IBS is a benign condition which is associated with many unpleasant and uncomfortable symptoms. It is the most common diagnosis made in hospital outpatient departments when patients are referred for investigation of bowel and digestive disturbances. In fact, in most cases, investigations are negative and exclude life-threatening illness such as cancer. IBS is really a diagnosis of exclusion and effectively a descriptive title for groups of symptoms.
In patients with IBS there is some evidence to suggest that there are problems with the co-ordination of the muscles in the bowel which can cause a build up of pressure inside the bowel, this then leads to changes in bowel function. The pressure receptors in the bowel can become sensitive and cause significant pain associated with the associated spasms. There is a great deal of anxiety associated with IBS but, nowadays, it is felt that this may be a result of the condition rather than the cause. In many cases patients with IBS feel that a particular food is the trigger and people can develop a ‘seek the food’ mentality. Identifying one trigger food can sometimes be helpful but all too often this may be replaced by a new ‘trigger’ and more and then more foods are excluded. In many cases it is actually the way foods are handled in the gut generally that is the problem in IBS patients.
Triggers can also be dose-related and only occur once the threshold is exceeded in terms of quantity of that particular food. Another theory is that we have developed to thrive on different combinations of foods, depending on our ancestry. We were hunter gatherers who thrived on meat and naturally growing foods rather than grains or cultivated crops. Consequently IBS could be due to eating a too narrow and restricted diet comprised of refined foods.
Click here to read Summary of NICE Guidance for IBS.