Microsoft word - ibs_info.doc

How do functional bowel disorders differ
from other bowel diseases?
PATIENT GUIDE TO
With functional bowel disorders the bowels look normal - it's the way they work which is disordered. THE IRRITABLE BOWEL
With other bowel diseases there is usually SYNDROME
something abnormal to see - an ulcer, for example. These are termed 'organic bowel disorders'. Does 'functional' mean it's all in the
What is the irritable bowel syndrome?
No, but many bowel symptoms are made worse by stress - this is true of both functional and organic Irritable Bowel Syndrome (IBS) is the term use to bowel disorders. Some people only get symptoms describe a collection of bowel symptoms which are when they are under stress. On the other hand, believed to be due to disordered activity of the others are psychologically well adjusted and have bowel muscle. It is what is known as a functional no stress in their lives but can be plagued by What is a functional bowel disorder?
Is it the same as 'colitis'?
The bowel is like a muscular tube which propels Although once called mucus or membranous food from mouth to anus allowing nutrients to be colitis, this disorder is quite different from ulcerative digested and absorbed on the way. The colon or colitis. In the irritable bowel syndrome, muscle large bowel is largely responsible for the absorption spasm seems to be the main problem, while in of fluid from the faeces, and for storing them ready ulcerative colitis there is inflammation of the large for evacuation. IBS is mostly a problem with the How common is it and who is affected?
IBS is extremely common in developed countries but may be less common in other countries, such as Africa and Asia. Probably one third of the people in Britain have occasional symptoms and 1 in 10 have symptoms bad enough to require medical attention. It commonly starts between 15 and 40 years of age and is more common in women. However, it may affect any age. 7. What are the main symptoms?
These may vary from patient to patient, but all will have at least some of the following: Abdominal pain. Most often it is colicky (gripey) in nature. It may be felt anywhere in the abdomen, but often low down on the left. The pain is often relieved by passing flatus (wind from the back passage) or by bowel A functional bowel disorder occurs if this normal function of the gut is not working correctly. For Irregular bowels varying between diarrhoea, example, if the muscle propels bowel contents too fast the patient gets diarrhoea, if it works too slowly constipation. Many patients find their pain is constipation occurs. If the muscle goes into spasm it can cause pain rather like muscular leg cramps. Small, hard, pelletty stools which may be covered in mucus. It is also quite common What other symptoms may occur?
Some patients get spasm in particular areas. The Urgency - a need to rush to open the bowels. splenic flexure syndrome (pain in the upper left This can lead to incontinence if a toilet is not abdomen) and 'proctalgia fugax' (a spasm in the lower bowel which causes a brief sharp pain in the Are any investigations necessary?
Investigations are usually arranged to exclude other bowel disorders that produce the same A brief, sharp spasm of pain felt low down symptoms as the irritable bowel syndrome. In many young patients, the doctor may diagnose and treat the disorder without investigation. In older Nausea, especially in the morning, belching, patients, the doctor may do investigations to exclude other possible bowel disorders. Some doctors may only investigate those who do not Are other organs affected?
respond to a trial of treatment. If some of the symptoms are not typical, such as weight loss or Some patients with IBS may also have an irritable blood in the motions, investigations are necessary. bladder causing frequency of passing urine, others may have indigestion and some women may find What investigations are helpful?
The main aim of tests is to exclude other bowel What is the cause of this disorder?
IBS is an exaggerated response by the bowels to situations of tension associated with normal daily living, leading to abnormal contractions or particularly likely to occur in an individual who eats an irregular diet, or one which is deficient in dietary fibre (roughage). The breakfast meal is particularly important in this respect: an input of roughage first thing in the morning before the stresses and tensions of daily living start seems to 'kick start' normal in IBS although spasm is sometimes seen. What treatment is available?
IBS sometimes follows an attack of viral or bacterial gastroenteritis/diarrhoea, particularly in a Although the irritable bowel syndrome may produce susceptible individual whose diet lacks dietary troublesome symptoms, it does not lead to serious There is no evidence that IBS is a bowel
i) an explanation of the disorder and how inflammation (like ulcerative colitis or Crohn's symptoms are produced helps to relieve anxiety disease), hereditary (although other members of and allow the patient to cope with infrequent the family may also suffer from it), or a food allergy episodes of symptoms, and reassurance that more (although some patients find they are intolerant of ii) increasing the fibre content of the diet How do symptoms develop?
particularly at breakfast time, encouraging the intake of foods such as high fibre breakfast cereals In general, muscle changes cause many of the (e.g. Weetabix, Shredded Wheat etc.), whole wheat bread, fruit, vegetable and berries, instead of refined foods such as white bread and desserts - see section 16 for a dietician's advice. Sometimes it may be necessary or convenient to take fibre supplements in addition, although raw bran generally tends to make diarrhoea and Eat plenty of fruit, 2 or 3 pieces daily at
wind/bloating worse. In this situation it is usually least, preferably without peeling them first (except better to take such medications as Fybogel or citrus fruits!). Dried fruit can be used to sweeten cereal or puddings in place of sugar and is useful Severe spasm or colic pains may respond to an antispasmodic although in general, drug treatment contraction, so reducing fat intake may help to alleviate some of the colicky pains of IBS. A lower Diarrhoea may sometimes need treatment with fat diet is also likely to benefit general health. drugs such as Loperamide (Imodium) especially at Avoid fried foods: grill, bake, boil, steam or Can IBS be cured?
Having made the necessary adjustments to diet with vegetables and pulses. Chicken and fish can and lifestyle, there is a good chance that the symptoms will gradually subside and become bearable over the course of several weeks or months. The IBS may well recur from time to time, skimmed or skimmed milk, low fat yoghurts and particularly at times of stress or following a bout of diarrhoea, for instance due to food poisoning. Beware of "hidden" fats in cakes, pastries, Dietician's advice
Look out for other lower fat products: low fat bowel function and can ease both constipation and spreads, crisps, sausages, etc. to replace the diarrhoea. It is found in many different foods, mainly cereal products, vegetables and fruit. Increase the amount gradually and always take plenty of fluids throughout the day to achieve the consumption of tea and coffee as caffeine can Use wholemeal bread in preference to
Food Intolerances Some people find that certain white or brown bread. There are many different foods are associated with the symptoms of IBS. If you suspect this, record which foods are concerned and discuss them with your doctor before Choose cereals high in soluble fibre, e.g. eliminating them from your diet. Any food Weetabix, Shredded Wheat, Porridge Oats.
intolerance should be investigated properly with These are higher than Cornflakes and Crisped medical and dietetic care to avoid unnecessary restrictions and a diet that may be deficient. Wholemeal flour can replace white flour in cooking. Try half of each to begin with. There are many choices of high fibre biscuits now. Digestives, Oat Biscuits, Ryvita, Bran biscuits and whole-wheat crackers are better choices than arrowroot biscuits, shortcake and custard creams. Replace white pasta and rice with wholemeal Use "pulse" vegetables: lentils and beans in soups, casseroles and on toast. These can replace some of the meat, fish, cheese and eggs in your diet, as they are also rich in protein. All vegetables contain fibre so try to include
at least 2 servings each meal. Always eat the skins where appropriate, e.g. jacket potatoes.

Source: http://finchpj.co.uk/IBS_Info.pdf