Picture the scenario: you have endured weeks, months or even years of anxiety, embarrassment and crippling stomach symptoms. Every meal time sparks fear of relentless pain, sometimes extreme bloating and maybe a mad dash to the loo. At other times, even going at all can be a struggle.
Doctors seem unable to find the reason – a few tests might have ruled out ‘anything serious’ such as cancer and other diseases. The advice? Stop drinking coffee, keep a food diary to identify ‘triggers’, and try not to worry too much.
Google searches prove baffling too: cut carbs, fat or sugar, or invest in a subscription for dubious-looking supplements. All of this will, undoubtedly, sound familiar to millions of Britons who have been slapped with a diagnosis of irritable bowel syndrome – more commonly known as IBS.
Studies estimate that at least one in five people in the UK suffers from the condition. And many will have tales of endless medical checks which fail to give answers. For years, because a physical cause is often elusive, patients were made to feel their problem was ‘all in the mind’. But today, GPs have a range of tests at their disposal that can help flag up what might be the matter.
Indeed, last month, in a review of more than 220 scientific papers, researchers at the British College of Nutrition and Health suggested that IBS was the result of not one, but more than a dozen different diseases and conditions.
The ‘catch-all’ term IBS was being used to describe illnesses that, when correctly diagnosed, require distinct treatment. They also identified a host of lifestyle factors that, if tackled, could bring about huge relief.
Lead author, nutritionist Ben Brown, even went as far as to say the term IBS should be banned to ‘prevent years of unnecessary suffering’. He added: ‘Both doctors and the patient should be digging deeper, and trying to understand why they have these symptoms.’
Professor David Sanders, a consultant gastroenterologist at the Royal Hallamshire Hospital in Sheffield, said: ‘On the outside, it seems like a single condition, but there are many different diseases that could be the cause that aren’t totally obvious at first glance. Patients can also have more than one condition at the same time. That’s why it’s often hard to work out what is going on. But when we do, and are able to give effective treatment, it can transform a patient’s life.’
Here are a few of the conditions that are commonly put down to IBS.
Tiredness could be coeliac disease: Coeliac disease happens when the body’s immune system, which usually protects against infection, mistakenly attacks healthy gut tissue. It does this in reaction to gluten, a protein in wheat, barley and rye – although the reason why is not known. One in four people with coeliac disease has previously been diagnosed with IBS. And while the condition is estimated to affect at least one in 100 people in the UK, only 30 per cent are currently diagnosed.
Symptoms start after a milky drink could be lactose intolerance: About five per cent of Britons are lactose intolerant. It means the body doesn’t produce enough of an enzyme called lactase, which digests lactose, the sugar in dairy. Symptoms usually come on a few hours after consuming milk, yogurt or cheese as the undigested lactose causes the intestines to go into overdrive, producing fluid to try to dilute it. The sugars also begin to ferment, producing gas. The result? Classic IBS symptoms. Intolerance usually first emerges in older children and young adults as the amount of lactase you produce decreases as you get older. The amount of dairy that must be consumed to trigger symptoms varies, so the condition isn’t always obvious. A smaller number of people get symptoms because they are believed to be intolerant to gluten – not to be confused with coeliac disease, as described above.
If there’s blood in the loo it could be Crohn’s disease or colitis: Crohn’s disease and ulcerative colitis are the two most common types of inflammatory bowel disease – a term used to describe conditions that cause the digestive system to become inflamed. Both diseases are the result of the immune system going haywire and attacking healthy gut tissue, causing permanent damage. Experts are still unsure why this happens. Crohn’s disease can affect people of all ages, but symptoms usually begin in childhood or early adulthood. Symptoms include pain and swelling in the tummy, diarrhoea and extreme tiredness. You may also notice blood in your stools.
Can’t stop rushing to the loo could be bile acid malabsorption: As many as a third of people diagnosed with IBS could actually have a condition called bile acid malabsorption. Bile is a substance that breaks down food and removes waste products after eating. Once it has done its job, bile is reabsorbed into the liver. But if the bowel is inflamed, damaged or too much bile acid is produced, digestive problems can occur. Causes include bacterial or viral stomach illnesses and removal of the gall bladder, the small pouch-like organ in the digestive system that stores bile. About six per cent of patients diagnosed with diarrhoea-dominant IBS are estimated to have a different condition – pancreatic exocrine insufficiency. This occurs when the pancreas does not produce enough enzymes.
