Symptoms of Irritable Bowel Syndrome (IBS) in women
Irritable bowel syndrome affects women more than men.
- what causes IBS
- diet and foods to avoid
Dr Morton's Test Kit© for inflammatory bowel disease
- abdominal pain, often provoked by eating
- bloating and trapped wind
- bowel problems, like constipation or diarrhoea
- trouble sleeping and feeling tired all the time
- indigestion (including acid reflux)
IBS in women
Irritable Bowel Syndrome (IBS) is a very common and often distressing condition which affects around 15% of the population. It occurs in both males and females, but women are more likely to suffer from it than men. Some studies have shown that women with IBS are more likely to have gynaecological problems, such as heavy bleeding, period pain and pre-menstrual syndrome (PMS). IBS symptoms can be significantly affected by the menstrual cycle.
The link between IBS and the menstrual cycle is not well understood. It is thought that the hormonal fluctuations and imbalances around menstruation might contribute. IBS symptoms can sometimes mimic the issues women experience around their periods, such as tummy pain, cramping, fatigue, bowel habit changes, and increases in stress or anxiety levels. It can be difficult for a woman to tell whether IBS is the culprit, or whether her periods are to blame.
What causes IBS?
IBS is known as a ‘functional disorder’ which means that the bowel just won’t work (function) normally in spite of the fact that there is no detectable physical abnormality within it. The bowel is essentially a muscular tube which propels its contents from top to bottom automatically by contracting rhythmically, much like a Mexican wave. IBS occurs if that wave action is disrupted without there being a physical obstruction or blockage of the bowel. This lack of an obvious cause can be extremely frustrating for people who suffer from the condition.
IBS often starts in teenage years or young adulthood. Emotional stress is a frequent trigger. Some 10% of cases start following a bout of gastroenteritis (diarrhoea and vomiting).
IBS and diet
There is increasing interest in using diet to manage IBS. For some people, food intolerances can trigger their IBS symptoms, so keeping a food diary and then excluding your personal trigger foods can be helpful.
- There are two kinds of fibre, soluble and insoluble. Soluble fibre (which dissolves in water) is found for example in oats (muesli/porridge) and in fibre supplements (such as Fybogel). Increasing soluble fibre consumption is generally helpful in treating IBS and can have the additional benefit of helping to reduce your cholesterol level. Insoluble fibre includes things like corn and wheat bran, and is generally unhelpful for IBS sufferers. Consumption should therefore be limited.
IBS exclusion/elimination diets
- In an exclusion or elimination diet, certain foods are excluded from your diet for a specific period of time, usually a few weeks. You then slowly reintroduce foods one at a time to see what reaction they cause.
- A relatively new development is the FODMAP (Fermentable Oligo-Di-Monosaccharides and Polyols) exclusion diet. FODMAPs are certain types of carbohydrates which can ferment in the gut, causing bloating and pain. The first four weeks of this regime involves a very strict exclusion diet so it should always be supervised by a qualified dietician. Studies have shown that good adherence to it will lead to significant improvement in about 75% of sufferers, especially for those where bloating is a problem.
The difference between IBS, appendicitis, coeliac disease and Crohn’s disease
IBS can be confused with many conditions, so it’s important to speak to a doctor to discuss your symptoms. Remember that IBS, although unpleasant, is not in itself life-threatening and does not cause any physical damage. It also does not cause bowel cancer. This doesn’t mean, however, that it’s not important, as the nature of IBS symptoms can be very debilitating.
IBS vs appendicitis
IBS can cause such severe pain that it can be mistaken for appendicitis or even gall bladder problems. In fact, sufferers of IBS are far more likely to have operations for these conditions than the general population.
Appendicitis is an acute infection of the appendix (part of the large intestine) that can be fatal if not treated by surgically removing the appendix. IBS is not an infection of the gut, and is not a life-threatening condition.
IBS vs coeliac disease
Coeliac disease, which is an allergy to gluten, can also be confused with IBS as it typically causes diarrhoea and bloating. There are thought to be about 500,000 adults in the UK with undiagnosed coeliac disease.
If you think you may have coeliac disease, you can be tested without needing to see a doctor by measuring the anti-tissue transglutaminase (TTG) antibodies in a blood test. You can order a coeliac disease home test kit from us by using the link above.
IBS vs Crohn’s disease
Crohn’s disease is a serious inflammatory condition of the whole gastrointestinal tube (from mouth to anus). It can cause ulcers, swelling, bleeding and abscesses anywhere in the digestive system. The gut wall looks very abnormal under a microscope.
With IBS, there is no inflammation, and no physical evidence of any disease.
IBS vs acid reflux
People with IBS are known to be at a higher risk of experiencing indigestion. There are many causes of indigestion, ranging from simply eating too much, to ulcers, obesity, medication, hiatus hernias and a condition called gastro-oesophageal reflux disease (GORD). IBS tends to be linked to GORD.
GORD happens when the muscular valve at the bottom of the gullet stops functioning properly, and allows the acidic contents of your stomach to travel the wrong way up the gullet. This is what we call acid reflux. It causes symptoms of burning and pain which can be so severe as to mimic a heart attack.
Infection of the stomach by bacteria called Helicobacter pylori (H. pylori) can also cause indigestion. Testing for this and treating it can be an important part of indigestion management. Find our home test kit for this above.
Treatments for IBS
Exercise and relaxation
Regular exercise and relaxation, for example yoga, can be helpful in controlling your symptoms, especially if they are triggered by stress.
Medicines for IBS
- Loperamide (Imodium), to control diarrhoea
- Ispaghula (Fybogel), a soluble fibre supplement
- Antispasmodic drugs which relax the muscle coat of the gut wall, including hyoscine (Buscopan), peppermint oil (Colpermin) and mebeverine (Colofac)
- Antidepressants (specialist supervision required)
Research has shown that psychotherapy can have long lasting benefits for sufferers of IBS, with one study suggesting that the positive effects of therapy can last six to twelve months.
When should I contact a doctor?
You should always speak to a doctor if you think you have IBS to rule out any other conditions and discuss possible management plans.
There are also some warning signals that you should watch out for. If you experience any of the following symptoms, it is important that you speak with a doctor as soon as possible.
- suddenly worsening indigestion
- unexplained weight loss
- persistent vomiting
- vomiting blood or what looks like ground coffee (old blood)
- passing blood in your stools or passing tarry, sticky stools (old blood)
- difficulty swallowing
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