Living well with IBS
This common condition has had a bad reputation with lots of misconceptions. Get the lowdown and learn how to manage it.
BY: Eleanor Yap
It affects approximately one in 10 Singaporeans – both genders and across the age spectrum. Though there is no data of whether the condition is more prevalent now but according to Dr Vikneswaran Namasivayam, consultant, Department of Gastroenterology & Hepatology, at Singapore General Hospital (SGH), there “appears to be greater awareness that may have led to increased diagnosis and patients seeking medical attention”.
Ageless Online finds out more from Dr Namasivayam about the condition and some ways to prevent or reduce the incidences:
Can you explain what IBS is?
IBS is characterised by abdominal discomfort that is typically relieved with passing motion and altered bowel habits, either diarrhoea or constipation.
It appears that patients with IBS have an increased sensitivity of the intestines to normal amounts of gas, which they perceive as being excessive and painful. Some IBS patients may have intestines that move either slower or faster than normal people. IBS patients may also have a different composition of bacteria in their gut compared to healthy people. Some patients develop IBS after a severe gut infection but most patients with gut infection do not go on to develop IBS.
IBS is a chronic condition but the vast majority of patients improve once they learn to cope with their symptoms. It can significantly impair one’s quality of life. Research has shown that IBS patients are more likely to undergo more medical tests, take more medications, have more frequent hospitalisations and miss more workdays.
What are some misconceptions about IBS?
Correcting the misconceptions:
- IBS is not the diagnosis given to you when your doctor does not know what’s wrong with you.
- IBS, like many other conditions in medicine, is diagnosed based on the pattern of symptoms that you have after your doctor has done a thorough job of asking you the right questions and completing a physical examination. Routine testing with scans and scopes is not generally required to make a diagnosis of IBS. However in older individuals (especially above 50 years) who present with alteration in bowel patterns, the gastroenterologist may consider performing a colonoscopy and other tests in the appropriate setting to make sure that the symptoms are not due to colorectal cancer.
- IBS does not lead to colon cancer.
- Although the symptoms may be severe at times, IBS is not life-threatening and does not lead to serious conditions such as colorectal cancer or inflammatory bowel disease.
- IBS does not cause blood in the stools.
- IBS does not cause the colon to bleed. Hence, any blood seen in the stool or on toilet paper should be promptly evaluated by a doctor. Often, this would require a colonoscopy.
- IBS does not only affect young women.
- IBS affects both genders and people of all ages.
- There are good treatment options for IBS.
- IBS patients with infrequent mild symptoms may be treated with over-the-counter medication and lifestyle changes. Patients with more persistent treatment have a variety of medications available, which they can discuss with their gastroenterologist.
Is it hard to diagnose IBS?
It is not difficult to diagnose IBS in the majority of patients. The diagnosis of IBS is made when the description of the patient’s symptoms fits a defined set of internationally-accepted criteria for diagnosing IBS. There is no single test that needs to be done to diagnose IBS. In selected instances however, tests may be ordered to rule out other medical conditions with similar symptoms.
Any other ways to prevent or reduce the incidences of IBS? Include more fibre? Take certain over-the-counter or prescription drugs?
There is no cure for IBS but there are many treatment options available to alleviate symptoms. Many patients cope by avoiding foods that trigger their symptoms such as beans and broccoli. It may help to keep a food diary to figure out which foods may be causing symptoms. Regular exercise may also help in improving symptoms.
Medications to relieve symptoms are chosen partly based on whether the patient suffers from diarrhoea or constipation. Antidepressant medications are used for relieving pain but at lower doses than used for treating depression. Counselling may also help as stress can worsen symptoms.
Let’s talk about probiotics. What are your opinion on this and its usefulness in dealing with IBS?
Probiotics are “good bacteria” that live in the gut. Research on the effectiveness of probiotics in treating IBS shows promise but more studies are needed to be sure if they work and, more importantly, which preparations are effective. There are many different probiotic preparations available which differ in their contents and hence effectiveness. Some of the bacteria present in probiotics have been shown to work in some studies but this does not apply to all probiotics that are available. In practice, some patients do benefit but a physician should prescribe it.
What about a low FODMAP diet?
FODMAP stands for Fermentable Oligosaccharides (fructans and galactans), Disaccharides (lactose), Monosaccharides (fructose) and Polyols (mannitol, sorbitol, etc). These are a group of short-chain carbohydrates (sugars) found in many foods. When taken in large amounts, foods high in FODMAPs may cause an increased volume of liquid and gas in the intestines that may trigger symptoms, such as abdominal bloating, pain, distension, in those with IBS.
A low FODMAP diet is a dietary intervention now used as treatment for IBS that shows promise.