cases, food may be forced through the bowel more quickly, causing diarrhoea during or shortly after a meal. In others, food passes slowly through the bowel causing hard stools and constipation.

IBS can affect people of any age. However, you are more likely to have IBS if you are young, and have a family history of IBS. Symptoms of IBS can be triggered or worsened during periods of stress or menses. Many people find their symptoms worsen when they eat certain foods, but this varies between individuals.

Signs and Symptoms of IBS

The signs and symptoms can vary widely from person to person. Some may experience only mild symptoms whereas for others the problem can be disabling. Since the symptoms of IBS can be similar to those of other serious conditions such as colon cancer, it is best to see your doctor if you have a persistent change in your bowel habits.

The most common IBS symptoms are:
Abdominal pain or cramping
Diarrhoea or constipation, sometimes alternating between the two

Other symptoms are:
A bloated feeling/abdominal distension
Mucus in the stool
A sense of incomplete bowel movement

IBS Diagnosis 

The doctor may suspect that you have IBS if your changes in bowel habits have persisted for a certain duration of time. Some tests may also be done to make sure that you do not have any other health problems that cause the same symptoms.

IBS is diagnosed by its signs and symptoms after confirming the absence of other diseases such as colon cancer, inflammatory bowel disease and other infective causes. Specific symptoms, called the Rome criteria, can be used to make a more accurate diagnosis.

In addition to a physical exam and some blood tests, a colonoscopy is done. For this, a thin, long flexible lighted tube is inserted into the rectum and slowly guided up to view the inside of your colon. In some cases, a short, flexible lighted tube is used to view the lower part of the colon. Computerised tomography (CT) scans of your abdomen and pelvis may also be done to rule out other diseases.

How Stress Affects IBS 

Stress can stimulate spasms in the colon triggering the IBS symptoms such as cramping pain or diarrhoea, so the proper management of stress levels in your life — i.e. through relaxation therapy, meditation, getting adequate sleep, decreasing stressful situations in your life, psychotherapy and exercise — can help reduce IBS symptoms.

Irritable Bowel Syndrome Treatment

IBS has no cure, but symptoms can be managed by changes to diet, lifestyle and stress levels. Treatment for IBS focuses on treatment of symptoms.

The doctor may prescribe medications to help you with some of your IBS symptoms. Some of these medications may include laxatives for constipation, antidiarrhoeals for diarrhoea and antispasmodics or painkillers to control abdominal spasms and pain respectively.

Keeping stress in check through meditation and regular exercise may also help to reduce IBS symptoms. It helps for family and friends to provide support and encouragement.

There are no foods that adversely affect all IBS sufferers, so most people control their symptoms by making customised changes to their diet. These can include:
Avoiding certain foods that may make IBS worse, such as alcohol, fatty foods, chocolate, caffeinated drinks like coffee and carbonated drinks like soda
Eating food with fibre such as fruits and vegetables to avoid constipation
Eating four to five small meals a day as large meals can cause cramping and diarrhoea for those affected by IBS

You may have to try a few things to see what works best for you. Your doctor can help you plan the right combination of medicines, diet and support to control IBS symptoms.



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