What’s new in IBS treatment?
Irritable Bowel Syndrome It’s an elusive, frustrating condition, but fresh approaches to diagnosis and management of Irritable Bowel Syndrome (IBS) spell good news for sufferers.
“IBS symptoms vary enormously,” says Consultant NeuroGastroenterologist Dr Anton Emmanuel. “Some people feel suicidal, while others may barely notice the condition unless they have a flare-up."
"Identifying IBS has become easier."
The condition is identified by abdominal pain or discomfort, alteration in bowel habits, and a time relationship between the two – in other words, all three elements present at once.
“It’s key for practitioners to make a positive diagnosis,” explains Emmanuel, who is a Consultant NeuroGastroenterologist at University College Hospital. “A big problem until now has been that, after going through tests to show it’s not a disease such as cancer, patients have felt left hanging because there’s no diagnostic test for IBS. They need to be told their symptoms are not all in their head, it is a real condition.”
Identifying IBS has become easier thanks to a new faecal calprotectin test which is less invasive than procedures such as endoscopy; and there are two or three new drugs available.
People can help themselves too: the FODMAPS dietary approach can be useful, while probiotics are “undoubtedly helpful”, though you need to work out which one’s best for you because our guts are as distinctive as our fingerprints. Because stress is a major factor for most IBS patients it’s very important to identify your own stressors, to help stop the symptoms in their tracks, says Emmanuel. “Relaxation and hypnotherapy techniques are often much more effective than drugs and they’re often available on the NHS - make make use of those services.”
As with IBS, women are more likely to suffer from chronic constipation than men. “Infrequency, or difficulty such as straining, over a period of three months are symptomatic – we’re not talking about constipation from eating too much pizza which clears up after a few days on a mild laxative.”
Biofeedback has emerged as a useful technique which helps people become aware of their own patterns and mechanisms, and not only has no side effects, but is potentially curative, says Emmanuel.
Foodwise, FODMAPS are not useful for chronic constipation, but eating regular meals is a key habit to get into. “Regularity (two or three main meals a day) is much more important than a high-fibre diet – don’t go stuffing yourself with more fibre if it’s not working. Also, don’t overdo liquids. The body needs between 1.2 and 1.5 litres a day – it’s not helpful to take a lot more.”