Irritable bowel syndrome (IBS) is a chronic medical condition that I am very familiar with as a GP and below I’m clearing up some of the misconceptions that exist when it comes to this complex diagnosis.
1. It is “real”
I often have patients query whether IBS is a “real” diagnosis. Short answer: yes, IBS is a diagnosis in itself and it can affect a patient’s quality of life considerably. IBS is a complex condition that involves brain and gut interactions, potential food intolerances and hypersensitivity to pain. For some patients stress or anxiety can manifest as gut symptoms. Others may have a hypersensitivity to any pain stimulus which means that any discomfort in the gut is picked up by the brain very strongly – this is what we are referring to when we talk about the brain and gut interaction. The brain and the gut talk to each other and it’s a very important connection.
IBS symptoms can vary from patient to patient. For some bloating and abdominal pain may be a real feature whereas for others constipation may be their predominant complaint.
2. You need to be worked up before we can diagnose you with IBS
IBS is a diagnosis of exclusion and you need to meet specific clinic criteria to be diagnosed with it. We perform a thorough history and examination and usually run some investigations (like stool tests and blood tests to exclude thyroid disease or coeliac disease for instance) to ensure there is no other reason for your bowel symptoms (it’s a diagnosis of exclusion which means we need to exclude other medical causes for your bowel symptoms).
If there are no concerning features and the investigations are normal, then we can consider the diagnosis.
3. There are plenty (and I mean plenty) of ways we can manage IBS symptoms
Lots of patients think they just have to deal with their grumbling abdominal symptoms; the bloating or constipation that is part of their day to day life but, there are loads of interventions for IBS.
Lifestyle management options
Really simple things like being physically active, managing stress well and getting enough sleep can help control IBS symptoms.
Dietary options
For some patients with IBS food intolerances may be a strong feature in which case dietary interventions, with the support of a dietician, can make a big difference to symptoms. If I suspect that sensitivities to certain foods are a factor in a patient’s symptoms, as a GP I will involve a dietician to take a full diet history and implement interventions to ensure that a patient is not cutting out important nutrients from their food without accounting for them elsewhere. Some of you may have heard of the low- FODMAP diet which can help with IBS symptoms; again, this is something that usually requires dietician input to be implemented properly.
Psychological strategies
These shouldn’t be underestimated when it comes to the management of IBS symptoms; psychological strategies like CBT and gut hypnotherapy can help patients immensely! I’ve had many patients benefit from these kinds of interventions and it again highlights how important the brain and gut interaction is when it comes to IBS symptoms. You can treat the brain and it can yield benefit in the gut!
Medications
There are medication options for IBS from natural medications like peppermint oil to prescribed medications like some anti-depressants that may significantly reduce symptoms for some patients.
They key is that there are loads of things we can do to help with IBS from lifestyle factors to psychological strategies to medications if required! IBS is complex but help is available, and you don’t have to “put up” with the symptoms – chat to your GP if you want to know more!