A guide to understanding your IBS: From diagnosis to treatment

If you have stumbled across this article, then it is highly likely you have been experiencing some uncomfortable (if not downright embarrassing!) tummy troubles. For some of you, it may feel like these issues have appeared out of the blue. However, in my experience, many people often suffer for years before seeking professional help. Whatever the case, navigating the endless suggestions and opinions online can be a minefield.

The goal of this article is to simplify the process, providing no-strings advice on how to navigate your IBS journey. Knowledge is power after all! So, without further ado…

Understanding IBS: What You Need to Know

Irritable Bowel Syndrome, commonly known as IBS, is a condition that affects the digestive system. It is characterized by chronic and recurrent abdominal pain and/or altered bowel habits lasting for at least six months. IBS manifests through a variety of symptoms, which can differ greatly from one individual to another.

Common Symptoms of IBS

Symptoms often include:

• Constipation

• Diarrhoea

• Abdominal pain

• Bloating

• Wind

• Nausea

• Reflux

  
  

It's important to note that symptoms can vary daily or remain constant. The inconsistency can be frustrating, making the diagnosis process challenging.

The Diagnosis Process for IBS

One of the reasons IBS can be frustrating is that it is often a diagnosis of elimination. To receive a diagnosis, it’s essential to rule out several other conditions. This is why it is advisable to consult your doctor as the first step.

When you have managed to secure an appointment, make sure to ask your doctor about two key conditions.

1. Do You Have Coeliac Disease?

Coeliac disease is an autoimmune condition. Here, the body attacks its own tissues upon consuming gluten. Symptoms can mimic those of IBS and can develop at any age. Thankfully, symptoms resolve with a gluten-free diet, verified through a blood test called TTG IgA (coeliac screen).

2. Do You Have Inflammatory Bowel Disease (IBD)?

IBD encompasses conditions such as Crohn's disease and ulcerative colitis. These conditions involve chronic inflammation of the digestive tract’s tissues. Symptoms can resemble those of IBS, yet treatment varies significantly. Identifying IBD typically entails a stool test known as faecal calprotectin.

If you are over 60 and experience sudden changes in bowel habits, or if you notice any bleeding, mention this to your doctor. In very rare cases, these could indicate bowel cancer.

What Happens After an IBS Diagnosis?

Option 1: Dietary Therapies

After receiving an IBS diagnosis, your first action should be to book an appointment with a dietitian.

A dietitian is an HCPC-registered professional. Their title is protected by law, ensuring that only qualified individuals with relevant degrees can provide dietary advice. This means you will receive clinically proven, research-backed guidance.

During your initial consultation, the dietitian will analyse your nutrition, lifestyle, and medical history. This evaluation helps determine the best dietary approach for you, which may include:

• Elimination of certain foods

• Modifications in fibre intake

• Identification of trigger foods

• Behavioural techniques

  
  

Every individual has unique symptoms and history, making a personalized approach essential.

Exploring the Low FODMAP Diet

One of the most well-researched diets for managing IBS is the low FODMAP diet. This diet is particularly beneficial for individuals experiencing bloating, pain, and/or frequent loose stools. However, it may not be suitable for those who primarily suffer from constipation.

FODMAPs are types of carbohydrates that can trigger IBS symptoms. They ferment in the gut, producing gas and drawing water into the bowel. The low FODMAP diet consists of three phases:

1. Elimination: Avoid high FODMAP foods for 4–6 weeks.

2. Reintroduction: Gradually reintroduce FODMAPs to identify personal triggers.

3. Personalisation: Establish a long-term dietary plan based on tolerated foods.

   
   

Misinformation about the FODMAP diet is widespread online. Thus, it is crucial to follow this diet under the guidance of a trained professional to ensure strict adherence and maximise its success.

Continuation with a Dietitian

Regardless of whether you adopt the FODMAP diet or choose a different approach, aim for at least three sessions with your dietitian. This ongoing support is vital for effective management of your IBS.

Option 2: Psychological Therapies

To understand how psychological therapies can assist in managing your IBS, we need to consider the science behind it. The gut and brain are linked through the gut-brain axis, connecting the gut's nervous system to that of the brain.

This connection allows for a two-way communication network, which explains how our mood can impact our gut and vice versa. Notably, two common psychological therapies for IBS treatment include:

• Gut-directed hypnotherapy

• Cognitive behavioural therapy (CBT)

  
  

Gut-Directed Hypnotherapy

This therapy aims to help you gain better control over your symptoms. Extensive research indicates that up to 76% of IBS patients experience at least a 50% reduction in symptoms with this method.

Gut-directed hypnotherapy can help to:

• Decrease gastrointestinal sensitivity

• Reduce the frequency and intensity of symptoms such as bloating and pain

• Alleviate anxiety and stress related to symptoms

• Build confidence in managing your IBS

  
  

Cognitive Behavioural Therapy (CBT)

Originally created to treat anxiety and depression, CBT has shown efficacy in treating a variety of conditions, including IBS. This short-term therapy helps develop a structured action plan through collaboration between you and your therapist.

Option 3: Medication for IBS Relief

Some IBS symptoms might improve with medication. If you find this route interesting, discuss it with your doctor. Keep in mind that many medications provide temporary relief and often don’t tackle the underlying issues. Therefore, it is advisable to combine medication with dietary and/or psychological therapies.

Empowering Yourself on Your IBS Journey

Now that you've reached the end of this article (thank you for sticking with me!), I hope it has provided you with a clearer understanding of pursuing an IBS diagnosis and exploring various management therapies.

Whether you opt to collaborate with a dietitian, delve into psychological treatments, or adopt a combined approach, you can move forward with increased confidence. Remember that managing IBS is a journey. Finding the right path can empower you to take control of your well-being.