The Ins and Outs of Irritable Bowel Syndrome

For as long as she could remember, *Ava Joslin suffered from stomach problems. As a child, trips to the doctor were regular and became habitual. She remembers that she was always doubled over in pain and vomiting bouts would continue almost non-stop during those trips.

“My parents were told that I suffered from acute gastritis. I was told to eat regularly and avoid fatty foods and when I had an ‘attack’, they would feed me milk and bread as I couldn’t keep anything down,” she recalls.

 “I saw a gastroenterologist when I started working. It was then that I was diagnosed with IBS,” she says. Well-meaning as her parents had been, the milk and bread diet had worsened Ava’s symptoms. “I wish we had known about my condition earlier, so we could have taken the right steps. I suffered for many years during my childhood,” she says.

IBS stands for Irritable Bowel Syndrome. It is a disorder of the digestive system that specifically affects the large intestines or colon. While IBS is well-known in the West, many people are still unaware of the condition in this part of the world. It is one of the most common disorders diagnosed by gastroenterologists.

Manageable but not Curable

IBS is not curable but it is certainly manageable. Fortunately, it is not deadly but it does cause a whole lot of discomfort and distress. Retired gastroenterologist Dr. Rasilah Ahmad says IBS can be crippling if not managed correctly. “Some sufferers aren’t able to travel even short distances or attend social events and their work is affected. They find their condition embarrassing and of course, physically painful,” she explains.

IBS tends to strike younger adults. Women are twice as likely to be afflicted and many exhibit symptoms when they are menstruating or under stress. Incidences of IBS are believed to be on the rise in the Asia Pacific region.

In Malaysia, only limited research has been carried out on IBS. One of the papers titled ‘Prevalence of Irritable Bowel Syndrome In Young Adult Malaysians: A Survey Among Medical Students’ by Universiti Malaya’s Faculty of Medicine is based on research that was conducted 10 years ago. The results revealed that women far outnumbered the men when it came to IBS.  

 

Too Fast or Too Slow?

There is no known cause for IBS. “It’s a bit of a mystery. Some people have had it since they were young. Some start showing symptoms after a big event in their life — a major illness for example,” says Dr. Rasilah.

Individuals with IBS are particularly sensitive to certain foods. Common symptoms for IBS include diarrhoea (bowel moving too fast) and constipation (bowel moving too slow). Some patients display both symptoms.

According to gastroenterologist Dr. Tan Huck Joo, “the disorder can also result from the interplay between environmental and genetic factors and it may be more likely to occur in people with a family history of the disorder”. Lifestyle can also be a factor.

Dr. Tan adds that a person is diagnosed with IBS if they have shown symptoms for at least six months or if they’ve had abdominal pain or discomfort for at least three days a month over the span of three months.

I think I have IBS. What do I do?

See a doctor as soon as possible if you suspect you have IBS. Among the tests carried out are:

  • Blood tests
  • Stool sample tests
  • Colonoscopy

Once confirmed, your doctor will make recommendations for lifestyle and diet changes, says Dr. Rasilah. Tips include:

  • Keep a food and symptom diary to identify your trigger foods. Common trigger foods include gluten and dairy
  • Take time to eat meals – chew your food well
  • Exercise regularly. Activities such as walking, cycling and swimming are good
  • Take time to relax. Stress is also a trigger
  • Make one change at a time so you know exactly which changes have a positive effect
  • Avoid eating large meals
  • Avoid spicy, fatty and processed meals

“IBS is manageable once you learn more about it. The mystery becomes less odd once you read up. With your doctor’s advice, life can go on as normal for an IBS sufferer,” Dr. Rasilah affirms.

 * Name has been changed to protect the privacy of the individual

Diet Changes to Alleviate IBS Symptoms

Food plays a big part in either aggravating or reducing IBS symptoms. Some foods are considered trigger foods because they worsen symptoms. Identify your trigger foods by keeping a food diary for about a month. Once you have recognised the culprits, avoid them. Make changes according to your symptoms.

If symptoms include bloating and wind

• Limit fruit juice to one small glass per serving

• Limit intake of gas producing foods e.g. beans and pulses, cabbage, cauliflower and also sugar-free mints or chewing gum

• Lactose can sometimes cause wind and bloating and increase IBS-type symptoms. Try consuming lactose-free cow’s milk, yoghurt, cream and cheeses instead of ordinary versions for two to four weeks. Using these products will help maintain your calcium intake. If it makes no difference, then return to using ordinary milk and dairy products

If symptoms include constipation

• Ensure a good fluid intake – about eight glasses/mugs (two litres) a day

• Increase your fibre intake gradually as any sudden increase may make symptoms worse. Choose whole grains and eat more fruit and vegetables. Oats and linseeds are good sources of fibre and will help to soften poo and make it easier to pass

• Try adding one tablespoon per day of brown or golden linseeds (whole or ground) to breakfast cereal, yoghurt, soup or on salad. Have a small glass/teacup (150ml) of fluid with each tablespoon of linseeds taken

• Avoid eating extra wheat bran.

If symptoms include diarrhoea

• Ensure good fluid intake – about eight glasses/mugs (two litres) a day

• Limit fruit juice to one small glass a day

• Limit caffeine intake from tea, coffee and soft drinks to three drinks per day

• Try reducing wholewheat breakfast cereals and breads and choose white versions instead

• Lactose can sometimes cause diarrhoea and IBS-type symptoms. As with bloating and wind, try using lactose free products for two to four weeks. If it makes no difference then return to using ordinary milk and dairy products

• Avoid sugar-free sweets, mints and gum containing sorbitol, mannitol and xylitol

• Avoid spicy foods such as curries and chillies.

 

Sourced from The British Dietetic Association

Extra Tips for Coping with IBS

  • Eat three regular meals a day
  • Try not to skip any meals or eat late at night. Smaller meal sizes may ease symptoms
  • Limit alcohol intake to no more than two units per day and have at least two alcohol- free days a week
  • Cut down on rich or fatty foods including chips, fast foods, pies, batter, cheese, pizza, creamy sauces, snacks such as crisps, chocolate, cake and biscuits, spreads, cooking oils and fatty meats such as burgers and sausages
  • Reduce your intake of manufactured foods and cook using fresh ingredients where possible

Sourced from The British Dietetic Association

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