About 20 per cent of the population may experience symptoms of irritable bowel syndrome (IBS) at some time during their life.
This chronic digestive disorder causes abdominal pain, diarrhoea and constipation and is twice as common in women as it is in men.
To date, extensive research has failed to identify the exact cause of IBS but it is thought it may have to do with overactivity of part or parts of the digestive tract or gut, and tests have shown that in people with IBS different parts of the gut are extra sensitive to distension (stretching) or pain.
Stress and anxiety may also be factors as these cause an overactivity of messages being sent from the brain to the gut.
About half of people with IBS can relate the start of symptoms to a stressful event in their life, with symptoms tending to worsen when they are stressed or suffering anxiety.
In addition symptoms can get worse for some people after they have taken a course of antibiotics, with antibiotics killing ‘good’ bacteria and causing an alteration in the balance of bacteria types in the gut.
The symptoms of IBS are usually worse after eating. Most people will experience a ‘flare-up’ of symptoms, lasting between two to four days, after which the symptoms improve, or disappear altogether.
The most common symptoms of IBS are:
- Abdominal pain and cramping which is often relieved by emptying your bowel.
- A change in bowel habits, eg diarrhoea or constipation or both.
- Bloating and swelling of your abdomen.
- Excessive wind (flatulence) which may have an offensive smell.
- Experiencing an urgent need to go to the toilet. If muscular damage to the anus has occurred eg in childbirth, faecal incontinence may occur.
- A feeling that you have not fully emptied your bowel.
- A sensitivity to certain foods may play a part in some cases so diet control is important. There is no ‘one-size-fits-all’ diet for IBS but dietary changes can often relieve IBS symptoms.
National President of the Pharmacy Guild of Australia George Tambassis said community pharmacies can play a major role in a number of areas to help patients manage their IBS.
“One treatment option suggested by a doctor may include lifestyle changes and these may involve stress management, introducing a healthy diet and exercise program and/or reducing alcohol intake,” he said.
“Many community pharmacies have diet and exercise programs which can help IBS patients and patients should consult their pharmacist for advice.
“A pharmacist may also be able to provide advice for patients who have been taking antibiotics.
“Restoring the gut balance may be necessary through the use of probiotics – dietary supplements that contain healthy bacteria for your digestive system.
“Probiotics may need to be taken for at least four weeks to see if they have a beneficial effect.
“Smoking can increase the risk of IBS, especially following gastroenteritis. Most pharmacists can provide counselling on how to give up smoking or direct patients towards smoking cessation products and advice.”
Pharmacists can also advise on medications, including interactions and side effects.
“This advice is particularly relevant when a patient is prescribed or advised to take medications to treat a flare-up of IBS. These can include anti-diarrhoeal medicines, painkillers, constipation treatments, antispasmodics (to ease cramping) and antidepressants (which are used to treat pain and depression),” he said.
“The use of antidepressants or psychotherapy has been found to make some struggling with IBS might feel better, a recent study reports.
“Psychiatric conditions including depression, anxiety, and somatisation – physical symptoms thought to have psychological origins – can be common among people with IBS.
“Pharmacists play an incredibly important role in the care of a patient and obviously their main focus is on medication.
“However they are also aware of psychological factors behind IBS and so are crucial to the wellbeing of the patients but not just in terms of medication.
“Over and above helping with medications they can point patients to other health professionals such as psychologists, dieticians and physiotherapists who can be helpful.”