Irritable Bowel Syndrome is one of the most common complaints in the western world. Around 50% of all gastrointestinal complaints and half of all GP referrals are due to IBS. Irritable bowel syndrome (IBS) is also known by many other names, such as spastic colon, mucous colitis, functional bowel disorder, dyspeptic diarrhoea, spastic constipation, anxiety and GI syndrome, and nervous bowel.

It affects 24% of all women and 19% of all men, usually developing in late adolescence or early adulthood. Before the menopause, more women than men present with IBS; after the menopause the numbers are about equal. The condition is characterized by intermittent periods of constipation or diarrhoea, often accompanied by bloating and/or abdominal pain, mucous in stools and bowel rumbling. 

Patients with IBS can be divided into:

• Those with constipation predominant IBS
• Those with diarrhoea predominant IBS
• Mixed IBS

Patients often complain of abdominal pain, typically above the left hipbone, and the pain is relieved by going to the toilet. The patient may also complain of a feeling of incomplete emptying of the rectum. Abdominal distension and bloating are suggestive of IBS, in the absence of any bowel obstruction. Non gastrointestinal symptoms may also be reported, like fatigue, or urinary tract problems. Up to 20% of patients develop symptoms after a bout of infectious gastroenteritis, and this is known as 'post infectious IBS'.

IBS needs to be distinguished from conditions with similar symptoms such as celiac, colorectal cancer, infective diarrhoea, diverticular disease, carcinoid syndrome, gallstones, appendicitis and inflammatory bowel disease (IBD). This is particularly important when the following indicators are present:

• A short history of symptoms
• Weight loss
• Nocturnal symptoms
• Rectal bleeding
• Age over 50 years

Stool tests usually find nothing significant – no blood, excess white cells, parasites or bacteria. Likewise, full blood count tests and inflammatory markers will be normal.

Factors that have been implicated in the mechanism of IBS are:

• Abnormal GI sensation
• Abnormal GI motility. Once partly digested food has left the stomach, it is moved through the digestive tract by rhythmic contractions of the muscles in the intestinal walls, a process called peristalsis. In irritable bowel syndrome, these muscles go into spasm for unknown reasons, becoming so uncoordinated that they move residues either too quickly (causing diarrhoea) or too slowly (causing constipation).
• Altered GI serotonin signalling. In these cases the use of a supplement like Stressolim, that normalises serotonin levels in the gut has been found to be useful, naturally relaxing the gut and returning it to normal function.
• Altered bacterial flora, or dysbiosis. Gut dysbiosis can be bacterialor fungal (candidiasis). In cases of bacterial dysbiosis Lactoferrin and Custom Probiotics CP-1 have been effective. Lactoferrin will kill off bad bacteria while  CP-1 will quickly replace beneficial bacteria in the gut. For a fungal dysbiosis, Candigest Plus and CP-1 have been effective.

Although IBS is often very uncomfortable, inconvenient and sometimes quite painful, (and I suffered from it for 35 years), thankfully this digestive disorder is not at all dangerous or life threatening. Nor does it ever lead to anything more "serious," like colon cancer or ulcerative colitis. 

For doctors, IBS can be challenging to diagnose, because tests often show no abnormalities even though symptoms are often all too real. As a result, a diagnosis of irritable bowel syndrome is usually arrived at by process of elimination, if you will excuse the pun, after other disorders with similar but more serious symptoms--such as diverticulitis, ulcerative colitis, Crohn's disease, or intestinal parasites--have been ruled out.

There is no inflammation of the bowel, yet the patient suffers a variety of symptoms. These can be varying degrees of abdominal pain from vague to excruciatingly sharp; alternating constipation to diarrhoea, watery stools, wind, bloating, nausea, sweats and a worsening of symptoms after eating a large meal, during or just before menstrual periods, or while under stress.

While experts have suggested many potential causes for irritable bowel syndrome, no single cause has been established beyond a reasonable doubt. The list of possible culprits has ranged from parasitic infections and lactose intolerance, to food allergies and overuse of antibiotics.
Does any of this sound familiar? It is a good idea to rule out any serious illness, especially if you have rectal bleeding, black or mucousy stools. If you have, check with your doctor.

Some GP’s will prescribe a high bran intake for IBS sufferers, but this may be one of the worst things to do, as bran is particularly irritating to the gut.

Other treatments available from your doctor may include:

• Tricyclic anti depressants, which may help to relieve pain at lower doses than normally used for depression. 
• Antispasmodics such as mebeverine may help in the short term with diarrhoea type IBS, but this is not a long term solution. 
• Peppermint oil may help with bloating. 
• Hypnotherapy may be useful, but is not widely available.

Because no two people are alike, a notion known as biochemical individuality, there is no single best diet for IBS. It may be wise to rule out the common sensitivities and allergies to wheat, sugar, cow’s milk, beef, pork, corn, coffee and orange juice as these are the major culprits in the onset of IBS. As with ulcerative colitis and Crohn’s, the ‘Stone age’ or elemental diet may help. This diet is free of all dairy, grains, red meat, refined sugars and processed foods. This can give your gut a rest from allergens and proteins that cause problems.

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