IRRITABLE BOWEL SYNDROME

IBS is a term which refers to a combination of abdominal and bowel symptoms. It is a “functional” problem with the bowel whereby the bowels look
normal but do not work in a normal way. The cause is not known but it may relate to an imbalance in the transmitters between the nerves in the wall
of the bowel. It is not related to bowel cancer or any other underlying serious bowel problem, although as it is very common it can sometimes appear
with other, unrelated conditions.

What are the symptoms?
Disturbance in the normal bowel pattern is a common complaint. Some people report loose or frequent bowel movements, others report constipation
and there is a third group who flit between the two extremes. Many people are troubled by intermittent abdominal cramps which often come before a
bowel movement and may improve somewhat after going to the toilet. Sufferers also commonly report bloating or excessive wind, and it is not unusual
to pass mucous (slime) with the bowel movements. Bleeding with bowel movements is not a symptom of IBS per se but can occur as a result of a
related problem, such as piles which can be linked to constipation.

What investigations will I need?
The main aim of investigating people with suspected IBS is to rule out other serious conditions of the bowel as there is no test for IBS itself. The
commonest tests used for this are colonoscopy, flexible sigmoidoscopy or virtual colonoscopy, but after I have made a thorough assessment I will
discuss the investigations I think are required and why. Once other bowel conditions have been ruled out, further tests are not usually needed, but in
some cases it is useful to look more closely at the function of the bowel, such as with severe constipation, as this can help with treatment planning.

What treatments are available?
IBS for the vast majority of people involves, at most, only treatment of specific symptoms as required. Some dietary or lifestyle changes can help
but many people find that they are happy to tolerate their symptoms in the knowledge that there is no serious underlying cause. More troublesome
symptoms such as severe diarrhoea or constipation can usually be managed satisfactorily with medications when they arise, as can abdominal cramps.
Rarely, if symptoms continue to cause trouble despite these relatively simple measures, some people may benefit from regular medications to prevent
the symptoms, or even consideration of further tests to look at the bowel function.