Irritable Bowel Syndrome

What is Irritable Bowel Syndrome (IBS)? 

The irritable bowel syndrome (IBS) is a common disorder sometimes called the "spastic colon". Many people have recurring gastrointestinal symptoms that can be attributable to IBS. IBS is a diagnosis after exclusion of other conditions such as bowel cancer, inflammatory bowel disease, infections and food allergies.

Causes of IBS

IBS is most likely due to a disorder of the smooth muscle layer of the bowel (over and under activity) resulting in symptoms of constipation and diarrhoea. This dysfunction has been attributed to previous diarrhoeal illnesses (secondary to bacteria or virus infections), dietary allergies and stressors in life. None of these theories have been proven thus making treatment difficult and unpredictable.

Symptoms of IBS

Symptoms vary but usually are present for a long duration

• Abdominal pain,  cramping, bloating - these symptoms are often related to passing bowel motion 

• Diarrhoea or constipation or both 

• Mucus discharge 

• Spasm of pelvic floor muscles causing rectal pain 

Risk factors for IBS 

• Young female 

• Family history of IBS 

• Underlying anxiety, depression, other mental health issues 

What is the management for IBS

• A consultation with your GP and initial assessments with blood tests, stool studies and CT may be necessary 

• Referral to a colorectal surgeon for consideration of colonoscopy

• A good doctor will ensure that your symptoms are appropriately assessed and treated 

• Reassurance re: no serious underlying pathology often alleviates symptoms.

• It is difficult to advise one particular treatment plan due to the mixed symptoms. Some treatments can help one symptom but exacerbate another. For example, fibre may improve constipation but worsen or aggravate bloating. Medical therapies may be commenced on a “trial and error” basis. 

• Counselling and relaxation therapy provided by experienced clinical psychologists may be helpful for some

• Long term treatments should be discouraged as the natural history of this condition is that of spontaneous remissions and exacerbations. 

• Consider testing for food allergies. 

• Surgery has NO role in the management of the IBS