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Irritable bowel syndrome (IBS) is a disorder rather than a disease. It causes a range of symptoms, including stomach cramps, bloating, diarrhoea and constipation. We talk about the condition and the treatments available.
Many of the symptoms of IBS are because the bowel is either overacting or underacting and therefore symptoms develop because it is not moving as the bowel should do.
Diarrhoea-predominant IBS does happen but it is less common.
The symptoms tend to vary between individuals and some are more severely affected than others. The symptoms tend to also come and go in periods lasting a few days to a few months at a time, often during times of stress or after eating certain foods.
Symptoms can also develop from certain foods. Evidence suggests that symptoms can get worse when consuming milk-based products. Common things like oranges and onions are often not well-tolerated by people that have IBS. There is also popularity for gluten-free products or wheat-reduced diets as a way to relieve IBS symptoms, but the effects of these diets on IBS are inconclusive.
It is important to rule out celiac disease, which can mimic IBS, by monitoring the diet closely, and making sure that the patient does not have inflammatory bowel disease, particularly Crohn's, that can also display symptoms similar to IBS.
The treatment really will be to analyse the patient’s stress levels. The patient should look at whether or not their symptoms are worse during the week or when they go home in the evening to their partner or family, to identify what may be triggering it and then addressing that. There are other things like the FODMAP diet, which is for anyone with bowel problems, but it can be very difficult to strictly abide by this diet.
There are all sorts of different treatments, diets, and therapies that can be tried by an individual person which would require talking to a GP and other healthcare professionals.
However, some of the diets that are recommended, apart from the FODMAP diet which is usually supervised by a dietitian, may be nutritionally unsound as they do not include a correct balance of nutrients.
Dietary advice has changed over the years, often because a new study proves a previous theory wrong, and so it is important for patients to approach diets through trial and error as our reaction to certain foods can vary between individuals.
For example, previously people were encouraged to go on a diet that was high in bran and that's now been shown not to be helpful for IBS. Recently, the FODMAP diet has been tried in some patients but it can be a very difficult diet to follow and unless the patient has got severe symptoms, most people will struggle to continue adhering to the diet.
The advice given to most IBS patients is that they monitor which foods they eat that may trigger the IBS and try cutting such foods out of their diet.