Irritable bowel syndrome (IBS)

Irritable Bowel Syndrome (腸易激綜合症), commonly known as "IBS", is a digestive system disease caused by intestinal dysfunction and is considered to be a disorder of gut-brain interaction. Approximately 11% of the world's population, or approximately 1 in 10 people, suffers from irritable bowel syndrome. The main symptoms of irritable bowel syndrome include abdominal pain, bloating, abdominal discomfort and changes in bowel habits. Symptoms usually appear irregularly, which greatly impacts a patient’s quality of life, disrupting social plans and work responsibilitiesAccording to statistics from the American College of Gastroenterology, most IBS patients are willing to trade 10 to 15 years of life for immediate cure of IBS, which shows that the disease seriously affects patients' daily lives.

Causes of Irritable Bowel Syndrome (IBS)

Intestinal function 

• Intestinal peristalsis is too fast or too slow, affecting digestion 
• Intestinal nerves are overly sensitive 
• The gut sends mixed messages to the brain 

External influence 

• Food that irritates the intestines, such as alcohol, caffeine, spicy or fatty foods 
• Psychological stress, such as tension and anxiety 
• Family history/genetic factors 
• Environmental factors such as work and relationships 

IBS Symptoms

Dr. John Wong from Gastroenterology and Hepatology pointed out that irritable bowel syndrome usually attacks irregularly, with symptoms appearing and disappearing sporadically, and can last for days or even months. Watch the video on YouTube to understand more about IBS. Here are some common symptoms of IBS:

• Abdominal pain/stomach cramps: Often severe after eating, but usually relieved by bowel movements 
• Bloating: Abdominal discomfort such as fullness or distension 
• Diarrhea: Passage of loose, watery stools, or frequent defecation of such
• Constipation: Difficult passage of lumpy or hard stools, often with straining

These symptoms are not specific for IBS. Other gastrointestinal conditions such as food intolerances, infections, inflammation related bowel diseases such as Crohn’s disease and ulcerative colitis, and even cancers can have overlapping symptoms.

Diagnosis of Irritable Bowel Syndrome

Everyone experiences symptoms like diarrhea or constipation occasionally, but if the problem persists, you need to see a doctor to diagnose whether it is caused by irritable bowel syndrome.
When seeking a consultation, the doctor will ask you in detail about your symptoms, occurrences (such as being often triggered by a certain food) and frequency, etc. Therefore, you can record it in advance so that the doctor can understand your condition more accurately.

When seeking a consultation, the doctor will ask detailed questions about your symptoms, occurrences (such as being often triggered by a certain food) and frequency, etc. Therefore, it's helpful to record this information in  advance so that the doctor can understand your condition more accurately.

The symptoms of IBS may be similar to other gastrointestinal diseases, doctors may suggest blood tests, stool tests, or endoscopic examinations to rule out other diseases.

Irritable Bowel Syndrome Treatments

Medications for IBS

In Hong Kong, there is currently no cure for irritable bowel syndrome, but medications prescribed by doctors can effectively relieve the symptoms and minimise their impact on patients' lives. For the common IBS symptoms mentioned above, medicines prescribed by your doctor may include: 

The type and strength of medications doctors use will vary depending on individual patients' conditions. Sometimes it may take several weeks for medication to take effect.

Psychological counselling   

The condition of irritable bowel syndrome may be affected by factors such as gut-brain interaction disorders, life stress and anxiety. Therefore, IBS treatment may include psychological counselling, or the use of medications to manage anxiety and mood disorders , alleviating psychological factors contributing to IBS.

Doctor Sharing

Daily care for IBS

• Develop healthy eating habits, including cooking your meals 
• Keep a food diary to track food that triggers IBS
• Release stress and emotions at the right time 
• Do exercise regularly 
• You can try taking probiotics for 2 month to evaluate their effectiveness 

Avoid

• Eating at irregular times or skipping meals 
• Eating too fast and not chewing 
• Eating foods that irritate your intestines (such as spicy, fatty and processed foods) 
• Overeating hard-to-digest food (such as sticky rice) 
• Drinking caffeine or carbonated drinks (such as coffee and soda) 
• Addicted to smoking and drinking

OT&P Medical Advice 

Regardless of whether you have IBS or not, everyone should develop a gut-friendly balanced diet and establish good bowel habits. If you experience persistent gastrointestinal sensitivity, intestinal cramps, or other issues that affect your daily life, sleep, or social interactions, and particularly if you notice blood in your stool or unusual weight changes, it is advisable to seek medical attention promptly to diagnose the cause and find the appropriate treatment.

References 

1. NHS. What is IBS? 19 Dec 2023 Retrieved from https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/  
2. Mayo Clinic. Irritable bowel syndrome. 19 Dec 2023 Retrieved from https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016  
3. Cleveland Clinic. Irritable Bowel Syndrome (IBS). 19 Dec 2023 Retrieved from https://my.clevelandclinic.org/health/diseases/4342-irritable-bowel-syndrome-ibs  
4. Johns Hopkins Medicine. Irritable Bowel Syndrome (IBS). 19 Dec 2023 Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/irritable-bowel-syndrome-ibs  
5. The Rome Foundation, Rome IV Criteria. 2016. Retrieved on 20 February 2024, from https://theromefoundation.org/rome-iv/rome-iv-criteria/