Irritable bowel syndrome can save your life!

Irritable bowel syndrome is one of the commonest and most troublesome of all diseases. Some experts claim that at one time or another as many as one in three people suffer from it. It affects men as much as women and it affects the young as much as the old. Children under ten can get it and there are many sufferers in their seventies and eighties.

Irritable bowel syndrome (IBS) probably affects as many people as toothache or the common cold.

It is also one of the most commonly misdiagnosed of all diseases - and one of the most badly treated. Once it has developed it hardly ever disappears completely.

That's the bad news.

But there is good news.

First, irritable bowel syndrome isn't dangerous or life-threatening; it doesn't turn into anything more serious, it won't turn into cancer and it won't kill you or even threaten your life. The symptoms associated with irritable bowel syndrome may be exhausting, irritating, worrying and disabling but there is no underlying pathology.

Second, although it does tend to hang around - once you have got it you've probably got it for life - irritable bowel syndrome can be controlled. There is no quick, simple, reliable cure because there is no clearly defined cause. But although you may not be able to conquer irritable bowel syndrome completely - and make the symptoms disappear - you CAN control it.

Third, and possibly most important of all, having irritable bowel syndrome can actually save your life. Not only are observant IBS sufferers more likely to notice changes in bowel habit which might indicate a developing cancer, but the fact that IBS sufferers usually find that they have to limit their intake of fatty food means that individuals with IBS are probably less likely to suffer from heart disease or cancer - the two biggest killers of our age.

Not many irritable bowel syndrome sufferers have less than three of the symptoms I'm about to describe - symptoms which I am going to group into categories simply for the sake of convenience.

First, there are the primary symptoms which involve the bowel itself and what goes on inside it. Pain is probably the most obvious of these symptoms - though it is also one of the most variable. It is often a colicky, spasmodic sort of pain which comes and goes in waves; it can affect just about any part of the abdomen and it frequently fades a little when the sufferer goes to the toilet. Bowel irregularities are common too.

Most sufferers complain of diarrhoea - which can sometimes be quite sudden and explosive - but, oddly enough, constipation is also a common symptom. Sometimes the two problems alternate.

The third very common bowel problem associated with this complaint is wind and this really is typical. Most sufferers complain that their tummies swell up so much that their clothes don't fit them properly. Many complain of embarrassing rumblings and gurglings and other noises and of the social problems associated with escaping wind.

In a survey of irritable bowel syndrome sufferers which was published in the British Medical Journal, it was found that every single patient with this problem complained of these three symptoms: abdominal pain, abdominal distension caused by wind and an abnormal bowel habit.

Next, there are the secondary symptoms which affect a lot of sufferers but which don't affect all patients. You're almost certain to have the three primary symptoms but you are unlikely to have all of these secondary symptoms.

One or two of the secondary symptoms are caused by wind that is so widely associated with irritable bowel syndrome and these will probably come and go as the wind comes and goes. Symptoms in this category include a feeling of being full all the time and not being able to eat very much, a constant feeling of nausea, heartburn and indigestion. Back pains of one sort or another are also fairly commonplace and these too are frequently a result of wind accumulating in the intestines. It's even quite common for irritable bowel syndrome sufferers to complain of urinary frequency and other bladder problems caused by pressure produced by wind in the intestines.

Last, but certainly not least, there are the mental symptoms which aren't in any direct way related to the intestines or what is going on inside them. Anxiety, depression and irritability are all common but the one mental symptom that really seems to affect irritable bowel syndrome patients more than any other is tiredness.

Even though you may be quite convinced that you are suffering from irritable bowel syndrome you shouldn't make the diagnosis by yourself without visiting your doctor. Although irritable bowel syndrome is probably the commonest of all bowel problems today there are other problems which can cause bowel symptoms and only by visiting your doctor can you be absolutely sure that you have got the diagnosis right.

What causes irritable bowel syndrome?

There are two main answers.

The first is stress.

I know that the word 'stress' has been used a lot in the last few years. And you may feel that it has been overworked. But the plain fact is that all muscles can be tightened up when you are under too much stress. Tension headaches are a good example of what happens when the muscles around your head are tightened by worry and anxiety. The muscles in your bowel walls are no exception - they are as vulnerable and as susceptible to stress as any other muscles - and in some individuals it is these muscles which suffer first when stress starts to get out of control. Lots of people who don't suffer from irritable bowel syndrome do get diarrhoea or cramping pains in their tummies when they are under too much pressure or when they are anxious.

The second explanation for the current epidemic of irritable bowel syndrome lies in the type of food we tend to eat these days.

In the last century or so the people who produce, market and sell our food have changed our diet almost beyond recognition.

Today most of us tend to eat a bland over-refined diet that contains very little natural roughage. And the result is that our bowels can't cope very well with this change - they haven't had time to adapt and so they struggle. Our grandparents ate a diet that contained lots of raw, natural foods. We tend to live on prepackaged, convenience foods that may be rich in vitamins and minerals but which are dangerously short on fibre. In addition, many modern packaged foods are far too rich in fat for our health.

Although there is no single wonder cure for irritable bowel syndrome there are a good many ways in which you can control your symptoms.

First, you can take a good, hard look at the amount of stress in your life.

Try, for example, to make a list of all the things which worry you, which make you feel uptight, which keep you awake at night, which give you butterflies in your stomach or which you know upset you.

Try to decide what things are really important to you. Decide how you are going to allocate your time. And make sure that every week you take some time off.

If you want to relax properly you're going to have to work at it - and that will take a little effort and a little time. Learning to relax is like learning to drive a car or learning to play golf or learning to dance: you'll only get good at it if you put some effort into it.

Next, you probably need to take a long, cool, careful and critical look at your diet.

You may benefit if you gradually (and it is vital to be cautious) increase the amount of fibre that you eat. To do this, start eating wholemeal bread or high bran cereals. Eat wholewheat pasta, brown rice, oats - in porridge for example - and more fresh vegetables and fruit, though if you suffer a lot from wind you will probably be wise to avoid any vegetables - such as sprouts - which seem to cause a lot of wind. Nibble fruit and nuts instead of chocolate and sweets.

Try to cut down your fat intake too.

If you eat meat then cut off the visible fat and avoid red meats as often as you can. Drink skimmed or semi-skimmed milk rather than the full fat variety; buy low fat salad dressings, single cream rather than double and eat more fish. Make low fat pastry, don't add fat when cooking, and grill, bake, steam, poach, casserole and boil rather than roast or fry. When you make chips, cut them thickly so that they soak up less fat and make sure that the fat is sizzling hot. Replace butter on vegetables with herbs and instead of butter on bread, use a low fat spread. Many IBS sufferers find that cutting down their fat consumption is the most important way to control their symptoms.

Next, try to do more exercise. Don't make the mistake of adding stress to your life by trying to run faster than anyone else or by trying to win the local tennis club trophy. But do try to take more exercise that is fun. Walk, swim, dance, cycle or work out in the gym - all those things will help you because gentle, regular exercise seems to have a soothing effect on the bowel.

Finally, although your IBS may well be with you forever (it is rare for the symptoms to disappear entirely) remember that by forcing you to change your diet for the better, IBS is one of the very few non life-threatening diseases that can actually save your life!

Copyright Vernon Coleman 2003