Irritable Bowel Syndrome (IBS)

IBS is a common disorder involving the gut. It affects 1 in 5 people and the cause is not easily identifiable but it is thought to be due to overactivity of the gut. As a GP it is important to exclude other possible more serious causes for the symptoms which are predominantly pain, bloating, and constipation and or diarrhoea. A good history from the patient will help with making the diagnosis but I commonly do blood tests checking for anaemia, inflammatory markers and antibody testing for coeliac disease and also sometimes refer on to hospital for further examination in unclear cases.

Once I have established the diagnosis the challenge is treat IBS successfully so that my patients are able to resume a normal life. It is a complex disorder and can be incapacitating to the extent that it has a dramatic effect on a patient’s quality life resulting in social avoidance. Getting my patients better means addressing the nervous and/or muscular overactivity, considering possible food intolerance, as well as in certain cases looking at changes of bacterial balance in the gut.

Most GPs are used to prescribing anti-spasm medication for pain, laxatives for constipation, peppermint oil capsules for bloating. It is worth however spreading the net wider and considering underlying stress elements as well as looking at diet. There is recent evidence of fermentable carbohydrates playing an important role (FODMAPS).

For a number of years IBS has been treated very successfully with hypnotherapy and in the studies done in Manchester this was carried out using visualization techniques. I have found using this along side a cognitive behavioural approach has been of huge benefit to my patients. Although the patients in the Manchester Study had 12 sessions many noticed a benefit after 3 sessions. I commonly see my patients for 3-4 sessions as I record the tailor made sessions on to their smart phone or do a recording for them to play at home. Successful treatment is dependent on the individual attention paid to the particular presentation and subsequent optimum management of the dis-ease.

Comments

  1. Thank your sharing. Great knowledge.

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