Irritable bowel syndrome (IBS): What are the signs?

Irritable bowel syndrome (IBS) is a common, lifelong gastrointestinal disorder characterised by a group of symptoms that are sometimes linked to stress levels, certain foods, and structural problems in the intestines.

Here, Dr Ahmed Albusoda, highly revered consultant gastroenterologist based in London, provides an expert insight into IBS, including symptoms and treatment.

What are the common symptoms of IBS?

IBS is a disorder characterised by a group of common symptoms which can vary in severity and frequency. These include:

• Bloating: IBS can lead to increased gas production and bloating, causing discomfort and a feeling of fullness.
• Abdominal pain: Often described as cramping or aching in the lower abdomen. This pain may be relieved after having a bowel movement.
• Changes in bowel habits: IBS can lead to alterations in bowel movements, such as diarrhoea, constipation, or a combination of both. These changes may occur over days, weeks, or months. Some patients may also have a strong and sudden urge to have a bowel movement, whereas others may feel like they haven't completely emptied their bowels after a bowel movement.
• Diarrhoea: Some patients may have frequent, loose, or watery stools.
• Constipation: Some patients may have infrequent bowel movements, often with stools that are hard and difficult to pass.

It's important to know that symptoms can vary from patient to patient, and also within the same individual over time. Additionally, not everyone with IBS will experience all of these symptoms.

How is IBS diagnosed, and what tests might be needed to rule out other medical conditions with similar symptoms?

IBS is typically diagnosed based on a combination of clinical criteria and the ruling out of other medical conditions that could be causing or contributing to the symptoms.

The diagnostic process involves the following steps:

1. Medical history: The specialist will take a detailed medical history, asking the patient about their symptoms, the frequency and duration of these symptoms, as well as any factors that seem to trigger or worsen these symptoms.
2. Physical examination: A physical examination will be conducted to assess the patient’s overall health.
3. Laboratory tests: While there is no specific diagnostic test for IBS, the specialist will order blood tests to rule out other conditions with similar symptoms. These may also include tests for inflammation and for coeliac disease.
4. Stool tests: Stool tests will be ordered to check for infections or parasites that could be causing gastrointestinal symptoms.
5. Imaging tests: Imaging tests like abdominal X-rays or abdominal ultrasounds will be performed to rule out structural abnormalities or other medical conditions. Additionally, the specialist may also recommend a colonoscopy or an upper endoscopy to visualise the lining of the gastrointestinal tract. These procedures can help rule out conditions like inflammatory bowel disease or colorectal cancer.
6. Breath tests: In some cases, hydrogen breath tests will be ordered to investigate certain conditions like small intestinal bacterial overgrowth or lactose intolerance, which can produce symptoms that are similar to IBS.
7. Mental health assessment: Stress and other psychological factors can play a role in IBS. The specialist will thus also conduct a mental health assessment as part of the diagnostic process.

What are the potential long-term effects of IBS, and how can treatment help manage these risks?

IBS is a chronic condition, and while it doesn't cause severe organ damage or life-threatening complications, it can significantly impact a patient's quality of life in many different ways. This includes:

• Ongoing symptoms: The chronic nature of IBS can lead to ongoing symptoms, including abdominal pain, changes in bowel habits and discomfort, which can greatly affect quality of life.
• Impact on mental health: IBS is often associated with psychological factors, such as stress, anxiety and depression. These conditions can be exacerbated by IBS symptoms and can, in turn, worsen IBS symptoms in a vicious cycle.
• Social impact: IBS can lead to lifestyle limitations, including the avoidance of certain foods, certain activities or certain social events due to the fear of symptom flare-ups.
• Absence from work or school: Severe IBS symptoms can lead to missed days at work or school, affecting performance and career.
• Changes in nutrition: Some patients with IBS make significant dietary changes or restrict their diets to manage their symptoms, which can impact nutritional intake and overall health.

IBS treatments are aimed at improving quality of life through symptom-control, with the goal of reducing the frequency and the severity of symptoms.

Treatment options for IBS may include:

• Dietary changes: Some patients with IBS benefit from dietary modifications under the guidance of a dietitian if specific foods are triggering their symptoms. Adjusting fibre intake may also be helpful.
• Probiotics: Some patients find relief from IBS symptoms by taking certain probiotic supplements.
• Psychological therapies: Stress and anxiety can exacerbate IBS symptoms. Cognitive-behavioural therapy (CBT), gut-directed hypnotherapy, and other psychological therapies can help patients with IBS to manage stress and anxiety, and to cope with other symptoms of IBS.
• Medications: Depending on a patient’s subtype of IBS, medications may be prescribed to address specific symptoms such as abdominal pain, diarrhoea, or constipation. These medications can provide relief, but they may not offer a permanent solution.

It's important to develop a personalised treatment plan for IBS that is tailored to each patient’s specific symptoms and needs. Treatment may involve a combination of approaches.

Can IBS be eventually cured?

IBS is generally considered a chronic condition - this means that it doesn’t have a known cure as of yet. Despite this, IBS is also a highly individualised and variable condition. While there may not be a cure, many patients with IBS are able to achieve significant symptom relief and maintain a good quality of life with the right combination of treatments and lifestyle modifications.

Dr Ahmed Albusoda is a renowned consultant gastroenterologist with over 10 years’ experience.

If you require expert diagnosis and treatment for IBS, don’t hesitate to book an appointment with Dr Albusoda via his Top Doctors profile today.