April 06, 2022
Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder characterized by chronic, recurrent abdominal discomfort and pain, with changes in bowel habits.
IBS is caused by problems arising between the gut and the brain. Psychological factors (including stress), certain foods and the micro-organisms (bugs) living in the gut can all play a role in triggering symptoms. Occasionally, it can start after a gut infection or antibiotic use, but more often there is no clear origin.
Some patients with IBS learn to manage their symptoms themselves, by changing their lifestyle or diet or managing stress differently. Others, however, will consult their general practitioner who can usually make the diagnosis based on the typical symptoms. General practitioners will carry out some blood tests, including one to rule out coeliac disease (an immune reaction to gluten) and, if diarrhea is present, a stool test to rule out inflammation. If there are concerning symptoms, including bleeding from the back passage, substantial weight loss or anemia, a strong family history of cancer, or the patient is older, then the general practitioner will refer to a Gastroenterologist for further tests. The Gastroenterologist may request a camera test of the large bowel, known as a colonoscopy, or do extra tests to look for other causes of diarrhea or constipation, especially if the patient’s symptoms are less typical of IBS.
Regular exercise, making some simple dietary changes, and adopting healthy eating patterns will help many patients. Some patients find reducing dietary fibre improves symptoms, while others may find that a soluble fibre supplement helps. Referral to a dietitian can be helpful if these first-line approaches to diet do not help. It is recommended that patients whose symptoms do not improve should be managed with an integrated multidisciplinary approach.
The multidisciplinary team of specialists at our clinic can assist in providing appropriate tailored education, advice and reassurance, shared decision-making, and management plans, and be facilitated by an ongoing supportive doctor-patient relationship and prioritisation of continuity of care.
Reference from the British Society of Gastroenterology guidelines on the management of irritable bowel syndrome.