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Health Q&A with Dr Rist: how do I keep IBS at bay?Created by Charlotte in Being You, Health and fitness, Q&A's
Q: I’d like some info on IBS – any help with diets and how to help keep it at bay? Are there different stages of IBS and does it get worse?
A: Irritable bowel syndrome is a really common problem affecting 10-15% of the population at some point and it is more common in women than men. If you are an IBS sufferer, and it can vary in severity over your lifetime, but it does not naturally progress or get worse over time.
IBS causes abdominal pain and can often cause a change in your bowel habit. The pain is often relieved by opening your bowels or passage of wind. Sufferers usually have erratic bowel movements, often complaining of periods of constipation alternating with episodes of loose stools. They often suffer with bloating too. These symptoms usually continue for long periods of time and we usually diagnose IBS only once someone has had symptoms for at least 6 months.
However, other potentially more serious conditions, can also present with these symptoms so if you have abdominal pain or a change in your bowel habit then it is important to see your doctor. This is particularly important if you also have unintentional weight loss, bleeding from the back passage, loose stools for longer than 6 weeks or have a family history of colon cancer or ovarian cancer.
We don’t really know why people develop IBS but it appears that genetics play a part. Stress often contributes to the symptoms too. There is also some evidence that it can develop after a bacterial tummy bug and there is research going into the use of probiotics to improve symptoms.
We usually do some tests to check that there aren’t any other conditions causing the IBS type symptoms. Your doctor will decide which investigations are most important for you.
We now think IBS sufferers fall into two groups- those who tend towards constipation, and those who tend towards diarrhoea. The medications we use are different for each of these groups- using laxatives more for those with more constipation and drugs to slow the stools down in those with diarrhoea.
We also use peppermint oil capsules, and other drugs which help with the spasm of the bowel in IBS. We sometimes use some anti-depressants and psychology techniques such as CBT (cognitive Behavioural Therapy) if stress appears to be a factor.
Diet is really important. It is sometimes helpful to have a consultation with a dietician. It can be helpful to keep a food diary, and record when your symptoms are worse to see how you react to different foods.
It is important to eat regularly and drink plenty of fluids, but avoid too much alcohol and fizzy drinks. Try not to have too much tea and coffee.
Sorting out your fibre intake can make a big difference. There are 2 types of fibre- those which can easily be digested (oats, barley, rye, fruit, root vegetables) and those which cannot be easily digested (bran, nuts and seeds except linseeds, wholegrain bread.)
If you have diarrhoea-prone IBS – cut down on fibre that is hard to digest. If you have constipation – prone IBS, increase the amount of easily digested fibre you have and also increase your fluid intake.
There is no evidence yet that probiotics that you can buy from the supermarket help but some people find they make a difference.
There is a new diet called the “low FODMAPs diet” which is now being suggested by some gastroenterologists. There is some information about this on the internet but if you would like to follow this diet, then I would suggest speaking to your own doctor or a dietician about it before starting as it requires quite a lot of exclusions form the diet.
by Dr Susannah Rist
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