Causes, symptoms and treatments
Irritable Bowel Syndrome (腸易激綜合症), commonly known as "sensitive bowel", is a ubiquitous digestive system functional disorder with an as yet unknown identifiable cause. The main symptoms of irritable bowel syndrome include abdominal pain, bloating, abdominal discomfort, and changes in bowel habits that can significantly affect a person’s daily life and social interactions.
Intestinal function
External influence
Irritable bowel syndrome typically causes the following symptoms, which may come and go for days or even months:
The Rome Foundation, a not-for-profit organization, with an international committee of experts, aimed at gathering scientific data to aid in the diagnosis and treatment of functional gastrointestinal conditions, has set forth the following diagnostic criteria* for irritable bowel syndrome:
*Criteria fulfilled for the last 3 months with symptom onset at least 6 months before diagnosis
In addition, the following subtypes of IBS are currently recognized:
The utility of colonoscopy in IBS is the direct assessment of the internal surface anatomy of the terminal ileum (last part of the small intestines) and the colon (large bowel). It is useful to visually examine if tumors (benign, malignant or pre-malignant), inflammation, ulcers, abnormal blood vessels, bleeding or diverticula (outpouching in the walls of the bowels) are present that might be the cause of the GI symptoms and provide an avenue for tissue biopsy. Complementing colonoscopy would be laboratory examinations from simple complete blood counts, routine stool and occult blood exams to more specific ones like for celiac disease e.g. tTg IgA Test, deaminated gliadin IgG & IgA test, IgA endomyseal antibody (EMA) test) or inflammatory bowel disease (Crohn’s or ulcerative colitis) e.g. CRP, fecal lactoferrin (Lf), calprotectin (Cal), polymorphonuclear neutrophil elastase (PMN-e). The absence of any significant findings among these “ruled-out” investigations, a consideration for irritable bowel syndrome (IBS) can now be made.
There is currently no cure for irritable bowel syndrome, but medications prescribed by doctors can effectively relieve the symptoms and reduce their impact on patients' lives. For the common symptoms mentioned above, medicines prescribed by your doctor may include:
Common Symptoms |
Prescription Medications |
Belly Pain/Intestinal Cramps |
Gastrointestinal Twitch Medicine |
Diarrhea |
Antidiarrheal medicine |
Constipation |
Laxatives, stool bulk formers |
It may take several weeks for the medicines to take effect. In addition, depending on the cause and extent, doctors may recommend patients take antidepressants or refer patients to receive psychological counselling to to address the psychological impact (or component) of irritable bowel syndrome.
When irritable bowel syndrome persists, or the above treatments fail to work, you can choose to meet with a psychotherapist and utilize psychological interventions like cognitive behavioural therapy, hypnosis and mindfulness-based therapies. This can help relieve tension or anxiety and reduce the frequency and severity of symptoms.
✔ Should
✘ Should not
In addition to following the above suggestions, you can choose appropriate foods according to the "Low FODMAP Diet" to reduce the load caused by diet on the intestines. FODMAP is a large class of small nondigestible, poorly absorbed carbohydrates. Their microscopic size, high osmotic activity, and higher fermentation by colonic bacteria lead to bloating, abdominal pain, and flatulence worsening IBS.
Fermentable |
Such as bread, pasta, udon and dried fruit |
Oligosaccharides |
Such as soybeans, garlic, onions and wheat |
Disaccharides |
Such as milk, cream and cheese |
Monosaccharides |
Such as apples, peaches, mangoes and pears |
And |
- |
Polyols |
Such as apricot preserves, mushrooms, broccoli flowers |
You can also read our recent blog about low-FODMAP and high-FODMAP foods in the UK’s Gloucestershire hospitals (NHS Foundation Trust) and our blog.
Here are some common FODMAP foods that are suitable for people with irritable bowel syndrome:
Regardless of whether you have IBS or not, everyone should develop a gut-friendly balanced diet and be able to establish good bowel habits. For any persistent gastrointestinal complaints such as bloating, abdominal cramps, changes in bowel habits and more that interfere with the daily life-work-sleep-social cycles, it is recommended to seek medical advice to address and manage the cause at the earliest. At OT&P we offer general practice and specialist consultations to cater to your medical queries and needs.
Please note that all medical articles featured on our website have been reviewed by qualified healthcare doctors. The articles are for general information only and are not medical opinions nor should the contents be used to replace the need for a personal consultation with a qualified medical professional on the reader's medical condition.