Irritable bowel syndrome (IBS) is a chronic or long-term medical condition where patients may experience abdominal pain, bloating, indigestion and change in bowel habit such as diarrhoea, constipation or a mix of both. IBS is very common in Singapore, affecting 9% of Singaporeans, however less than half of patients experiencing IBS see a doctor for their symptoms. Most patients with IBS see a Gastroenterologist (Specialist in gastrointestinal medical conditions) for relief of abdominal pain.
Causes of IBS
IBS is a complex medical problem which is not completely understood. There are many different causes of IBS and may often be a combination of causes which differs from patient to patient. Such causes can include:
- Diet intolerance
- Mood problems: Stress and anxiety
- Abnormal intestinal bacteria content
- Nerve abnormality
- Hormone abnormality
- Abnormal movement of the intestine
Diagnosis of IBS
In order to diagnose a patient with IBS, the doctor will need to perform an assessment, which will involve a detailed analysis of the patient’s current bowel condition and physical examination. Following that, a diagnosis can be made based on the presence of typical symptoms which include a combination of the following;
- Improvement or worsening of abdominal pain after passing motion.
- Change in frequency of passing motion.
- Change in the form of the stool. (Too hard or watery)
IBS Treatment
Irritable bowel syndrome is a longstanding condition. Its symptoms may come and go and even change with time. There is no “cure”, but the symptoms can usually be reduced to a manageable level, bringing it under control as eliminating it completely may not be possible.
In order to treat and manage your IBS, it is very important to have a good working relationship with your doctor. Treatment needs to be individualised to balance factors like effectiveness, side effects, cost, and inconvenience, and may require multiple visits to your doctor. It is also important that you understand your own condition and identify factors which make it better or worse. Different methods including diet, stress and lifestyle management, in addition to medications, may be required, and a combination of these treatments is often required for severe cases. Identify which of these treatments work best for your symptoms, and provide feedback to your doctor, for them to make the required adjustments.
Below are several methods used in the treatment of IBS:
- Diet management
- Psychological management
- Antibiotics
- Probiotics
- Symptomatic treatment
IBS Tests
Test (investigations) to exclude the presence of structural abnormality may be necessary especially in conditions where patients have the following criteria;
- Aged more than 45 years old;
- Experience difficulty swallowing;
- Have blood in stool;
- Experience unintended weight loss;
- In pain while sleeping at night;
- Feverish;
- Personal or family history of gastrointestinal cancer;
- Had an abnormal result from a physical examination;
- Failure to improve with treatment. These tests may include blood or stool tests, abdominal scans and endoscopy (intestinal camera tests).
In some instances, further tests which assess the movement of various parts of your intestines, or the amount of bacteria in your intestines, may be performed to establish the underlying cause and guide treatment.
IBS tests include:
- Blood Test
- Imaging Scans
- Endoscopy
- Breath test
- Tests to assess intestinal movement
All this testing may seem cumbersome, but it is vital in finding out the cause of your stomach problems. Once you have a diagnosis, your doctor can start the right treatment and put you on the road to relief.
Dr Wang Yu Tien
Consultant Gastroenterologist
Nobel Gastroenterology Centre
