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Symptoms of IBS

The symptoms of IBS may include abdominal pain, altered bowel habits (e.g., constipation, diarrhoea, or constipation alternating with diarrhoea), abdominal bloating and gas. Abdominal pain may be dull or sharp, steady or cramp-like. The pain may follow eating and may often be relieved by the passage of gas or a bowel movement. Other symptoms that are common in IBS include looser or more frequent stools with the onset of pain, and the feeling of a stool still being present after evacuation. Mucus (a green or white stringy material) can be present on or in the stool, or sometimes passed separately. Sometimes IBS is accompanied by indigestion, and nausea, and may be associated with other disorders such as chronic fatigue, fibromyalgia, interstitial cystitis and painful periods

The exact cause of IBS remains unknown, so there is no specific laboratory test which can be performed to diagnose the condition. Therefore, diagnosis is based a person having the symptoms common to IBS, and exclusion of other bowel disorders. The list of symptoms used to diagnose IBS is an internationally agreed system, referred to as the Rome III Criteria.

The Rome III Criteria states that, in order to make a diagnosis of IBS, there must be at least three months, continuous or recurrent, in the last 12 months of abdominal pain or discomfort which has two of three features:

  • Relieved with defecation; and/or
  • Onset associated with a change in frequency of stool; and/or
  • Onset associated with a change in form (appearance) of stool.

Diagnosis should also include a careful medical history, history of any coexistent illness, a physical examination, and a family history.

Further details about specific IBS symptoms:

  • Abdominal pain

    Abdominal pain

    One of the main symptoms of IBS is pain that is felt over the stomach or abdominal area. The pain can be crampy or sharp, and may last from a few minutes to hours, and can be felt anywhere, although the lower part of the abdomen is the most common place. Typically the pain is associated with a change in the bowel habit and may be relieved or exacerbated by going to the toilet.

    Pain relief in the form of applying a hot pack (warm) to the abdomen, for short periods may be helpful, and the frequency and severity of pain episodes may be reduced by treating the IBS with dietary modification, stress management, natural, over the counter and prescribed medications.

    Natural alternatives (not requiring a prescription) for pain relief include herbal preparations and peppermint oil capsules and probiotics, all of which have been shown to ease some of the symptoms of IBS.

    Prescription medication known as anti-spasmodics for which there are a few types have been used to relieve the pain of IBS. Anti-spasmodics are thought to work by reducing cramping and are generally safe to use.

    Pain in IBS can be troublesome, and may have significant impacts on the life of the person with IBS. Learning techniques to cope with the symptoms is an effective strategy to make living with IBS easier. Several techniques that are effective include methods used by psychologists, for example cognitive behavioural therapy and more noted later in this section.

  • Diarrhoea

    Diarrhoea

    Loose bowel motions can be a feature of IBS. You may have been diagnosed with diarrhoea predominant IBS by your doctor. A trial of dietary fibre may be worthwhile as a number of patients with IBS find this can alleviate the symptoms, by increasing the bulk of stools. It is important to recognise that there are many different types of fibre, both in your diet and as supplements, and these can have quite different effects, so you may need some advice as to which is best for you to try first. It is important to recognise that it is important to start at a low dose and work your way up slowly, and that some people may get worse with fibre. Diarrhoea can also be reduced by antidiarrhoeal medications that can be purchased over the counter, for example Loperamide (Imodium or Gastro-Stop). These reduce the number and severity of the bowel actions, but don’t generally affect pain. They can be taken as required or (on advice from your doctor) regularly.

  • Constipation

    Constipation

    Hard infrequent bowel motions or difficulty passing a bowel motion is a common complaint for some IBS patients and may cause bloating and worsen other symptoms. Adequate intake of water and activity is important in preventing constipation, but taking large amounts of water is not beneficial. The addition of fibre to your diet can help in some people. Fibre is available in a number of forms commercially as well as in your diet in the form of dried fruit, prunes and prune juice. Again it is important to start at a low dose and work your way up gradually to avoid exacerbating symptoms. If this is insufficient, there are a number of medications that may be useful, most of which can be purchased without a prescription, but this should be discussed with your doctor prior to use, as laxatives bought over the counter are not encouraged for long term use with IBS unless directed by your doctor. New specialised prescription medications may have a role with constipation predominant IBS, for example prokinetic drugs such as prucalopride, which has just been released, may reduce symptoms in patients who do not get adequate relief from other therapy.

  • Bloating

    Bloating

    Abdominal bloating is a common complaint in IBS. Dietary modification can be an effective way of preventing abdominal bloating and discomfort. Discussion with your doctor can guide you in the necessary direction and if required, specialised dietician’s advice may be helpful.

  • Depression and anxiety

    Depression and anxiety

    Symptoms of anxiety and/or depression are commonly reported by individuals suffering from IBS. These may be due to the IBS symptoms themselves, or to other issues such as family, relationship, financial stresses or even to significant life changing events from the past. A previous diagnosis of depression or anxiety disorder is also been shown to be associated with some IBS in some sufferers, but not all.

    The symptoms of severe IBS may interfere with the normal activities of day to day life. This may eventually lead to symptoms such as tiredness, low mood, low energy levels, and feelings of being out of control, tense or anxious (i.e. worry). This in itself will make the experience of living with IBS more difficult and can create a vicious cycle, impacting on the overall condition of the person and quality of life.

    If any of the above feelings or events is pertinent to your care, then this should be discussed with your doctor, and if there are previous unresolved psychological issues then it would be the right time to address these as part of the treatment plan. Treating these issues improves the ability of the mind and body to cope with IBS. If your doctor feels that depression and/or anxiety is contributing to your symptoms, your doctor may suggest medication. This may take some time to work out the right medication and dosage before it has a favourable outcome. Alternatively, a referral to a psychologist for further assessment and treatment may be appropriate. Psychologists have several modes of therapy such as cognitive behavioural, relaxation training or hypnotherapy which are effective methods of treating IBS, a fact which has been proven in medical trials.




MORE LINKS

If you are interested in other gastrointestinal-focused information and intervention websites developed and hosted at
Swinburne University of Technology,
please go to:

IBDclinic.org.au for individuals with Inflammatory Bowel Disease

Gastroparesisclinic.org for individuals with Gastroparesis

DISCLAIMER

This website and its content is not intended or recommended as a substitute for medical advice, diagnosis or treatment. Always seek advice of your own physician or other qualified health care professional regarding any medical questions or conditions.

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