Irritable Bowel Syndrome (IBS) is defined as a chronic and episodic functional digestive disorder, which means that it occurs over long periods of time (years) and manifests symptoms a certain times (episodic).

Sufferers of IBS typically have some of the following symptoms: abdominal pain, bloating and transit disorders (which can be constipation and or diarrhoea).

However, on examination, there is usually no identifiable lesion or injury in the gut or biological abnormalities that explain the symptoms. These symptoms do have a significant impact on an individual with IBS quality of life.

How does one know if they have IBS?

A doctor (general practitioner) or gastroenterologist could diagnose an individual with IBS. Generally speaking, if one suffers frequently with abdominal pain and a change in bowel movements (constipation and or diarrhoea), bloating and this happens repeatedly over months, then it would be prudent to consult with a doctor.

What are the symptoms?

Recurrent abdominal pain or discomfort associated with a change in bowel movement patterns (constipation/ diarrhoea) and quality of stools (hard and lumpy or loose and mushy), recurrent bloating with discomfort.

Causes?

Stress can certainly play a role. Stress — feeling mentally or emotionally tense, troubled, angry, or overwhelmed — can stimulate colon spasms in people with IBS.

The colon has many nerves that connect it to the brain. Like the heart and the lungs, the colon is partly controlled by the autonomic nervous system, which responds to stress. These nerves control the normal contractions of the colon and cause abdominal discomfort at stressful times.

People often experience cramps or 'butterflies' when they are nervous or upset. In people with IBS, the colon can be overly responsive to even slight conflict or stress.

Stress makes the mind more aware of the sensations that arise in the colon, making the person perceive these sensations as unpleasant.

Some evidence suggests that IBS is affected by the immune system, which fights infection in the body. The immune system is affected by stress. For all these reasons, stress management is an important part of treatment for IBS.

Stress management options include stress reduction (relaxation) training and relaxation therapies such as meditation counseling and support, regular exercise such as walking or yoga, changes to the stressful situations in your life and adequate sleep.

Other causes?

Over the years various theories have been proposed to understand the underlying cause ranging from genetic predisposition, to 'spasm' of the muscle in the gut (was called spastic colon), to an altered way in which the brain and the gut speak to each other, to psychopathology meaning that there was a psychological component to the expression of IBS. More recently, it has been shown that IBS can follow post another gut infection or inflammation and also that it involves altered gut flora — and this is where probiotics come into the picture.

How is it diagnosed?

It can be diagnosed using a certain set of criteria called the Rome III criteria and very specifically based on the individual's symptom history and the timing thereof. Doctors may order various clinical tests to exclude other medical conditions of the gut.

How is it treated?

Treatment has to be very individual specific and related to the individual's symptoms.

There may be a variety of pharmacological treatment recommended. However, importantly, dietary manipulation can have a significant impact on the symptoms.

Diet is also individual specific and it is recommended to keep a food diary to identify those foods that trigger an adverse response. Generally, insoluble fibres should be excluded (bran, seeds, skins of fruits) but soluble fibre should be included (oats, psyllium husk, isapgula husk).

More recently, probiotics are showing great promise in helping to reduce the symptoms of bloating, flatulence and abdominal distension. So including a fermented dairy product with proven probiotics can help improve discomfort.

While Activia is not a treatment, it is a probiotic food that has been scientifically proven to help improve digestive transit time and digestive discomfort like bloating and abdominal distension.

Can you put on weight from IBS?

There is no direct correlation between IBS and weight gain. In fact, some individuals may lose weight due to perceived discomfort in the gut and relationship to food.

Are there different forms of IBS?

Yes, some individuals have IBS with constipation, others IBS with diarrhoea and some with a mix of constipation and diarrhoea.

Who can I contact if I need help/advice.

If you find yourself experiencing symptoms of abdominal pain and change in bowel habits that recurs, your first stop should be with your family doctor. If he/she finds it necessary, they will refer to a gastroenterologist.

In terms of managing your symptoms from a nutritional intake point of view, it is advised to consult with a dietitian, who will be able to work with you to identify foods that trigger symptoms, and to plan and guide you on your daily meals to ensure that you have adequate nutritional intake.