Irritable Bowel Syndrome IBS - What is it and how to manage it

IBS is short for irritable bowel syndrome. It is considered a chronic functional bowel disorder that is characterised by several symptoms that affect the functioning of the small and large intestine such as such as pain, cramping, bloating and gas, constipation or diarrhoea, or both as well as urgency with defecation. Symptoms may come and go over time and new symptoms may emerge – they may be quite mild but also severe. This can make managing IBS really tricky and often quite stressful. 

It’s now believed as many as twenty percent of the Australian population experience IBS symptoms and women are three times more likely to be diagnosed with IBS than men. The symptoms of IBS cross over with other conditions, such as coeliac disease, so it’s important to get a formal diagnosis from your doctor to rule out more serious conditions.  

It’s unknown what causes IBS and there are no formal tests, it is diagnosed based on symptom criteria. The exact cause of IBS is unknown but there are several factors that are thought to contribute, such as a greater gut sensitivity, a change to gut motility or the way food moves through our gut, a leaky or inflamed gut, as well as dysbiosis or an imbalance of bacteria in the gut. IBS can also start after a gut infection like gastroenteritis (gastro). 

What’s often not discussed is the impact IBS can have on people’s lives. Many sufferers report a major impact to their quality of life, often choosing not to go out and socialise, or participate in activities. It can impact work and study because of being in pain or feeling uncomfortable, or a fear of a symptom trigger or flare up of symptoms. 

The research on IBS has come leaps and bounds in recent years and although there is no treatment for IBS, there is now a wide range of highly effective management options for sufferers, they include: 

Dietary 

•  Low FODMAP diet: This diet has been shown to improve the symptoms of three out of four IBS sufferers. It’s a three-phase elimination style diet that removes potential trigger foods, then reintroduces them to identify problem foods and how much can be tolerated. 

• Modifying your diet: fibre, caffeine, fat, alcohol and spicy food  

Mind & lifestyle 

There is a strong link between the gut and the brain known as the gut-brain axis and one can trigger the other, for example stress and anxiety can cause IBS and IBS can cause stress and anxiety.  

• Gut directed hypnotherapy 

• Cognitive behaviour therapy (CBT) 

• Other stress management techniques: such as meditating, reading, gardening and cooking 

• Exercise: movement, stretching, yoga 

Pharmaceutical & supplements 

• Medications: such as antispasmodics, antidepressants and antibiotics can be prescribed that may help to target the main IBS symptom 

• Natural over the counter remedies: such as peppermint oil, probiotics, laxatives and herbal formulas have been shown to be effective in helping to manage some IBS symptoms. 

Many of these management options require the advice and support of a trained health professional so be sure to seek out an accredited practising dietitian, GP or psychologist trained in gut-directed hypnotherapy and CBT. Monash University developed the low FODMAP diet, the FODMAP App and other resources that can be helpful for IBS sufferers to get the most up-to-date information on IBS.