Irritable Bowel Syndrome
Irritable bowel syndrome, known as IBS, is a common problem. Around 20% of people are likely to suffer from IBS at some point during their lives. Because the symptoms of IBS are similar to the symptoms of many other conditions, it often takes years to exclude other conditions and to diagnose your symptoms as IBS.
IBS is more common in women than in men and occurs more often in younger people. It is usually on-going, and there are times when symptoms are worse than others. Having IBS does not mean you are more likely to develop colon cancer later in life.
Symptoms of IBS
The difficulty with diagnosing IBS is that not everybody has the same symptoms, although they all have the same condition. Some people with IBS mainly have constipation, others have diarrhoea. Many people with IBS alternate between periods of constipation and diarrhoea. Symptoms may include:
Cramps and bloating in your lower abdomen, which usually get better after having a bowel motion or passing wind
Constipation – feeling you have not managed to empty your bowels completely, having bowel motions less often, or passing small, hard stools
Diarrhoea – having bowel motions too often and passing very loose stools
Flatulence, or wind, and/or rumbling noises from your abdomen
Needing to rush to the toilet
Mucus in your stools.
IBS triggers
The cause of IBS is not known, but certain things can trigger its symptoms, including:
Stress
Food poisoning
Certain food and drinks
Some medication
Some people find avoiding alcohol, caffeine and nicotine can reduce their IBS symptoms
Some women suffer from symptoms of IBS just before, or during their period, although they should talk to their doctor to exclude endometriosis as the cause.
See Your Pharmacist or Medical Professional
If you have other medical conditions, take regular medication for any reason, are elderly or frail, or the person with the IBS is a child, you should always talk to your pharmacist. Also talk to your pharmacist if:
You are aged over 40 and have noticed a change in your bowel habit
You have blood in your stools
Your stools float or are hard to flush down the toilet
You have unexplained weight loss
You also have a fever
You have severe constipation, diarrhoea or abdominal pain
You are being woken at night by your symptoms
You have recently travelled overseas, particularly to developing countries
There has been a change in your usual symptoms if you have an on-going problem with IBS
You are pregnant or breastfeeding
You have allergies to medications.
A diagnosis of IBS is not usually made by a doctor until other possible causes of your symptoms have been ruled out.
Treatment Tips
Keep a diary of events surrounding each IBS attack to help identify triggers.
Reduce stress – relaxation techniques or counselling can be helpful
Exercise regularly – being active helps digestion
Eat a well-balanced diet, including plenty of fresh fruit and vegetables, and drink lots of water
High-fibre foods, such as cereals and bran, help some people but can make symptoms worse in others
Increase fibre gradually – avoid excessive amounts
Some people find that avoiding alcohol, caffeine and nicotine can reduce their IBS symptoms.
Treatment Options
If diet and lifestyle changes do not help on their own, medication can be used to manage symptoms of IBS.
Always discuss treatment options with a pharmacist to ensure the best outcome.
Medicines to help treat diarrhoea in IBS
[PHARMACY ONLY]
e.g., Diamide, Diastop, Imodium, Imodium Advanced (with simethicone)
Anti-diarrhoeal medications work by slowing down bowel movements, which allows time for more water to be absorbed back out of the stools, making them less loose
They also help reduce cramping, abdominal pain and the frequency of bowel motions
Simethicone helps relieve wind.
TREATMENTS that may help either diarrhoea or constipation in IBS
[GENERAL SALE]
e.g., Metamucil, Mucilax, Normacol, Normacol Plus (also contains a stimulant laxative)
[SUPPLEMENT]
e.g., Benefiber, Metamucil Fibersure
Bulk-forming laxatives or fibre supplements may be used by some people with IBS to normalise stool consistency when stools are particularly loose
If bulk-forming laxatives are taken without the usual amount of water, they bulk up the stool making it easier to pass
Alternatively, bulk-forming laxatives may also be used for constipation in IBS. When this is the case, then they need to be taken with plenty of water
Benefiber and Metamucil Fibersure are fine powders with minimum taste. They can be sprinkled on foods and in cooking without pre-mixing to increase fibre content of the diet.
Medicines to help treat constipation in IBS
[GENERAL SALE]
e.g., Coloxyl, Movicol, Movicol-Half
[PHARMACY ONLY]
e.g., Arrowcare Laxofast, Coloxyl with senna, Dulcolax, Duphalac, Laevolac, Laxsol, Microlax enema, Senokot
Osmotic laxatives, such as Duphalac and Laevolac, work by pulling more water into your stools, making them less hard
They do not have an immediate effect and may need to be used for a few days before they begin to work
Lactulose (e.g., Duphalac, Laevolac) can be mixed with water, fruit juice, lemonade or milk to make it more palatable
Iso-osmotic laxatives, such as Movicol, deliver extra water to your bowel and help soften stools – they usually take one or two days to work
Stool-softeners, such as Coloxyl or Arrowcare Laxofast, help water to get into stools, making them softer
A Microlax enema can be used if your constipation is severe, and should work within 30 minutes
Stimulant laxatives, such as Senokot and Dulcolax, should be taken at night to have an effect the next day. They can cause ‘lazy bowel’ if used long-term – only use for short periods. They can sometimes cause abdominal cramps.
Products to relieve cramping, bloating, flatulence in IBS
[GENERAL SALE]
e.g., peppermint oil (Colpermin, Mintec)
[PHARMACIST ONLY]
e.g., Gastro-Soothe
Peppermint oil can help with cramping, bloating and flatulence
Gastro-Soothe can also help with cramping
Other medications, such as mebeverine (Colofac), are available as [PRESCRIPTION ONLY] from your doctor.
Probiotic supplements
[SUPPLEMENT]
Eg, bifidobacteria, lactobacillus, Primadophilus Reuteri
May help to regulate the digestive system, encouraging more uniform stools
They may also reduce abdominal pain and bloating.
Natural/herbal products/supplements
e.g., kiwifruit extracts (Phloe capsules, chewable tablets, powder), chamomile, blond psyllium, guar gum, peppermint, wheat bran
Kiwifruit extracts contain prebiotics, enzymes and dietary fibre to optimise bowel health
Chamomile has an antispasmodic effect and can help relieve trapped wind and assist with healing of the gut lining
Many other natural ingredients (including psyllium, guar gum, peppermint, wheat bran) have also been shown to be effective in IBS.
More Information
Availability of medicines
GENERAL SALE available through pharmacies and possibly other retail outlets.
PHARMACY ONLY available for sale through pharmacies only.
PHARMACIST ONLY may only be sold by a pharmacist.
PRESCRIPTION ONLY available only with a prescription from your doctor or other health professional.
Consumer Medicine Information on some medicines is available at the government website www.medsafe.govt.nz
