Irritable Bowel Syndrome (IBS)
Definition: recurring abdominal pain at least once per week in the last three months with two or more of the following features:
- Pain related to needing to pass a bowel motion
- A change in the frequency of needing to pass a bowel motion
- A change in the appearance of the bowel motion.
Types
IBS-C – constipation
IBS-D – diarrhoea
IBS-M – mixed (both diarrhoea and constipation)
There is no test to diagnose IBS but checking to see if you don’t have other bowel conditions is important.
Please see your doctor if you have any of the above signs and symptoms of IBS.
Inflammatory Bowel Disease (IBD)
Definition: chronic inflammatory conditions of the digestive system such as ulcerative colitis and Crohn’s disease.
Features include:
- Diarrhoea
- Abdominal pain and cramping
- Rectal bleeding
- Fatigue and weight loss.
Someone with IBD needs to be under the care of a gastroenterologist and/or a colorectal surgeon to help manage their condition.
Please see your doctor if you have any of the above signs and symptoms of IBD.
Management
If you have been diagnosed with either IBS or IBD, it is important to look after yourself and your bowels. This includes:
- Eating a healthy diet and avoiding foods that trigger symptoms
- Keeping a record of the food you eat, to monitor if anything causes or worsens your bowel symptoms
- Managing your stress levels through meditation and breathing exercises
- Sleeping well. Getting enough sleep every night is important for managing fatigue
- Exercising regularly is vital for general health and wellbeing.
Continence Concerns
If you have continence concerns related to IBS or IBD, it can be beneficial to visit a continence health care professional such as a pelvic health physiotherapist or nurse continence specialist, to find out if your bowel pattern, control and comfort can be improved.
Continence concerns can include needing to rush to the toilet to use your bowels, having accidents on the way to the toilet, struggling to pass a bowel motion, feeling like you have not completely emptied your rectum or lower bowel, having accidents without even knowing and not being able to control wind.
It is always worth seeing a continence healthcare professional if you have continence concerns, to support you in understanding what is happening with your bowel and how to manage it.
Continence Assessment
A continence assessment can guide a continence health care professional to understand your bowel condition and how to support you with the condition. Questions you may be asked during an assessment includes your:
- Bowel patterns
- Bowel symptoms
- Medical history including surgical history and obstetric (pregnancy and childbirth) history
- Medications
- Diet
- Toileting posture and technique and
- Physical examination (including your abdomen, pelvic floor and anal sphincters)
Based on this information you provide, a continence health care professional will develop a management or treatment plan with you, to support you to improve your bowel symptoms, control and patterns. This may include:
- Suggested changes to what and when you eat and drink
- Pelvic floor exercises or relaxation
- Deferment or holding on techniques
- Toileting regime for when to use the toilet
- Reviewing or altering how you use the toilet
- Reviewing laxative or anti-diarrhoea medication use.
You may be referred to a dietitian to look at your diet and observe whether you should try a low FODMAPs* diet, to see if altering certain types of sugars in your diet improves your symptoms. You may also be referred to a clinical psychologist to look at any relationship stress, anxiety, depression or trauma which may be contributing to your bowel symptoms, emptying and control.
What are FODMAPS?
FODMAPs stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. These are a group of sugars which are not properly absorbed in the gut and may trigger symptoms of IBS. For more information go to monashfodmap.com/about-fodmap-and-ibs/