Irritable bowel syndrome

 

Article written by Dr Ruth Dyson

Definition

Irritable bowel syndrome is a chronic condition of the gut that results in a variety of symptoms including episodes of abdominal pain, cramps, bloating and altered bowel habit (constipation, diarrhoea or a combination of the two). 

Prevalence

Because the definition of IBS varies it is difficult to say how common it is but a recent study (1)found that it affects about 1 in 10 people worldwide and in the UK the prevalence is reported as 10-20% by NICE (2)(National Institue for Health and Care Excellence)

Cause

It is conventionally referred to as a "functional" condition which means there is no single, specific, disease process responsible but rather it is an imbalance of the function of the gut. Having said this there are a number of factors which contribute to the development of IBS type symptoms and with more specific testing we are finding that there may in fact be a cause identified in many previously "ideopathic" cases.

There is a very strong link between the brain and the gut (known as the "Brain-Gut Axis") so stress is often a contributary factor. Many people find that their symptoms may be worsened by certain foods and there is a degree of food intolerance present. Another distinct cause can be an imbalance of the gut bacteria, termed "dysbiosis", or an overgrowth of bacteria in the small bowel, termed "SIBO". Detailed analysis can also show that there is a degree of inflammation within the bowel and/or a breakdown of the usual barrier function of the gut, termed "leaky gut".

Symptoms and Signs

The symptoms of IBS include abdominal pain (which is often cramping in nature and may be releived by passing stools), bloating, diarrhoea, constipation, passing excesive wind, nausea, dyspepsia, urinary symptoms, tiredness and "brain fog". Symptoms such as rectal bleeding, a persistent change to loose stools in those over the age of 50 years or unexpected weight loss may be a sign of a more serious underlying condition and should be promptly assessed.

Investigations

If you have symptoms of IBS it is important to see your GP who may arrange some tests (including blood +/- stool tests) however NHS testing is quite limited. If there are any concerns about a more significant underlying condition then endoscopy (camera) tests may be arranged. If conventional tests have not identified a cause for the IBS type symptoms then it may be helful to have further testing with a more comprehensive stool analysis or other tests as recommended by your health practitioner.

How is IBS managed?

Managment of IBS is aimed at reducing symptoms and improving quality of life. It may involve medications prescribed by your doctor (e.g. antispasmodics, laxatives or tricyclic antidepressants e.g. amitriptyline). You may be advised to cut out certain foods which exacerbate your symptoms or to avoid high FODMAP foods for a time. If there is an imbalance of gut bacteria then dietary approaches along with herbal treatments and probiotics can help to restore the balance.

What complementary therepies shall I try?

  • Hypnotherapy There is good evidence to support the use of Hypnotherapy in the management of IBS and it is recommended by NICE (2)and the NHS(3)It is especially useful where there is an element of stress contributing to, or resulting from symptoms. Dr Ruth Dyson has a particular interest in IBS.
  • Nutritional assessment and advice via our Nutritional Therapist, Ruth Taylor (which may include functional testing of the gut) can also be very helpful.
  • Integrated medicine. As IBS is a complicated condition you may benefit from the holistic assessment and management offered by one of our Integrated Medicine Doctors.
  • Acupuncture. The insertion of fine metal needles into the acupuncture points stimulates sensory nerves under the skin and in the muscles of the body. This in turn regulates body functions to restore health. 
  • Homeopathyis a natural system of medicines based on the belief that the body can cure itself. Accurately selected remedies from plants and minerals are given to stimulate the healing process.
  • Reiki and reflexology. These therapies aim to stimulate and restore the natural balance of the body and place it in a position to restore or boost it’s own natural healing system.

What practitioners can I see about this condition?

Follow up

After you initial consultation, we recommend that you have regular check-ups to monitor your symptoms and response to interventions. The practitioner will advise on appropriate follow up arrangements for your individual situation.   

Multidisciplinary approach

At The Natural Practice we are able to work collaboratively between our practitioners and will always ensure you have the most approriate advice and management. Depending on your needs, your care may be shared with other practitioners at the natural practice or elsewhere. Whenever you permit us, we will write to your GP to ensure they are aware of our recommendations and follow up arrangements.

Further information:

References

  1. The epidemiology of irritable bowel syndrome; Clin Epidemiol. 2014; 6: 71–80. Published online 2014 Feb 4.
  2. Irritable bowel syndrome in adults: diagnosis and management Clinical guideline [CG61] Published date: February 2008 Last updated: April 2017
  3. Efficacy of individual and group hypnotherapy in irritable bowel syndrome (IMAGINE): a multicentre randomised controlled trial; Carla Flik et al; The Lancet Gastroenterology and Hepatology; Vol 4 (1) Nov 2018.  

 

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