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Irritable Bowel Syndrome (IBS)

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What is Irritable Bowel Syndrome (IBS)?

Irritable bowel syndrome, or as it is commonly called, IBS, is a gastrointestinal condition that can be quite debilitating and has been known to adversely affect the quality of life. It affects 1 in 5 Singaporeans and is the second most common reason for calling in sick.

Not to be confused with irritable bowel disease (IBD) which comprises Crohn’s disease and ulcerative colitis, IBS is a common chronic condition affecting 9-23% of the world’s population. It impacts the gastrointestinal tract and is not harmful, in the sense that it cannot lead to any gastrointestinal malignancies like cancer, but it can be very disruptive and embarrassing.

What causes IBS?

A study conducted in 2014 found that the exact cause if IBS is still unknown and poorly understood, however, there are several characteristics that have been observed in individuals with IBS, these are:
  • Intestinal muscle contraction: individuals with IBS tend to have altered intestinal muscle contractions.
  • Visceral hypersensitivity: visceral organs, which consist of the organs in your chest, abdomen, and pelvic region, are more sensitive to pain in individuals with IBS. This stems from issues in the nervous system that over-reacts when the gastrointestinal tract moves and stretches during digestion.
  • Infection: a bacterial or viral infection which causes diarrhoea, also known as gastroenteritis, can cause IBS.
  • Inflammation: one of the persistent issues seen in individuals with IBS.
  • Stress: exposure to stress in the early stages of life can result in numerous IBS symptoms.
  • Gut bacteria imbalance: microbes in the gut of individuals with IBS are different from those who do not have IBS. 

What are the common symptoms of IBS in Singapore?

The symptoms of IBS vary from person to person. If you suffer from IBS, you may have one or more of the following symptoms:

  • Abdominal pain or discomfort
  • Change in appearance of stools
  • Bloating
  • Change in frequency of stools
  • Acid reflux or heartburn
  • Headache
  • Muscle aches and pains

Because the symptoms of IBS are so varied, it is commonly misdiagnosed as other medical conditions. 

Is Irritable Bowel Syndrome (IBS) painful?

Yes, individuals with IBS often report abdominal pain and other symptoms that may cause pain.

Who is at risk of IBS in Singapore?

A 2017 study found that individuals with the following factors are more at risk of IBS:

  • Infection resulting in food poisoning: eating or drinking contaminated food and drinks can result in food poisoning which puts an individual at 4 times a higher risk of IBS than someone who has never had food poisoning.
  • Women: women are more likely than men to suffer from IBS.
  • Use of antibiotics: antibiotics are known to kill bacteria. The trouble with antibiotics is that it does not differentiate between good and bad bacteria. This results in an imbalance of bacteria in the gastrointestinal tract, which can be one of the causes of IBS.
  • Psychological distress: individuals with depression or anxiety are at a higher risk of IBS.
  • Somatic symptom disorders: individuals with somatic symptom disorders obsess over physical symptoms and senses. This makes them more prone to being hypersensitive to the normal movement of the gastrointestinal tract, especially during digestion. 

How is IBS diagnosed?

The symptoms and causes of IBS are very ambiguous, hence, accurate and diligent diagnoses must be conducted in order to prevent a misdiagnosis. There are a number of ways in which IBS can be diagnosed, these are:

  • Complete medical history: your gastroenterologist will ask you questions about your medical history, symptoms, foods that trigger your IBS symptoms, family history of IBS, etc.
  • Blood test: this helps to check for anaemia and rule out medical conditions such as coeliac disease.
  • Stool test: also done to rule out infections.
  • Colonoscopy: a thin and flexible tube with a camera and light attached at one end, is inserted into the anus and led up through the rectum and large intestine for a proper examination. 
  • Computed tomography scan (CT-scan): is a non-invasive diagnostic imaging tool that uses a combination of x-rays and computer technology to produce cross-sectional, horizontal, or axial images of our body. This helps your gastroenterologist to identify any abnormalities.
  • Gastroscopy: a thin and flexible tube with a camera and light attached at one end, is inserted into the mouth and led down through the oesophagus, into your stomach and your small intestine for a proper examination. 

The Rome III diagnostic criteria is used to diagnose someone with IBS. The criteria is that the individual must experience abdominal pain or discomfort at least 3 days a month for the last 3 months, with the beginning of symptoms 6 months prior. 

The abdominal pain must ease after defecation, and symptom onset should be related to a change in stool appearance and frequency. 

What are the treatment options for IBS in Singapore?

The treatment options vary from person to person with IBS and is used only to alleviate symptoms rather than as a cure for IBS.

These treatment options are:

  • Exercise
  • Reducing caffeinated drinks
  • Reducing stress
  • Eating smaller meals
  • Avoiding trigger foods
  • Taking probiotics and prebiotics
  • Avoiding deep fried food
  • Eat high fibre food

Frequently asked questions

Can IBS be cured?
No, IBS is incurable, treatment can only alleviate symptoms
Is IBS contagious?
No, IBS is not contagious.

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