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Irritable Bowel Syndrome - A Summary
| This leaflet gives a brief summary of irritable bowel syndrome. There is another more detailed leaflet on irritable bowel syndrome, and one on fibre in the diet. |
What are the features of irritable bowel syndrome?
Common symptoms include:
- Pain in the abdomen which comes on from time to time. The pain often eases when you pass stools (faeces) or wind. The severity of the pain can vary from mild to severe.
- Bloating and swelling of the abdomen, and passing more wind than usual.
- Bouts of constipation and/or bouts of diarrhoea. Some people pass mucus too.
- The stools may become small and pellet like, or watery and ribbony.
- A feeling of not emptying your bowels after going to the toilet.
- Urgency, which means you have to get to the toilet quickly.
Some people have occasional mild symptoms. Others have unpleasant symptoms for long periods. Many people fall somewhere in between, with flare-ups of symptoms from time to time. IBS is common and can affect anyone at any age. The cause of IBS is not known. There is no test that confirms the diagnosis of IBS. A doctor will usually diagnose IBS from the typical symptoms.
What are the treatment options for irritable bowel syndrome?
- A high fibre diet (or fibre supplements) may help if constipation is a main symptom. However, in some people with IBS, especially those with diarrhoea, extra fibre may make symptoms worse (particularly bloating).
- Diet. Some people with IBS find that one or more foods can trigger symptoms, or make symptoms worse ('food intolerance'). If so, you can cut out that food or foods. The commonest food intolerances that cause IBS symptoms in the UK are to: wheat, rye, barley, dairy products, coffee (and other caffeine-rich drinks such as tea and cola), and onions.
- Antispasmodic medicines relax the muscles in the wall of the gut. There are several types which work in different ways. Therefore, if one does not work well, it is worth trying a different one. If one is found to help, then you can take it 'as required' when symptoms flare-up. For example, for a week or so at a time to control symptoms when they flare-up.
- An antidiarrhoea medicine such as loperamide can help if diarrhoea is a main symptom.
- An antidepressant is sometimes used. In particular, it tends to work best if pain and diarrhoea are main symptoms. (Antidepressants have other actions separate to their action on depression. They are used in a variety of painful conditions, including IBS.) Unlike antispasmodics, you need to take an antidepressant regularly rather than 'as required'.
- Talking treatments. Stress and anxiety can trigger symptoms, or make them worse. Some people have found such things as relaxation techniques, stress counselling, cognitive behaviour therapy, psychotherapy, and similar therapies useful in controlling symptoms of IBS.
- Various other treatments are sometimes used such as herbal medicines and probiotics. However, more research is needed to clarify their role. Newer drugs that affect the gut are also being studied and may become useful treatments in the future.
Further help and advice
The Gut Trust
Tel: 0114 272 32 53
Web: www.theguttrust.org
Offers advice, information and support for people with IBS.
References
- Irritable bowel syndrome, Clinical Knowledge Summaries (2005)
- Spiller R, Aziz Q, Creed F, et al; Guidelines for the management of Irritable Bowel Syndrome. Gut. 2007 May 8;. [abstract]
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