Irritable Bowel Syndrome (IBS)

In most cases, IBS is manageable with medication and lifestyle changes, but it can be challenging to deal with. At Pharmacy Online, we have a range of effective treatments that help you combat IBS symptoms and combat flare-ups.

With a dedicated team of registered pharmacists, we can help you choose the right medicines for your needs and look forward to a convenient online service.

What is Irritable Bowel Syndrome?

IBS is an umbrella term for a range of symptoms that affect the digestive system. People often experience it throughout their lives, but the condition can go into remission and reappear later.

It impacts everyone differently, with some people avoiding certain foods while others notice their symptoms flare up in times of stress. According to Guts.UK, IBS affects 3.2 million people in the UK (or one in 20), making it one of the more common conditions.

What's the difference between IBS and IBD?

IBS and IBD are different conditions each with unique symptoms:

• Inflammatory Bowel Disease: IBD is a disease that causes damage to the intestines, with Crohn's Disease and Colitis being common forms of IBD. The condition can also increase the risk of developing colon cancer.
• Inflammatory Bowel Syndrome: IBS is a syndrome which causes symptoms but isn't as bad as IBD. IBS doesn't have an increased risk of colon cancer.

Studies show that people with IBS are more likely to develop Crohn's or Colitis, but managing the symptoms and treating the condition can prevent it from turning into a chronic disease (NCBI).

The causes of Irritable Bowel Syndrome

There are no known causes of IBS, but various factors contribute to a person experiencing symptoms. Your lifestyle, stress levels and previous infections could all play a role in developing an irritable bowel, but understanding the contributing factors can help you reduce the condition's impact.

Age and gender

According to JNM, women experience IBS more than men, which is partly due to changing oestrogen and progesterone levels. Also, the condition is more common in people under 50, although there's no known reason for this.

Nervous system complications

Your digestive system has nerves that can sometimes overreact when your stomach naturally stretches from stool or gas. When this happens, they send signals to your brain, which might cause an overreaction from the body, resulting in severe pain, gas constipation or diarrhoea.

Intestine contractions

The muscles in your intestine walls are central in helping food move through them successfully as they contract to push food through your digestive tract. However, these contractions can go into overdrive sometimes, which results in a stronger reaction from your body.

Gut microbes

Your gut microbiome is central to overall health, and achieving the right balance of bacteria can protect your body. However, people with IBS often have a different microbiome than people without it, which can result in intestinal problems and a range of symptoms.

Stress

Research shows that stress is a significant contributor to IBS, and early childhood anxiety can increase your chances of dealing with the condition later in life (NIH). Many people find their condition reappears when they're under a lot of stress, but minimising your anxiety can reduce the symptoms.

Infections

If you've experienced severe gastroenteritis or any other form of infection, your chances for IBS are higher. Some people still have bacteria in their gut, which causes issues and can impact how your intestines work.

IBS symptoms

IBS can cause a range of symptoms, but the most common include:

• Mucus in stool
• Diarrhoea
• Gas
• Abdominal pain
• Constipation
• Feeling like you haven't fully emptied your bowels
• Painful bowel movements

Some people might experience symptoms worse than others, and it also depends on the type of IBS you have. Most people have mixed IBS, which causes alternating constipation and diarrhoea, while some mostly experience constipation.

The triggers of IBS

With the symptoms of bowel-related conditions varying, it's essential to understand your triggers. Everyone is different, and knowing the factors contributing to your symptoms can help you eradicate them and avoid frequent flare-ups.

Stress and anxiety

When you're anxious or stressed, your body will trigger an immediate reaction, which can trigger symptoms associated with IBS. However, stress doesn't directly cause the condition, but it does make IBS worse, and you might notice a range of symptoms when you're worrying about something.

Dietary factors

Certain foods can aggravate IBS, including soda, citrus fruits, cabbage, beans and fried foods. Many people find their symptoms improve after cutting out these foods or consuming them less frequently. You know your body; keeping a diary can help you identify harmful foods.

Complications associated with IBS

Irritable Bowel Syndrome isn't usually dangerous, but it can result in a range of complications that make it challenging to enjoy a happy and healthy lifestyle. Let's take a look at them so we can see why receiving a diagnosis is so important.

Increased risk of Irritable Bowel Disease

IBD can cause long-term complications, and you might require surgery in severe cases. Many people successfully manage Crohn's and Colitis, but it can mean significant dietary changes and long-term symptoms.

Reduced quality of life

The symptoms of IBS vary between people, but some experience severe pain and prolonged gas. You might constantly feel the increased need for a bowel movement, making it hard to go out and enjoy yourself.

Sleep disruptions

The cramps associated with IBS can make it challenging to get enough sleep—especially if you're constantly getting up to use the bathroom. A lack of sleep also contributes to a less effective immune system and more anxiety.

Your doctor might prescribe sleeping tablets or medicines for anxiety to relieve stress and allow your body to refresh.

Painful menstrual cycle

IBS can also impact your menstrual cycle, as the pain from a bowel movement can also impact your period. Many women find their pain becomes worse, and they might need to take time off work or use medications to relieve the symptoms.

Physical problems

Constipation can also cause swelling, which impacts the bladder. People with IBS might find they need to urinate frequently, which can disrupt their work and social lives. Heartburn and indigestion are common symptoms; some people might avoid food, which inevitably causes weight loss.

Diagnosing Irritable Bowel Syndrome

Doctors don't have specific tests to diagnose IBS, but your GP will look at your symptoms and use other tests to rule out conditions such as Coeliac Disease, Crohn's and Colitis. Depending on your age and symptoms, there are numerous approaches for diagnosing IBS.

General examinations

Your GP will ask questions about your symptoms, including their frequent triggers. Also known as the Rome criteria, your diagnosis is based on the frequency and consistency of your stools and whether you have pain at least once a week for three months.

Stool tests

Examining your stool can help doctors assess whether parasites, bile acid or bacteria are present, which can help them determine whether you have an infection or another condition that could be causing the symptoms.

Assessing for other conditions

Some symptoms might point to other conditions, and your GP will refer you for tests to eliminate them. The symptoms that could point to another condition include:

• Frequent nausea and vomiting.
• Abdominal pain that occurs at random times - especially at night.
• First experiencing symptoms after turning 50.
• Blood in the stool or from the rectum.
• Symptoms of iron deficiency.

The following tests can rule out more serious conditions such as bowel cancer and help your GP determine whether you need more effective treatment for an irritable bowel.

Colonoscopy

Colonoscopies examine the colon by inserting a long tube into it. Using a small camera, they can read your colon for polyps or tumours, facilitating the diagnosis of colon cancer. These tests can also help health professionals eliminate Crohn's.

Endoscopy

If your specialist wants to examine your stomach and upper digestive tract, they'll perform an endoscopy, which involves inserting the tube into your throat. These tests enable specialists to look for ulcerative colitis, Coeliac disease and other gastrointestinal disorders.

CT Scan

A CT scan is beneficial for examining your pelvis and abdomen to look for potential causes of frequent abdominal pain. Specialists use these scans to evaluate whether you might have a tumour, which is a sign of cancer.

Allergy tests

People with lactose intolerance can present the same symptoms as IBS, but a simple test can look for allergies. If your test returns positive, you'll have to cut out all lactose products, and the symptoms should go away.

Irritable Bowel Syndrome treatment options

Treating IBS often requires diet and lifestyle changes, as well as medications to combat the symptoms. As the condition impacts everyone differently, it's important to remember that there's no fix-all solution, and navigating IBS often requires various approaches to see which suits your needs most.

Dietary changes

If you notice a distinct link between certain foods and your symptoms, removing them from your diet could reduce pain. Certain foods can aggravate IBS, including:

• Carbonated Drinks: Soft drinks and alcoholic beverages can also increase your symptoms, but switching to non-carbonated options can make a big difference.
• FODMAP: Foods high in FODMAPs include grains, dairy products, vegetables and fruit. Following a low-FODMAP diet can help you reduce your symptoms.
• Gluten: If you suffer from diarrhoea, eliminating gluten can reduce the frequency.

Supplements and over-the-counter medications

People with IBS should always be careful regarding supplements, as they can result in more symptoms. However, fibre supplements are beneficial as they can reduce constipation and help your body expel waste more efficiently.

Over-the-counter medications that can potentially control symptoms include:

Anticholinergic medication: Suitable for relieving pain and discomfort from bowel spasms. However, taking too much of these medicines can cause constipation.

Laxatives Can help with constipation, but some people with IBS might find it causes other symptoms, including cramps and loose bowel movements.

• Tricyclic antidepressants: Effective for treating depression, tricyclics are also beneficial for calming the neurons, which can ease symptoms.
• Diarrhoea tablets: Anti-diarrhoea medication can prevent severe episodes and harden bowel movements.
• SSRIs: Also known as Selective Serotonin Reuptake Inhibitors, these antidepressants can treat the low moods associated with IBS.
• Painkillers: Some medicines are designed to reduce bloating and abdominal pain, which allows you to handle bouts of IBS easier.

IBS medications

If your symptoms are causing severe problems, you can also access medications that specifically treat IBS. However, these medications require an IBS diagnosis and your doctor's approval or a registered online pharmacy.

Popular IBS treatment options include:

• Lubiprostone: Ideal for women with bowel disorders that cause constipation, lubiprostone is often used as a last resort when other medications don't work.
• Mebeverine: An antispasmodic medication slows down the movement of muscles in the uterus and bowel, preventing severe cramps. Taking mebeverine tablets can also reduce trapped wind and bloating.
• Eluxadoline: Eluxadoline is renowned for enhancing rectal muscle tone and easing diarrhoea.
• Alverine Citrate: Another popular antispasmodic medicine, alverine citrate is only available with a prescription and can eliminate pain from severe abdominal cramps.

Alternative therapies

As IBS can cause a lot of emotional stress and cause you to skip meals due to anxiety, it's always worthwhile exploring other treatments that can help you manage the symptoms effectively. Alternative therapies can help you practise relaxation techniques and navigate the condition effectively.

Mental health therapies

Many people feel ashamed when dealing with mental health problems, but speaking to a counsellor can help you learn valuable coping techniques for dealing with anxiety and depression. IBS patients might benefit from boosting their mental health and feel more confident about living with an irritable colon.

Acupuncture

Acupuncture is a time-tested technique that stimulates various signals in your body. Researchers performed a series of studies on holistic practice and concluded that regular sessions can ease symptoms of IBS.

Essential oils

Peppermint oil can reduce symptoms of IBS - especially when compared with oregano. You can use oils by rubbing them into your skin or using a diffuser.

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