As a practicing Consultant Gastroenterologist, by far the commonest condition that I see in my out-patient clinics, is IBS
The patients are usually are at their wit’s end by the time they get to see me, having harassed their GPs into submission to make the ‘second opinion’ referral.
A syndrome is a cluster of medical symptoms and signs that when put together form the diagnosis. With IBS sufferers the main complaints are of bloating (doctor I feel 6 months pregnant!), wind (I can’t go out for a meal because it is too embarrassing for my family!), excess mucus production (I can’t believe I have to still wear pads at my age!) and diarrhoea or constipation or both (doctor I don’t know whether I am coming or going!).
IBS sufferers may also get bad heartburn, back ache, urinary frequency and symptoms in women are often worse during or around menstruation. Symptoms usually start in the late teens or following an episode of gastroenteritis and there is a strong association with stress and anxiety.
Any new symptoms in an older patient however, should be investigated as there are potentially more serious causes.
The bottom line with IBS sufferers however is, ‘THERE IS NOTHING WRONG WITH THE BOWEL!’
Because of the above, IBS can be tricky to treat. How do you ‘treat’ a normal bowel or stress and anxiety…?
Bloating and diarrhoea can be helped by antispasmodics such as mebeverine or mint derivatives such as colpermin. Heartburn can be controlled with anti-acid medication. Constipation can be managed by high fibre (although this may make the bloating worse!).
I tend to immediately refer patients to my very clever dietitian colleagues for dietary exclusion which can be dramatically helpful. I do also occasionally treat with low dose tricyclic antidepressants which can also help with the bloating. Sometimes acupuncture, hypnotherapy and psychotherapy may be needed but sadly there is no panacea.
So IBS is no fun for anybody. Certainly no fun for the patients, their GPs, or for me as a so-called ‘specialist’, as I frequently feel inadequate in being able to help them.
Written by Dr M J Webberley – consultant gastroenterologist
For more information on IBS please click here
Dr Helen Webberley
Dr Helen Webberley is an NHS GP with a practice in South Wales, and an experienced online doctor providing healthcare advice and treatment via the Internet. She is a talkhealth expert in the Online Clinics. If anyone has any queries about their health then feel free to contact her.
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I agree with your observations, Dr. Webberley, thank you for making these views more widely known.
on October 15, 2015 at 9:58 am Bob BrotchieYou allude to psychotherapy and, being a counsellor I am biased!
I have been sharing mindfulness (yes, I know it’s in vogue!) with clients suffering what appears to be IBS (who have seen their own G.P) and I see same or similar benefits that I myself achieved; a reduction or complete dissipation of the symptoms associated with IBS.
I do agree that one-size does not fit all and that a holistic approach is required, especially in regards to diet, as well as stress and anxiety, etc.
I would like to ask if you are aware of any evidence-based research available for perceived or actual benefits for IBS sufferers who have actively engaged with a more mindful approach? Thank you in advance.
Hi. it’s like this. If one runs a four stroke petrol combustion engine with diesel, it will clap out. My focus was the science, medicine. Best wishes.
on October 15, 2015 at 10:53 am stefanieHi, I had chronic constipation growing up. I would sometimes go once every five days.
on October 15, 2015 at 10:30 am stefanieI had a high iron intake, supplemented due to my nose bleeds. Through experimenting with diet I found that prolonged wheat gluten intake will mess up my digestive system giving me fatigue, bloating and IBS. I find that B Vitamin supplements help with metabolism and digestion. Biotin is manufactured by gut bacteria, if I’m correct, though sometimes a little help is needed to get it started if the immune bacteria a lacking. Encouraging the gut flora to flourish helps, it’s a question of balance. I’m not a doctor and appreciate everyone is different, though this I find works for me. The herbal yeast liquid ‘ Bio-Strath’ is a great tonic for guts, it’s tasty too. Good luck!
My real problem was with my hormones, though I am now on the mend
thanks to Dr. Webberley. All the best and again, good luck!