The Secrets of your Irritable Bowel Syndrome (IBS)
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1 The Secrets of your Irritable Bowel Syndrome (IBS) Dr Simon Greenfield Consultant Gastroenterologist Spire Harpenden Hospital Pinehill Hospital, Hitchin QE2 Hospital, Welwyn Garden Lister Hospital, Stevenage
2 What does irritable bowel syndrome (IBS) mean? A functional condition of the gut for which there is no structural abnormality leading to bowel symptoms
3 Typical IBS symptoms Bloating/Wind Diarrhoea Abdominal pain Constipation Passage of mucus per rectum
4 Why do we get IBS? The gut is a long pipe surrounded by muscle and filled with nerve endings. Normal muscle contractions (peristalsis) propel food/fluid and faeces in a coordinated manner down the gastrointestinal tract.
5
6 Please click on the full stop below Peristalsis.
7 Why do we get IBS? Ineffective peristalsis leads to constipation Over active peristalsis leads to diarrhoea The gut is normally collapsed but can become distended with air resulting in bloating The nerve endings in the gut wall may become more sensitive to stretching resulting in pain
8 Who gets IBS symptoms? Can run in families Previous episode of food poisoning Previous antibiotic use/anti-inflammatory use (NSAIDs) Possibly related to an acute physically or emotionally traumatic event Stress/anxiety can affect gut motility More common in women (possibly related to pelvic floor damage when giving birth)
9 Symptoms Bloating/Wind Day time diarrhoea urgency gastro-colic reflex loose stools frequent stools Pain with diarrhoea relieved by opening bowels
10 Symptoms Constipation Nothing for days or weeks Just pass pellets Often return to loo shortly after going (rectal dissatisfaction) Passage of mucus rectally
11 How to treat symptoms BLOATING/WIND Are you Fast eater? (air swallower) Gum chewer? Lover of fizzy drinks? Eating too much fibre? If the answer is yes cut back! Medical treatment mebeverine/merbentyl
12 How to treat symptoms Diarrhoea due to increased peristalsis Too much coffee/caffeine? Low sugar gum? Other low sugar products (sorbitol) Too much alcohol? Too much dairy cheese/cream/chox? Too much veg beans/cabbage/mushrooms/onions? Too much anxiety? If the answer is yes cut back!
13 How to treat diarrhoea Cut back as above Increase white rice Loperamide/codeine Relaxation/meditation/hypnosis Stop anti-inflammatory drugs
14 Treating abdominal pain Pain usually due to increased gut contractions Treat diarrhoea first Try anti-spasm medication such as Merbentyl/mebeverine before meals Buscopan for attack of pain Amitriptyline low dose Hypnotherapy
15 Treating constipation Are you in a dehydrating environment? Are you drinking enough fluid Are you drinking too much caffeine (diuretic)? Are you exercising? Eating regularly? Do you deny yourself? Are you bearing down properly?
16 Treating constipation Lots of fluid Exercise No rice Care with fruit and veg (makes bloating worse) Don t ignore mother nature!
17 Treating Constipation Laxatives Suppository Enema Senna (stimulant) Milpar (stool softener) Movicol/Laxido If fails consider biofeedback
18 When is IBS not IBS? Blood/pus in stool Getting up at night with diarrhoea Change in bowel habit over 45 years A change in your normal IBS symptoms Discuss with your GP
19 What might happen if you meet me? Discuss your symptoms and especially your diet Agree a strategy If symptoms new/changing I might consider blood tests for - Blood count - Protein Level - Markers of inflammation - Wheat allergy blood test
20 Anything else? An examination of your bowel may be required. For examples of a colonoscopy click below v=6kg5wzqfadq&has_verified=1
21 Thank you for watching this To book an appointment: For the latest breaking news about your stomach and bowels visit us on
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