Irritable Bowel Syndrome is a term applied to bowel troubles that haven’t been otherwise diagnosed as conditions such as Coeliac Disease and Inflammatory Bowel Disease (IBD).
You should generally be checked by your GP for coeliac disease and other diseases which may affect the bowel or reproductive tract before being diagnosed with Irritable Bowel Syndrome. Along with a change in bowel motions, bloating is a common symptom of IBS. Bloating is the feeling of increased pressure in the abdomen whereas distension is a measurable increase in size.
This can be caused by solid, liquid or gas build-up. There are a variety of triggers of IBS and so investigation and treatment varies between individuals based on symptoms and response to treatment trials.
Solids – from excessive constipation.
Liquids – from water being drawn into the intestine to dilute food particles that were not effectively absorbed by the body.
Gas – produced by bacteria, feeding on the unabsorbed food particles. The bacteria ferment the food and produce gas. Some of the gas will travel down the remaining part of the gut to be passed as flatulence or wind. Most is absorbed into the bloodstream across the lining of the large bowel and taken up to the lungs and breathed out.
The major cause of abdominal pain and discomfort in IBS is due to distension of the bowel. People with IBS often feel pain at lower levels of distension than others. Another cause of abdominal discomfort is severe contraction of the muscles in the gut wall, causing cramping abdominal pain. Usually (but not always) pain from the stomach and duodenum is felt in the upper abdomen, from the small bowel in the middle abdomen and from the large bowel in the lower abdomen.
Foods and eating patterns which can make symptoms worse include: - Overeating - Eating quickly - High fat foods - Caffeine - Alcohol - Stressful mealtimes - Skipping meals
For Irritable Bowel Syndrome diet plans:
There are 3 common modes of treatment for IBS.
1. Diet. We may investigate a Low FODMAP Diet, a low carbohydrate diet, a low food chemical diet or simply manipulate types of fibre and fluid. Sometimes our first course of action for an Irritable Bowel Syndrome Diet is ineffective and we move onto the next most likely cause.
2. Medication. Cramping pain may be treated with drugs that relieve muscle spasm, or peppermint oil has been found to be effective for some, or low dose antidepressants.
- Diarrhoea may be treated by drugs that slow the bowel.
- Constipation can be improved by fibre supplements, laxatives or stool softeners.
- Sleep disturbance, anxiety and stress may be treated with antidepressants.
- Antibiotics are sometimes used to treat small intestinal bacterial overgrowth.
3. Psychological Therapies. Cognitive behavioural therapy and hypnotherapy have been shown to have some benefits.
Other therapies may include the use of Probiotics, Prebiotics, Exercise, Acupuncture and Traditional Chinese Medicine.
1. The amount of gas produced – everyone’s bowel has a different combination of bacteria and some bacteria produce more gas than others.
2. Visceral Hypersensitivity - your bowel’s message of pain, sometimes given at a relatively low level of distension.
3. How well your gut moves or expels gas – for some people it sits for extended periods causing distension.
4. The way abdominal muscles react to distension – some are weaker and allow more pronounced distension causing greater discomfort.
5. How your gut reacts to stress or anxiety.
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All dietitians have some knowledge about bowel problems including constipation and diarrhea but identifying and treating the dietary cause requires additional expertise. Amanda Clark (Adv APD) has over 25 years' experience in the field and has devised an Irritable Bowel Syndrome Diet toolkit of treatments used by all our dietitians to suit the varying causes of IBS.
An initial consultation with a Gold Coast dietitian at Great Ideas in Nutrition will assess your history, what has been tried before, the investigations and tests you have had previously and the foods that you feel trigger symptoms. An order of likelihood of success will be applied to 2 or 3 treatment methods and the most likely successful one is suggested for treatment. If you wish to investigate that path, then resource materials are provided and a plan of action is set. Review appointments usually occur on a fortnightly basis until the problem is identified and resolved to your satisfaction.
Appointments may be made in person at our Tweed Heads-Coolangatta practice, our Bundall clinic or an online dietitian can be conducted via telephone or skype. Contact us for more information on 07 5536 6400.
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