Irritable bowel syndrome (IBS)

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What is it about ?

Irritable Bowel Syndrome (IBS), also known as spastic colon or spasmodic colitis, is a condition characterized by an upset stomach, a feeling of discomfort or bloating in the stomach, and a change in the type of stool. The cause is not well known, and it is believed that there are several. Peristaltic disorders (peristalsis is the way the walls of the digestive tract move to move food through the digestive tract), intestinal hypersensitivity, infection (eg, stomach flu), and stress can be factors underlying.

What is its frequency?

Studies show that each year, about 9 women and 4 to 5 men in 1,000 see their GPs with symptoms of irritable bowel.

How to recognize it?

The symptoms below are typical of IBS:

  • pain felt in various places of the belly or a feeling of discomfort in the belly;
  • improvement in complaints after having a bowel movement (defecation);
  • variable defecation frequency;
  • alternating soft (diarrhea-like) and hard stools;
  • feeling bloated (especially during the day, after meals);
  • presence of mucus in the stool;
  • feeling like you have to go to the bathroom often;
  • feeling of incomplete defecation.

There are three types of SCI: a variant mainly marked by the constipation, a variant mainly marked by diarrhea and a mixed variant with alternating diarrhea and constipation. People with IBS often also have problems in the upper part of the digestive tract, such as stomach pains. Most also suffer from fatigue, back pain, headaches, a more frequent urge to urinate and a feeling of incomplete emptying of the bladder. Symptoms vary depending on your reaction to food and different situations in life. Symptoms appear from time to time.

The following signs are not characteristic of IBS. In these situations, you are strongly advised to consult a doctor:

If you often suffer from stomach aches, you should see your doctor. There are indeed many possible causes, and it is often best to rule them out first.

How is the diagnosis made?

Your doctor will ask you questions and examine you. The information thus obtained may already be sufficient in cases of IBS mainly marked by constipation and accompanied by characteristic symptoms. If you mainly suffer from diarrhea, a blood test may be helpful to rule out gluten intolerance (celiac disease). A Lactose intolerance (intolerance to dairy products) should also be taken into account.

In some people, a colonoscopy Is usefull. For this examination, the doctor inserts a small camera through the anus to examine the colon. The goal is to rule out intestinal inflammation or cancer.

What can you do ?

Many people with IBS fear they have a serious illness. Talk to your doctor; he will answer your questions and be able to reassure you.

In more than half of patients with IBS, symptoms worsen after eating. Some diets can be helpful: discuss them with a doctor, dietitian or nutritionist. Caffeinated drinks, dietary supplements, fatty foods, and bran make symptoms worse. The effect of a change in diet is not immediately evident. The adapted diet must respect the principles of healthy lifestyle. So don’t cut out all fruits and vegetables from your diet and get enough exercise. Physical activity speeds up the passage of air and stools through the intestines and reduces symptoms of IBS.

Generally, IBS is more bothersome in times of stress. Your body is actually trying to get a message across to you. Try to find the right balance between active life and relaxation. Yoga, relaxation exercises, and hypnotherapy can be helpful in treating the symptoms of IBS.

Peppermint oil is also said to have a beneficial effect.

Try to stay social, even if you are bothered by the symptoms of IBS. Avoiding these activities will only make the problems worse in the long run.

What can your doctor do?

Your doctor will give you some advice and reassure you. Your doctor, dietitian or nutritionist can help you find a diet that’s right for you. Certain carbohydrates, grouped under the acronym FODMAP (from English Fermentable Oligo-, Di-, Mono-saccharides And Polyols), ferment in the colon and cause stomach pain and bloating.

People with bloating or pain are advised to try the FODMAP diet for 4-6 weeks, avoiding these carbohydrates found in the following foods:

  • cereals: rye, wheat and oats,
  • certain fruits and vegetables: apple, pear, plum, apricot, cherry, watermelon, cabbage, onion, asparagus, artichoke,
  • mushrooms,
  • legumes: peas and beans,
  • some sweeteners,
  • probiotics,
  • yogurt to aid digestion or health drinks enriched with fiber,
  • honey.

Your doctor may also prescribe medication to ease the symptoms. Unfortunately, there is no drug that can cure the disease. The available drugs have varying effects and do not work equally well in all patients. The most used products are:

  • certain antispasmodics (spasmolytics): these are products that relieve cramps, such as peppermint oil or mebeverine;
  • certain medicinal fibers such as ispaghul (also called Plantago ovata or psyllium);
  • certain probiotics: the “good” intestinal bacteria;
  • certain antidiarrheals;
  • certain antidepressants.

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Source

Foreign clinical practice guide ‘Functional bowel disorders and irritable bowel syndrome (IBS)’ (2000), updated on 03/30/2017 and adapted to the Belgian context on 04/02/2018 – ebpracticenet