Life with irritable bowel syndrome (IBS) can be really tough – not only are the symptoms difficult to deal with but it’s also heavily stigmatised. Probably because as a nation we’re quite rubbish when it comes to talking about poo.
This month, which also happens to be IBS Awareness Month, national charity The IBS Network has launched a campaign encouraging people with the condition to talk openly about life with IBS so they don’t suffer alone.
It’s thought 12 million people in the UK are impacted by the condition, which is characterised by frequent abdominal discomfort and bowel symptoms that cannot be explained by any other disease.
Bronwen Barber, 56 from Barnsley, developed IBS in her teens with symptoms including stomach cramps and bloating. After struggling on her own for many years, she is now able to manage it. “When I was first diagnosed with IBS there were times when I felt overwhelmed and just had to manage on my own the best way I could,” she said. “After many years of struggling, I now know what works for me and what doesn’t so I can get on with living my life without too much disruption.”
To kickstart conversations around all things bowel-related, we spoke to the IBS Network about the typical symptoms of the condition, as well as the diagnosis and treatment process.
IBS is different for each person and can be triggered by things like food, stress and anxiety. The key symptoms are:
:: Stomach pain or cramps – which are usually worse after eating and lessens after going to the toilet.
:: Feeling like you need the toilet but not being able to go.
Some people might also experience symptoms such as flatulence, passing mucus when you go for a poo, tiredness, lack of energy, feeling sick, backache, problems urinating (like needing to pee often, sudden urges to pee, and feeling like you can’t fully empty your bladder) and incontinence.
If you have any of the above symptoms, it’s worth booking in to see your doctor who can ask more questions around how often you get the symptoms and how long you’ve been having them for. They will then feel your stomach to check for lumps and might also do a blood test to check for coeliac disease. They may also ask for a stool sample to check for infections or inflammatory bowel disease (IBD).
For most people who are under 50 years old and have symptoms of abdominal pain associated with bloating and a change in bowel habit, the diagnosis should be reached quickly, according to Dr Simon Smale, gastroenterologist and medical adviser to The IBS Network.
People over 60, however, might find the diagnosis process takes longer, as lots of other illnesses related to age need to be ruled out. If a person has blood in their stools or has lost weight, more tests might also be required (to rule out things like bowel cancer).
Dr Smale says that when healthcare professionals are less confident of making a secure diagnosis, what should usually take a few weeks and a limited number of relatively non-invasive tests becomes “a lengthy and often cumbersome process of investigation” which extends to months or even longer.
He adds: “The presence of these symptoms does not always signify sinister disease, in fact in most cases no worrisome findings are evident even after investigation.”
Treatment for IBS is very much tailored to the individual, based on whatever it is that’s triggering their flare-ups. So, first of all, it’s important to identify exactly what these triggers are.
“For some, psychological stressors are the most common cause, while for others dietary triggers are more common,” says Dr Smale. “For many people, it is a combination of these and other lifestyle factors, such as sleep (or lack of it) and exercise which exacerbate symptoms.”
A key part of treating the illness is helping people to identify their triggers and then providing advice on lifestyle changes they can make to avoid them.
“Starting with diet – a regular meal pattern and avoiding excess caffeine, nicotine, alcohol, carbonated drinks and indigestible sugars, as sometimes found in diet drinks and some pre-prepared meals – is a reasonable start,” says Dr Smale. What’s also worth noting is that onions, garlic and brassicas (veggies such as broccoli, cauliflower, cabbage, etc) are common foods that may exacerbate symptoms.
If diet is definitely a trigger, then you might want to speak to a dietician to come up with a specific diet plan. Although it can be hard to stick to these, especially if your job requires you to eat out a lot or you rely on getting lunch from your work canteen.
Sleep should also be prioritised, as well as regular exercise and relaxation.
Dr Smale adds: “Recognition of the impact of stress and particularly long-term psychological stresses is important and can lead to the development of strategies to manage those stresses.” Psychological support and alternative therapies might be beneficial here.
While medication is useful for the management of specific symptoms – laxatives for constipation, antispasmodics for pain and anti-diarrhoeals for loose stools – Dr Smale says on the whole, medication has limited benefits.