Today we will take a look at IBS, its causes and its symptoms. And at the end of this post, I will help you piece together a list of IBS-specific information. You can bring this with you to your doctor if you are concerned about having IBS yourself!

As some of you know, I myself was diagnosed with irritable bowel syndrome. I received my diagnosis at the age of 22, and finally my symptoms starting piecing together!

My first memories of IBS affecting my life were during my school years. I was always afraid of feeling hungry during school hours. I needed to be prepared to the MAX when it came to school lunches and snacks. This was because any change to my regular eating pattern left me in a rather awkward position. My tummy would gurgle loudly. It would also make odd high pitched noises that were so loud you could hear them across the classroom. As well as that, I would get very bloated and needed regular toilet trips.

As I approached my late teens, I started applying for after-school jobs. Without fail, the nervous minutes before a job interview often included urgent toilet trips and more embarrassing tummy noises. Then school presentations started having a similar effect on my gut. I often felt nauseous and was also afraid to join in with gym class at times as my tummy was so bloated and crampy. I felt awkward and I felt embarrassed. And mostly, I felt confused. However time went on, and these symptoms became part of my life. I felt that I had to accept that my tummy and I would just not be friends.

Year one in Dietetic college, and I was keen to “clean up my diet”.

I thought that eating healthier would be my magic cure for crampy bloating. I started eating high fibre breakfast cereals. But not just that – I upped my vegetable game and snacked on large portions of fruit. But low and behold, my abdomen ballooned more than ever. I had days that I simply did not want to leave the house for fear of my tummy noises outvoicing me.

By second year of college, I had decided to gather my courage and speak to my doctor about my concerns. My doctor discussed my symptoms with me and I was sent for a blood test to rule out coeliac disease. I was also referred to a gut specialist to rule out any problems. Just a side note here: I had my gallbladder removed when I was 19. So the doctor was concerned there may have been scar tissue causing problems after the surgery. Thankfully, I had a scan in the hospital which was able to rule out any issues with my intestines.

With all results in hand, I headed back to my doctor. Yet, at this stage I felt lost.

My blood test showed there was nothing wrong with me. My gut specialist in the hospital found no problems with my scan. However, if nothing was wrong with me, why was I so miserable? My doctor discussed my symptoms further with me, and that was the day that she told me that I probably had irritable bowel syndrome. With this diagnosis I was sent on my way. I was told that there was no cure. I was given a tablet that I would have to take if my bloating ever got “BAD BAD”. And that was it.

Cue third year of college and I was busy beyond belief. Studying, presentations, a weekend job and dietetic work placements. I had parked the idea that my gut would ever feel better, and was too busy to really delve into what role diet could play on my symptoms. I mean, yes I do have first hand experience in how difficult it can be to take charge of your health!

Towards the end of third year in college we finally started to learn about the role of nutrition in digestive health. And at last, a one hour lecture on irritable bowel syndrome changed my life.

If only I had known all those years how much an effect that diet really does play on IBS symptoms! And not just diet, but our lifestyle, our exercise levels and our mood! I now manage my IBS mostly through diet, exercise and meditation. I do occasionally require a tablet to manage cramps (especially if I have chosen to eat foods that I know might make me bloated). But overall, my symptoms are very well controlled and no longer affect my social life.

So today let’s take a look at those first stages of the IBS journey. We will learn about what IBS really is, through to how you may be diagnosed.

First, let’s clarify a little on what Irritable Bowel Syndrome is.

IBS is a term we use to describe a variety of gut symptoms. It is a disorder that interferes with the normal functioning of your large bowel. It affects 10 to 20% of the population and is twice as common in women than men

While symptoms of IBS can change daily, and over time, they usually include:

• Changes in your bowel habit (such as constipation or diarrhoea). Sometimes the abdominal pain or discomfort goes away after you move your bowel. Or you may find that your bowel habit and stool consistency is different when you have the abdominal pain. Occasionally, you might also pass mucus from your rectum.
• Pain or discomfort in your abdomen.
• A feeling of bloating, tension or hardness in your abdomen.
• A feeling that your symptoms are worse after you eat.
• Often you may find that the place where you feel the pain or discomfort in your abdomen changes location.
• You might also find that you have symptoms such as backache, tiredness, bladder problems or nausea.

So what causes IBS?

Well, the exact cause of IBS is not known. However, it is speculated that different people may have one or more of the following factors:

Microflora

Firstly, some people have gut bacteria that cause more bloating than others. The bacteria that live in our gut are called our “microflora”. And this microflora is different from person to person. It is perfectly normal to have bacteria living in our gut! Actually, it is very necessary to have healthy bacteria there, as they help us digest our food and can keep infections at bay! The types of bacteria that live in our gut are unique to us. And they can change day to day. They are affected by the food we eat and the place where we live. They can also be affected by some medication, such as antibiotics. Some people have a microflora that makes them more prone to IBS, meaning that the types of bacteria that live in their gut might create more gas than others.

Muscle contractions

Another thing that may cause IBS is how strong the contractions of the lining of our gut is. Our intestines have a lining of muscle that contracts to help us move food through our gut. For some people, these contractions can be harder than for others. If the contractions are stronger or last longer than usual, they can cause the crampy feeling you get with IBS, and it can lead to gas, diarrhoea and bloating. For some, the contractions may be weak however, and can cause your food to move more slowly through the gut. This can then also cause bloating and can lead to constipation.

Inflammation

Inflammation in our gut can also contribute to IBS. Some people have a higher level of immune cells in their intestines. This has been linked to increased pain and diarrhoea.

Stress

For many people with IBS, their symptoms get worse when they are nervous or stressed. It is unclear exactly how stress is linked to the symptoms, but it is likely related to hormones and a response of our nervous system.

Nervous system

Some people have are more sensitive to the feeling you get when your intestines stretch from gas or stools moving through the gut. This can be because of an abnormality in the nerves system in your gut. When your gut and your brain are not communicating properly, and signals between them are not coordinated correctly, you can experience more pains and a change in bowel habits.

Foods causing gas

Some foods that you eat may cause more gas to be produced in your intestines than other foods. If you are more sensitive to these feelings of bloating, this can trigger IBS symptoms.

Hormones

Women are more likely to have IBS than men, and sometimes symptoms get worse when you have a period. Therefore there is likely a link between hormone levels and IBS.

Gastroenteritis

For some, a bad tummy bug, caused by bacteria or a virus may lead you to develop IBS.

In order to be diagnosed with IBS, your doctor will discuss your symptoms with you.

Usually a doctor will first ask you if you have experienced any changes in bowel habit, pain or discomfort in your abdomen and a bloated feeling in the past 6 months.

If you have, then your doctor should consider IBS as a possible cause for these symptoms. In order to formally diagnose you, you need to have some specific symptoms. Firstly you need to have either abdominal pain or discomfort that goes away after passing a bowel motion or pain/discomfort at the same time as having a change in bowel habit.

You then also need to have two of the following:

• A change in how you move your bowel (for example, needing to strain, or a feeling of urgency to move your bowel).
• Bloating, tension or hardness in your abdomen.
• A feeling that your symptoms are worse after you eat.
• Passing mucus from your rectum.

Before a true diagnosis is made, your doctor will need to rule out any other problems that may be causing your symptoms.

This will include a blood test to check for anaemia and levels of inflammation. A blood test is also done to check that you don’t have a gut disorder called coeliac disease. If your doctor thinks it is needed, he may send you for a scan or ask for a stool sample, but this is not as common as needing a blood test.

Your doctor should also ask you if you have noticed any unintentional weight loss. He should check if you have noticed any bleeding from your rectum, and ask if you have any family members who have had bowel or ovarian cancer.

At the end of this post, I will give you a list of questions that you might want to ask your doctor if you are concerned about bloating and bowel changes.

Once you have been diagnosed with IBS, there are several things that can be done to help you to improve your symptoms. Today I have divided these into three aspects: Lifestyle, diet and medication.

Lifestyle and IBS (mind and body)

Firstly, finding ways to deal with nerves and stress may help to ease or prevent your IBS symptoms. Counselling, cognitive behavioural therapy, hypnotherapy, relaxation exercises and mindfulness have all been used to help reduce symptoms associated with irritable bowel syndrome. Yoga is also shown to have positive effects on IBS symptoms. In general, it is recommended to try to gradually increase your physical activity levels to help both your body and mind to become healthier.

Diet and IBS

Next, our diet can greatly influence our IBS symptoms. I have covered some surprising ways to help you manage your IBS through diet in this POST! The dietary strategies recommend to start with some small and simple changes to your diet. The next step would be to avoid certain foods that are known to cause gas for many people. And then there are some specific diets such as the Low FODMAP diet that can be tried. Especially if all other dietary strategies are not relieving your symptoms enough.

Medication and IBS

For many people, diet and lifestyle changes are enough to help to reduce IBS symptoms. However, based on your symptoms, your doctor might also recommend for you to try some medications. These can include laxatives, probiotics, antibiotics, fibre supplements, anti-spasm medications, anti-diarrhoea meds, pain relief and anti-depressive meds. You should continue to follow your doctor and dietitian’s diet and lifestyle advice while you are taking these medications.

If you are concerned about your bowel habits or your possible IBS symptoms, you can visit your doctor. When you go to your doctor, it might be useful to have some information prepared in advance.

Consider keeping track of your bowel habits. In a little diary, keep track of the date and time that you move your bowel. You can use a chart called the “Bristol Stool Chart” to describe your stool.