Irritable Bowel Syndrome

What is Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) is a prevalent gastrointestinal disorder that affects the digestive system. Characterised by a range of symptoms, IBS can significantly impact an individual’s quality of life. While the exact cause remains elusive, understanding the condition helps in effective management and treatment.

Irritable bowel syndrome is classified by how your bowel movements are affected. The types of IBS are:

  • IBS with diarrhea (IBS-D): Your poop is mainly watery and loose.
  • IBS with constipation (IBS-C): Your poop is usually lumpy and hard.
  • IBS with mixed bowel habits (IBS-M): You experience both hard and lumpy and loose and watery bowel movements at the same time.

Causes of IBS

While the precise cause of IBS is not yet fully understood, several factors are believed to play a role in its development:

Altered Bowel Motility

Some individuals with IBS experience abnormal movement in the colon, either too fast or too slow, leading to diarrhoea or constipation, respectively.

Visceral Hypersensitivity

People with IBS may have a heightened sensitivity in the gut, causing amplified pain from stimuli that are normally not painful.

Psychological Factors and Stress

Emotional stress doesn’t cause IBS, but people with IBS may have an increased sensitivity to stress-related symptoms.

Neurotransmitter Imbalance

An imbalance in chemicals within the brain, which transmit nerve signals, may affect gut function and pain perception in IBS patients.

Infection or Inflammation of the Gut

Some people develop IBS after a severe bout of diarrhoea caused by bacteria or a virus. IBS might also be associated with a surplus of bacteria in the intestines.

Symptoms of IBS


Stomach Cramps: Often relieved after going to the toilet.

Bloating: A sensation of the stomach being stretched, which may be accompanied by sharp pains.

Other Symptoms

Diarrhoea: Frequent loose stools.

Constipation: Difficulty in passing stools and infrequent bowel movements.


Symptoms can last for days to months and may vary in intensity. Be aware of ‘red flag’ indicators such as unexplained weight loss, bleeding from the back passage, or symptoms starting over the age of 60, which require immediate medical attention.

Diagnosis of Irritable Bowel Syndrome (IBS)

The diagnosis of IBS is primarily based on clinical assessment, as there is no definitive diagnostic test for the condition. The process typically involves:

Medical History

A detailed account of symptoms, their duration, and any potential triggers is taken. This helps in distinguishing IBS from other gastrointestinal disorders.

Physical Examination

A thorough physical examination, especially of the abdomen, can provide clues and help rule out other conditions.

Rome IV Criteria

Often used by clinicians, these criteria stipulate that the patient must have had recurrent abdominal pain, on average, at least one day per week in the last three months, associated with two or more of the following:

  • Related to defecation
  • Associated with a change in stool frequency
  • Associated with a change in stool form

Exclusion of ‘Red Flag’ Indicators

Symptoms such as unexplained weight loss, anaemia, blood in stools, or a family history of gastrointestinal cancers, inflammatory bowel disease, or celiac disease warrant further investigations to rule out other conditions.

Laboratory Tests

While not diagnostic, certain tests like blood tests, stool tests, and others might be ordered to rule out other conditions.

Colonoscopy or Sigmoidoscopy

In some cases, especially if there’s a family history of colorectal cancer or if ‘red flag’ symptoms are present, a visual examination of the colon might be recommended.

Treatment Modalities

Pain Medication

This involves the use of medications such as Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), opioids, and other specialised medications designed for pain management. The type and dosage are tailored to the individual’s condition and medical history.


Minimally invasive treatments aim to effectively relieve common pain conditions by targeting pain sources.

For chronic pain conditions originating from spinal issues, Neurospan can be performed by our team of pain specialists from Singapore Paincare Center.

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Managing Irritable Bowel Syndrome (IBS)

Dietary Considerations

Identify and Avoid Trigger Foods: Certain foods can exacerbate IBS symptoms. Common culprits include dairy products, certain fruits and vegetables, fatty foods, carbonated drinks, and caffeine. Keeping a food diary can help identify which foods trigger symptoms.

Low FODMAP Diet: FODMAPs (Fermentable Oligo-, Di-, Mono-saccharides And Polyols) are specific types of carbohydrates that can be hard to digest and may cause symptoms in some people with IBS. 

Increase Fibre Intake Gradually: While fibre can help with constipation, introducing it too quickly can cause gas and bloating. Increase fibre intake slowly and drink plenty of water alongside.

Lifestyle Adjustments

Regular Exercise: Physical activity can help reduce the severity of IBS symptoms by improving bowel function and reducing stress. Activities such as walking, swimming, or yoga can be beneficial.

Adequate Sleep: Ensuring a regular sleep pattern and getting enough rest can help in managing IBS symptoms. Sleep disturbances can exacerbate gastrointestinal symptoms.

Behavioural and Psychological Interventions

Stress Management: Stress is a known trigger for IBS flare-ups. Techniques such as deep breathing, meditation, and progressive muscle relaxation can help manage stress levels.

Cognitive Behavioural Therapy (CBT): CBT can help individuals identify and change negative thought patterns and behaviours that may contribute to IBS symptoms. It can also provide strategies for coping with the condition.

Maintain a Symptom Diary: Keeping a detailed record of food intake, stressors, and symptom occurrence can provide valuable insights into potential triggers and patterns. This diary can be shared with doctor to tailor management strategies.


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    Frequently Asked Questions

    Are there any genetic factors that increase the risk of developing IBS?

    While the exact cause of IBS is not fully understood, some studies suggest that there may be a genetic component, as the condition seems to run in families.

    How does IBS differ from Inflammatory Bowel Disease (IBD)?

    IBS and IBD are distinct conditions. IBS is a functional disorder, meaning it affects how the bowel works without causing visible signs of damage. IBD, which includes conditions like Crohn’s disease and ulcerative colitis, involves inflammation of the digestive tract and can cause visible damage. Receive a proper diagnosis as the treatments for the two conditions differ.

    Are there any specific tests to confirm IBS?

    There is no specific test to diagnose IBS. The diagnosis is typically based on symptoms and ruling out other conditions. However, certain tests like blood tests, stool tests, and colonoscopy might be ordered to exclude other conditions.

    Can IBS lead to more serious conditions or complications?

    IBS itself is not known to cause more serious conditions. However, chronic symptoms can impact an individual’s quality of life. Manage symptoms and work closely with a doctor to ensure optimal health.

    How common is IBS in children, and how is it managed differently than in adults?

    IBS can affect children, though it’s more commonly diagnosed in adults. The management in children is similar to adults but may require additional considerations regarding growth, development, and ensuring a child-friendly approach to treatment.

    Can changes in weather or climate affect IBS symptoms?

    Some individuals with IBS report that their symptoms are affected by changes in weather or climate, though the reasons for this are not fully understood. Monitor symptoms and adjust management strategies as needed.