For as long as she could remember, Ms Kyla Tan had trouble with her bowels. She experienced pain regularly, with severe attacks lasting as long as three days, accompanied at times by diarrhoea or constipation.

But the pain from one episode three years ago was so intense that she had to be admitted to hospital.

As a nurse at Singapore General Hospital’s (SGH), Department of General Surgery, the 21-year-old was familiar with such symptoms, which could be due to a condition as harmless and common as irritable bowel syndrome (IBS), or something more serious like colorectal cancer. She suspected the former, and was relieved when the diagnosis following her hospital stay confirmed it.

“Sometimes, the stomach pain got so bad that I was bent over for the most part of the day and could hardly walk. But I was glad the tests confirmed irritable bowel syndrome and not something more serious,” said Ms Tan.

"Irritable bowel syndrome is a common and harmless condition, but it is still little understood and its exact cause is unknown", says Dr Vikneswaran Namasivayam, Consultant, Department of Gastroenterology & Hepatology, Singapore General Hospital (SGH), a member of the SingHealth group.

“The symptoms can be severe at times, but irritable bowel syndrome is not life-threatening and does not lead to serious conditions such as colon cancer,” said Dr Vikneswaran. “Most patients improve once they learn to cope with their symptoms.”

He said that some people with the condition have “intestines that move either faster or slower than normal”, and added that patients are more likely to suffer from stress and anxiety, which aggravate the symptoms. Women also tend to suffer from the symptoms when menstruating.

Treating the symptoms of IBS

Many people go through life without knowing they have the condition if the symptoms are mild. But more people are seeking medical attention, probably because of greater awareness of the condition, said Dr Vikneswaran, noting that irritable bowel syndrome is the most common condition seen at his department.

In most cases, treatment for IBS consists of pain medication to ease the symptoms. Patients are asked to look out for triggers – mostly food and stress – and to avoid them.

Maintaining a food diary can help identify the foods that cause the symptoms. Caffeine, fatty food, alcohol and complex carbohydrates tend to be the culprits, said Dr Vikneswaran.

Otherwise, leading a healthy lifestyle with regular exercise, a balanced diet and a positive attitude helps people with the disorder.

Some people have found that eating yogurt or mint can help. However, yogurt can cause people who are lactose-intolerant to develop symptoms similar to irritable bowel syndrome, said Dr Vikneswaran.

In Ms Tan’s case, eating spicy food often set off a severe bout of diarrhoea – up to six or seven times a day – and intense stomach cramps. A ready stock of anti-diarrhoea pills helps to keep the symptoms at bay.

She also takes daily medication to control the intestinal spasms which, in her case, can occur even when she avoids food that is known to trigger the symptom.

Ms Tan doesn’t allow the disorder to disrupt her life, though she concedes that “the diarrhoea is actually quite troubling”, especially when she is out, because “it’s very difficult to find a clean public toilet”.

Even so, she still meets friends for meals and continues to go for morning runs. She also indulges in spicy food occasionally, but in moderate amounts.

“I still eat a McSpicy or some laksa, nasi lemak or tom yam soup if I don’t have to work the next day. I just enjoy the food and suffer the consequences the next day!” she said.

Irritable bowel syndrome is a common disorder

Irritable bowel syndrome is a common disorder which occurs when the nerves of the intestines are oversensitive, which affects the way they function.

A normal amount of gas in the stomach can bring about abdominal discomfort or bloating, which is relieved once the bowels are cleared. Patients may also experience other s​ympto​ms, such as constipation and diarrhoea.

The condition affects about 10 per cent of Singaporeans, and it doesn’t discriminate between men and women, or the young and old. But it tends to be more commonly seen in people below 50 years of age.

The disorder also seems to affect those who are more highly educated and on the higher rungs of the socioeconomic ladder.

Some patients develop irritable bowel syndrome after a severe gut condition, but most patients with gut infection do not go on to develop the disorder.

Could it be something more serious?

The symptoms of irritable bowel syndrome, such as bloating, stomachache, constipation and diarrhoea, could be associated with those of many other disorders.

It is therefore best to consult a doctor to rule out more serious conditions with similar symptoms.

Consult a doctor immediately if you

  • are distressed by your symptoms
  • develop symptoms for the first time after age 50
  • have a family history of colorectal cancer or inflammatory bowel disease
  • have other symptoms such as rectal bleeding, unintended weight loss, low blood count (anaemia) or diarrhoea that awakens you from sleep

Ref: S13