IBS Awareness Month is here: Do You Have the Stomach for the Fight?

IBS Awareness Month occurs each April and this provides an ideal opportunity for attention to be focused on important health messages about irritable bowel syndrome (IBS) diagnosis, treatment options, and quality of life issues when managing the condition.

For those suffering with IBS, rest assure that there are millions of others in the same boat. IBS is a very common disorder, with worldwide a prevalence estimated at around 9% to 23%. Despite this, there are undoubtedly millions of people around the world who are suffering in silence, without a proper diagnosis, and maybe even unaware that their symptoms indicate a medically recognised disorder.

IBS is a long-term gut disorder in which abdominal pain or discomfort is experienced, usually sporadically, together with erratic bowel habits. This comes in the form of diarrhoea, constipation, or alternating bouts of both. The condition may also be referred to by one of many more outdated terms, such as irritable colon, mucous colitis, nervous stomach, spastic colitis or spastic colon.

Other symptoms may also be present, including: backache, belching, bladder problems, headache, heartburn, loss of appetite, nausea, tiredness, and quickly feeling full after eating.

Over 10% of the population suffer with IBS and this percentage could increase in the future if the nation’s stress levels rise – stress is a primary cause of IBS.

Other factors that can lead to IBS can include a combination of a number of issues such as: inflammation of your bowel (i.e. after an infection like gastroenteritis), dietary factors (foods high in carbohydrates, foods high in fat, spicy foods, alcohol, fizzy drinks and caffeinated drinks are culprits), genetics (family members may have also had IBS), or mental issues such as depression.

Unfortunately, there is no definitive treatment or cure for IBS and no ‘one size fits all’ remedy to rectify the problem, but there are certain IBS treatments that can ease symptoms for some sufferers, hopefully helping them to lead a more normal day-to-day life. These include prescription medications such as Constella, Mebeverine, Xifaxanta, and over-the-counter products such as Buscopan IBS Relief and Colpermin. The prescription medications may only be obtained by completing an online consultation with one of the Medical Specialists® Pharmacy GMC-registered doctors, or by sending a private prescription to Medical Specialists®.

There are also numerous other dietary and lifestyle choices that those with IBS may find beneficial in helping symptoms subside. These include:

. Drink around eight cups of fluid each day – preferably water. Limit caffeinated and alcoholic drinks.

. For those finding it impossible to give up tea and coffee, restrict the intake to three cups per day at the most.

. Have regular meals, evenly spaced out, and pacing yourself whilst eating. Also, do not go long periods without eating anything.

. Those with IBS that often flares-up during times of stress, depression, or anxiety, are advised to try relaxation techniques, such as breathing exercises or meditation, in addition to more physically-involved activities such as pilates or yoga.

. Consume no more than three portions of fruit per day.

. Those suffering with diarrhoea should avoid artificial sweeteners such as sorbitol. This is contained in some sugar-free sweets, chewing gum, and certain diabetic and slimming products.

. Vigorous exercise, for a minimum of 30 minutes per day. This should be done at least three times each week. It is important for patients with IBS to discuss with their GP which exercise is most suited for them.

Gut problems are one of the most common types of disorders seen by doctors and are certainly nothing to be ashamed about. If anyone is experiencing any kind of stomach complaint, they should consult a GP immediately. The GP will ask detailed questions about lifestyle, diet, etc. before making a formal diagnosis and discussing how to go forward with the condition, or make a referral for further detailed scans if necessary, to see if there is an underlying problem.

Have a gut feeling it’s more than IBS? Sufferers of SIBO flock to Medical Specialists® Pharmacy

Since Medical Specialists® Pharmacy added the antibiotic Xifaxanta (rifaximin) to their range of treatments for irritable bowel syndrome (IBS), the requests for this medication – which is also used to both prevent and relieve the symptoms of traveller’s diarrhoea – has simply skyrocketed.

Xifaxanta might be unfamiliar to the majority people suffering with IBS as the drug was launched in the UK back in 2011 primarily for the treatment traveller’s diarrhoea associated with non-invasive strains of Escherichia coli (i.e. episodes not associated with fever).

However, some doctors have suggested that patients suffering with IBS should consult their doctor about being prescribed a course of rifaximin for treating their condition, with New York times best-selling author Dr Mark Hyman recommending two 200 mg tablets three times a day for seven to 10 days as one of his ‘5 steps to curing IBS’, describing this as the ‘best way to deal with the chronic bacterial overgrowth that causes bloating and irritable bowel syndrome’.

Interestingly, Medical Specialists® have noticed a burgeoning trend; a growing number of patients that come to them requesting Xifaxanta are now stating in their online consultation that they have been diagnosed with a condition by the name of small intestinal bacterial overgrowth (SIBO), also known as small bowel bacterial overgrowth syndrome (SBBOS).

SIBO occurs when an abnormally excessive amount of bacteria begin to grow within the small intestine. The colon (large intestine) is rich bacteria, but the small intestine is not supposed to be so plentiful with bacteria. In the small intestine there are around less than 10,000 bacteria per millilitre of fluid, in comparison to at least 1,000,000,000 bacteria per millilitre of fluid in the large bowel.

Why does SIBO occur?

The gastrointestinal tract is comprised of a long muscular tube responsible for transporting digesting food to the colon. The coordinated motion of the stomach’s muscles and small intestine propels food from our stomach, then passing through the small intestine and into the colon.

During this muscular function, there is also a clear-out of bacteria from the small intestine and a limit imposed to the amount of bacteria allowed to collate in the small intestine.  Unfortunately, conditions can arise that can interfere with the regular actions taking place in the small intestine, and it is this that results in SIBO, with bacteria now able to linger for longer and multiply. Without a normal muscular activity occurring, bacteria can spread backwards from the colon and into the small intestine.

SIBO is not the product of just one single type of bacteria though, but is caused by an excessive growth of numerous kinds of bacteria that are usually present in the colon.

The specific causes of SIBO are often debated, but a number of risk factors have generally been agreed upon, which are: crohn’s disease, celiac disease (long-standing), diabetes mellitus (type I and type II), IBS, low stomach acid, previous bowel surgery, taking multiple courses of antibiotics and organ system dysfunction, such as liver cirrhosis, chronic pancreatitis, or renal failure.

What are the symptoms of SIBO?

The initial symptoms of SIBO are almost identical to those associated with IBS, and include: abdominal pain/discomfort, bloating, constipation, diarrhoea, excessive wind and indigestion.
If the bacterial overgrowth is severe and prolonged, it could be detrimental to the digestion and absorption of food, leading to a deficiency of vitamins and minerals. Weight loss can sometimes then follow as a result of this and symptoms unconnected to the gastrointestinal tract, such as fatigue and body aches. The symptoms are often chronic and a person suffering with SIBO can expect to have symptoms that can drastically vary in severity over the course of months, years or even decades before they are given a diagnosis of small intestinal bacterial overgrowth.

Diagnosing SIBO

As the initial symptoms of SIBO are non-specific and almost identical to irritable bowel syndrome, it may take a long period of time before SIBO is considered as the cause of the symptoms by the doctor or health care professional.

Instead, it is usually health problems linked to a malabsorption of proteins, fats and vitamins that will raise the alarm for any possibility of SIBO, and the patient will probably be made to have blood tests to determine any reasons for anaemia, electrolyte imbalance and vitamin deficiencies.

Next, the patient will usually have to undergo breath-tests which look for the by-products of digestion, in particularly those associated with intestinal bacteria. The common tests include a hydrogen breath test, bile acid and D-xylose. The results can help to determine if the patient’s symptoms are due to SIBO and thus the patient will not have to have a biopsy or endoscopy.

Treating SIBO

To treat SIBO, doctors and health care professionals will usually discuss with the patient ways at managing and treating any possible underlying health problems, as it is not always sufficient merely to target the excess bacterial growth. In addition, effective methods of controlling the symptoms of SIBO will be discussed as it cannot always be ‘cured’.

Antibiotics are typically prescribed to the patient as one method of controlling the excess bacteria, with the most common antibiotic prescribed for this purpose being the previously mentioned Xifaxanta. Whichever antibiotic is prescribed to the patient will not remove all bacteria though, as some are still needed to aid a normal digestive function.

So whether you suffer from IBS, SIBO, or other stomach and bowel problems, click here to go to the stomach and bowel area of the Medical Specialists® website, which is full of helpful information, links and different treatment options.