2017 HCHB_digital

Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder with
a worldwide prevalence of 10%–20%. Symptoms can range from minor and
occasional to severe and disabling. 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 a person’s symptoms as IBS.
IBS is more common in women than in men and occurs more often in people in
the 20 to 40-year-old age group. IBS can occur in children and many people can
trace the onset of their symptoms back to childhood. Onset in old age is rare. The
exact cause of IBS is not known but experts suggest it may stem from a problem
with nerves that control the bowel.
Symptoms of IBS
The difficulty with diagnosing IBS is that symptoms can vary, although alternating
diarrhoea and constipation is considered a key symptom for diagnosis. Sufferers
typically describe three to four days of constipation followed by one to two days
of loose bowel motions. Other symptoms typical of IBS include:
• abdominal bloating – may more commonly occur in the evening, and may
be accompanied by increased gurgling and rumbling. Clothing may become
uncomfortable
• cramping, often just prior to a bowel movement; also increased flatulence
• mucus in the stools
• sensation of incomplete evacuation of the bowel or an urgent need to
evacuate the bowel
• tiredness.
IBS may also cause lower back pain and has been associated with painful
periods, pain with sexual intercourse, fibromyalgia, and bladder symptoms.
IBS triggers
Certain things can trigger IBS symptoms, including:
• change of routine
• food intolerance
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Lactose is the most common dietary trigger for IBS. Fructose and sorbitol
may also trigger IBS.
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Alcohol, caffeine, carbonated drinks, dairy products, fried or fatty foods,
low-fibre diets and preserved foods have also been implicated.
• hormones
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Some women are prone to IBS symptoms around the time of their period,
although endometriosis should be excluded as the cause.
• infection or food poisoning
»»
Bowel symptoms may persist long after the offending bacteria or virus has
been eliminated. Estimated to be responsible for up to 25% of IBS cases.
• smoking
• some medicines (eg, antibiotics, antacids, painkillers)
• stress, depression or anxiety.
TREATMENT OPTIONS
Category Examples Comments
Antispasmodics
Smooth muscle relaxants
Probiotics
Food supplements
Laxatives
Anti-diarrhoea products
Natural / herbal products /
supplements
[GENERAL SALE]
eg, peppermint oil (Colpermin, Mintec*)
[PHARMACIST ONLY MEDICINE]
eg, hyoscine (Gastro-Soothe*)
[SUPPLEMENT]
eg, IBS Support, Primadophilus Reuteri
eg, gluten-free wheat dextrin (Benefiber)
eg, inulin fibre (Metamucil Fibresure)
[GENERAL SALE]
eg, docusate (Coloxyl), lactulose (Laevolac),
psyllium husk (Metamucil), sterculia (Normacol)
[PHARMACY ONLY MEDICINE]
eg, loperamide (Diamide, Imodium Zapid)
eg, guar gum, kiwifruit extract, peppermint,
slippery elm, turmeric
Peppermint oil provides natural relief of abdominal bloating, distension and cramping.
May be helpful for abdominal pain or cramping.
May help to regulate the digestive system, reduce abdominal pain and bloating, and
encourage more uniform stools. Studies have indicated a benefit for probiotics species such
as Bifidobacterium, Lactobacillus, and Propionibacterium.
Fine powder with minimum taste. Can be sprinkled on foods and in cooking without
premixing to increase fibre content of the diet, encouraging more uniform stools.
Most laxatives only treat constipation; however, bulk-forming laxatives (containing psyllium
or sterculia) can also be used to bulk up watery unformed stools. When used to regulate
stool consistency, less water can be drunk as the fibre absorbs fluid from the bowel.
See Constipation for more information about constipation.
Slow down bowel movements, allowing reabsorption of fluid by body. Can help reduce
cramping, abdominal pain and the frequency of bowel motions. May be used regularly in
people with IBS to regulate ongoing diarrhoea.
Many natural ingredients (including probiotics, guar gum, peppermint, turmeric) have been
shown to be effective in IBS. Kiwifruit extract contains prebiotics, enzymes and dietary fibre
to optimise bowel health.
Products with an asterisk have a detailed listing in the Irritable Bowel Syndrome section of OTC Products, on page 250.
Page 102 HEALTHCARE HANDBOOK 2017-2018 Common Disorders