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what is it?
Irritable bowel syndrome (IBS) is what doctors call a functional bowel disorder. This means simply that the way your bowel works or functions is altered from normal in some way, even though, when tests are done, the intestines appear normal with no evidence of injury, infection, inflammation or malignancy (cancer).
IBS tends to develop between the ages of 20 and 40 and affects men and women equally, although women are three times more likely to seek medical help and it is often worse premenstrually (see premenstrual syndrome ). It sometimes appears after a bout of gastroenteritis or a course of antibiotics. Although IBS may be little more than a minor nuisance, it can become more severe and an unfortunate few are crippled by symptoms.<
In IBS, food passes more rapidly than usual through the digestive system (rapid transit) causing frequent bowel motions. In addition, the normal gut movements (peristalsis) that propel food through the bowel are stronger and more frequent.
Symptoms may include:
- Abdominal pain, which is often experienced in one of the four 'corners' of the abdomen. Pain may be triggered by eating and relieved by opening the bowels.
- Diarrhoea and constipation (often alternating)
- Bloating
- Indigestion, rumbling wind and flatulence
- Early satiety (feeling full within a short time of starting to eat)
- Stools may be ribbon or pellet like and sometimes contain mucus
- Although opening your bowels may temporarily alleviate pain you may feel as if they are never emptied properly.
what causes it?
The bowel of someone with IBS looks normal and healthy and the condition often begins or first becomes noticeable during a period of emotional stress. Unfortunately this has sometimes led to the condition being dismissed as 'psychosomatic'. True, as with many illnesses, anxiety and depression can aggravate symptoms, but that does not mean that it is imaginary. It can also begin after a bout of infective diarrhoea or food poisoning. Some doctors think this may be due to an intolerance to a particular food or foods developing following the infection. Many experts now believe the condition is a result of disturbed chemical messages in the gut leading to a disruption of the peristaltic waves.
If you develop symptoms of IBS or a change in your usual bowel habit for the first time after the age of 40, seek medical help as these symptoms appearing for the first time in middle age may sometimes be due to intestinal disease that needs full investigation.
how complementary therapies may help
Each therapy has been coded from 1 to 5 depending on the amount of scientific evidence there is for its effectiveness. The higher the number the stronger the evidence, so 5 = definitely, 4 = probably, 3 = possibly, 2 = opinion, and 1 = rumour. (There is more detail about these in the 'does it work?' section of 'before you start'.)
Having said this, the codes aren't meant to be cast in stone or to put you off trying a particular therapy or therapies if you feel they might be helpful to you.
Go to therapies for a full description of each individual treatment, plus information on how to find practitioners.
hypnotherapy
(code 4)
There's mounting evidence that hypnotherapy can help improve IBS. The precise way in which it reduces symptoms remains to be unravelled although several studies have shown that it can slow bowel transit time, reduce the secretion of stomach acids and calm gut motility (movement). Treatment may be 'gut directed' — that is focused specifically on symptoms and on helping you control the movements of your gut — or it may be aimed at more general relaxation and stress relief.
acupuncture
(code 3)
According to Chinese thinking symptoms of IBS may be caused by stagnation of liver chi deficiency of kidney chi or spleen and possibly an excess of 'damp heat' leading to a disturbance of the gut flora and/or food intolerances. Treatment aims to rebalance the flow of chi by stimulating the acupoints related to these areas and so alleviate symptoms. The acupuncturist may also recommend Chinese herbs .
herbal medicine
(code 3)
A herbalist will assess your diet and lifestyle and recommend a number of different herbs. The precise ones will depend on your symptoms but may include soothing herbs such as calming marshmallow, meadowsweet and oats.
Peppermint has long had a reputation as helping to ease indigestion and digestive problems and there is now research that suggests that specially prepared peppermint oil capsules may indeed have a beneficial effect, although it's not conclusive.
nutritional therapy and naturopathy
(code 3)
There's some evidence that an exclusion diet in which you leave out suspect foods may help. Treatment is likely to consist of encouraging you to keep a food diary to identify foods that may trigger symptoms. Some studies show that eating more soluble fibre (found in the skins of apples and foods such as pulses) can help where constipation is a dominant symptom. However insoluble fibre such as wheat bran may actually aggravate diarrhoea.
other therapies
Simple homeopathic remedies and constitutional treatment (see homeopathy may be worth trying. acupressure, yoga, biofeedback and autogenic therapy can all help reduce stress and in this way may help alleviate symptoms of IBS.
» help and info
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(July 2002)
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