health articles Irritable bowel syndrome
Irritable bowel syndrome or IBS is an unpleasant condition that causes cramps, bloating and bowel disturbance. IBS can affect your health, wellbeing and lifestyle; you may need to plan outings, activities and work around the food you eat and the access you’ll have to the nearest toilet.
If your IBS affects your quality of life, the experienced doctors at Virtually Healthcare can provide expert investigation, support and treatment to help you control your symptoms and live a full and active life.
What is Irritable Bowel syndrome?
IBS is a common syndrome that affects between 5 and 10% of people[1]. It is defined by its symptoms rather than by specific changes in the structure and health of the bowel. If you have irritable bowel syndrome, you will experience a group of symptoms, including regular abdominal cramping or bloating, together with constipation, diarrhoea or the passage of mucous. You may also experience frustrated defaecation, in which you need to go to the toilet but can’t[2].
If your symptoms are made worse by eating, you’ve been suffering for more than six months, and your doctor can find no other cause for your problems, then you may have IBS.
Most people with irritable bowel syndrome have a sensitive or reactive gut. You may notice that diet, stress or changes in your way of life can trigger symptoms. IBS can be unpleasant and frustrating, but modifying your lifestyle and diet can help. The doctors at Virtually Healthcare can provide treatment, help you identify your triggers, and support you to control your bowels instead of letting them control you.
[1] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31548-8/fulltext
[2] https://www.theibsnetwork.org/have-i-got-ibs/what-is-ibs/
IBS treatment at Virtually Healthcare
Virtually Healthcare is an innovative GP practice, providing expert care in the comfort, safety and privacy of your home. The Virtually Healthcare service is designed to fit with modern lives. Consultations are easy to access, discreet and convenient, with virtual appointments available seven days a week.
The highly skilled team includes more than 40 clinicians working together to investigate and treat disease and help you optimise your health and wellbeing. As well as experienced GPs and nurses, the team includes a dietitian to offer a comprehensive primary care service to manage your IBS.
During the pandemic, many patients are finding it more challenging to access healthcare. Virtually Healthcare provides quick access video or telephone appointments, with consultations available the same day if you contact us before 3 pm. Our clinicians can provide professional assessment and advice, arrange investigations, prescribe treatment or arrange for a face-to-face review.
At Virtually Healthcare, our focus is on you. Our clinicians take a holistic approach to IBS treatment. They can arrange investigations, provide support and advice, follow NICE best-practice treatment guidelines[1] and guide you to reliable information that will help you understand and manage your symptoms.
[1] https://cks.nice.org.uk/topics/irritable-bowel-syndrome/
What causes IBS?
We do not fully understand the causes of IBS; it is believed to be linked to several factors. Many people report an initial trigger such as an episode of gastroenteritis, a traumatic or upsetting event, or a course of powerful antibiotics[1]. There is an apparent interaction between the nervous systems in the bowel and the brain, the emotions and the gut’s microbial make-up and immune system[2].
[1] https://www.theibsnetwork.org/have-i-got-ibs/what-is-the-cause-of-ibs/
[2] https://gutscharity.org.uk/advice-and-information/conditions/irritable-bowel-syndrome/#section-2
How can you help yourself with IBS?
You can help identify your IBS triggers and modify your diet and lifestyle to control IBS. The doctors will offer support and guidance. Keep a diary detailing what you’ve been eating, what you’ve been doing and any stresses and life events. Note your symptoms, including any constipation, pain or diarrhoea. This can help you and your GP track down any triggers and identify things that improve your gut health.
What you eat and how you eat it can affect your bowel. Rushing a meal or eating on the go may trigger a reaction. The food and factors that cause problems can vary between individuals. Look out for:
- Fatty foods.
- Manufactured and processed meals.
- Fresh fruit: Fruit is full of vitamins but can upset your digestion. If you’re struggling, stick to no more than three pieces a day.
- Bloating foods: Some foods can cause bloating and wind. Sprouts, beans and pulses, cauliflower, and sugar-free mints or chewing gum are all common culprits.
- Bran: Wheat bran can help constipation, but it can also make your bloating and pain worse. Fibre from oats, vegetables, a little fruit and linseeds with eight glasses of water a day will help keep your stools soft and regular.
- Stress: Stress can trigger IBS. Stress is often an unavoidable part of modern lives, However, controlling your response to pressure with exercise, meditation, yoga or relaxation techniques can prevent it from affecting your bowels.
- Lifestyle: Your way of life can affect your mental and physical wellbeing. Eat small regular meals, exercise regularly, limit alcohol to no more than two units per day and cut down on caffeine and fizzy drinks.
Gut bacteria
Balancing your gut bacteria may help restore and maintain the health of your bowel. Probiotics in yoghurt drinks or supplements may ease IBS. The probiotics decrease the growth of harmful bacteria in the bowel, preventing them from releasing toxic chemicals that can make you feel bloated and unwell[1].
When making changes, be patient. It can take time to discover what works and what doesn’t. Make changes gradually, one by one, so that you can identify what’s made the difference.
What are the symptoms of IBS?
Irritable bowel syndrome causes symptoms that come and go over time. The typical features include:
- Abdominal pain and cramping.
- Bloating or distension.
- Change in bowel habit- this could be a change to the frequency or consistency of your stools. You may notice constipation or diarrhoea.
- Passing mucous from the back passage.
- Straining, urgency, or a feeling of incomplete evacuation when opening your bowels.
How do you diagnose irritable bowel syndrome?
There is no specific test for IBS. The experienced GPs at Virtually Healthcare can diagnose most people with IBS based on their symptoms and clinical history. They may arrange investigations to exclude any other causes of bowel disturbance, including inflammatory bowel disease, cancer and coeliac disease. This is particularly important if you have experienced weight loss or rectal bleeding or have a family history of bowel disease. Investigations can include:
- Full blood count (FBC).
- Blood test for inflammatory markers such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).
- Stool sample for blood and inflammatory markers (calprotectin)
- Coeliac blood test.
- Referral for flexible sigmoidoscopy or colonoscopy if they want to exclude polyps, cancer, Crohn’s disease or ulcerative colitis.
What is the treatment for IBS?
The GPs at Virtually Healthcare provide empathetic and supportive care for all our patients with IBS. They follow NICE guidelines and work with you to control the difficult and distressing symptoms. They will:
- Provide advice and offer reliable sources of information and support.
- Treat any stress, anxiety or depression.
- Advice about diet and nutrition. Recommending regular meals and a healthy, balanced diet.
- Provide guidance on adjusting fibre intake according to symptoms.
- Consider a trial of over-the-counter probiotic supplements to balance the healthy bacteria in your bowel. This can be particularly useful if you have diarrhoea or bloating.
- Advise soluble fibre supplements, such as Fybogel, or foods high in soluble fibre if you are constipated.
- Ensure you have an adequate fluid intake.
- Encourage regular physical activity[1].
If your symptoms persist, they may prescribe further treatments or refer you to a hospital gastroenterology team for specialist investigations and care.
[1] https://cks.nice.org.uk/topics/irritable-bowel-syndrome/
Hot topics in IBS Can stress cause IBS?
We don’t fully understand the causes of IBS. However, psychological stress appears to be an important factor in the development of the condition. Stress can also trigger symptoms in people living with irritable bowel syndrome.
In one paper, the researchers said:
‘More and more clinical and experimental evidence showed that IBS is a combination of irritable bowel and irritable brain.’
Clinical and experimental studies show that stress affects the sensitivity, motility, and permeability of the gut; it can also impact its secretion. By managing the stressors in your life, or learning how to cope with them better, you may help prevent their effects on your bowels[1].
What is the difference between IBS and IBD (inflammatory bowel disease)?
Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are entirely different bowel conditions. They have some similar symptoms, including pain, change of bowel habit and passage of mucous, but there are significant differences in bowel health and treatments.
IBS: Irritable bowel syndrome is a functional gastrointestinal disorder. There is a disturbance in bowel function but no significant changes in the structure and health of the bowel. IBS causes abdominal pain, cramping and bloating together with diarrhoea and constipation.
IBD: Inflammatory bowel disease includes Crohn’s disease and ulcerative colitis. These are diseases in which there is destructive inflammation of the bowel, which can be seen on sigmoidoscopy or colonoscopy and biopsy. Chronic inflammation can lead to structural changes to the bowel and can increase the risk of bowel cancer. IBD causes bowel disturbance, pain, rectal bleeding, the passage of mucous, malaise and weight loss. Crohn’s disease can lead to fistula formation ( abnormal communications between the bowel and the skin, bladder, vagina or other structures.) IBD treatments are often powerful and can be toxic. They target inflammation and are not effective in people with irritable bowel syndrome[1].
[1] https://www.crohnscolitisfoundation.org/what-is-ibd/ibs-vs-ibd
Types of consultations we offer
We offer written, telephone and video consultations with a range of male and female clinicians from GPs, nurse practitioners, and primary care specialists such as physiotherapy.
Telephone
Video
Written