Stomach Pain: Is It IBS or a More Serious Illness?

Irritable bowel syndrome (IBS) 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 symptoms, such as constipation and diarrhoea.

Irritable bowel syndrome (IBS) affects about 10 per cent of Singaporeans, and it doesn’t discriminate between men and women, or the young and old. But it is generally less common in people over 50 compared to younger age groups.

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.

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

If your condition does not get better in two weeks or gets worse, you should see a doctor. You should also see a doctor immediately if you experience any of the following:

• Frequent vomiting or you have blood in your vomit
• Black sticky stools
• Difficult or painful swallowing
• Unexplained weight loss or loss of appetite
• Severe, excruciating upper tummy pain
• Shortness of breath, sweating, or pain that spreads to the jaw, neck, or arm 

"Irritable bowel syndrome is a common and harmless condition, but it is still little understood and its exact cause is unknown", says doctors from the Department of Gastroenterology & Hepatology at 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 colorectal cancer (also known as colon cancer). 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.

As IBS is a lifelong condition with no cure, it is important to learn how to monitor symptoms and rely on self-help measures in the event of symptom flares,.

The most important thing to monitor is the association of your IBS symptoms with specific triggers, be it food, irregular meals, medications, stress or any other factors you notice.

The best way to do this is via a symptom diary, which can be found at the back of this brochure. Using a diary to track symptoms and food intake can also help you decide what types of dietary adjustments will be most helpful.

If you notice any patterns, try and avoid or modify factors that may make the symptoms worse. 

Other eating advice to avoid triggering IBS are:

• Avoid large, irregular meals which challenge the gut much more. It is recommended to take regular, small frequent meals and to chew food thoroughly before swallowing.
  
  
• Try to drink at least 6 to 8 glasses of water daily
  
  
• Avoid or reduce gassy drinks (e.g. soft drinks), alcohol, strong tea or coffee. If you have been consuming a lot of caffeine (tea, coffee, coke), try gradually reducing your intake.
  
  
• Avoid or reduce consumption of artificial sweeteners and high fructose corn syrup (check ingredients of your groceries as many products such as ketchup, soft drinks, salad dressing, frozen food, canned fruits contain this).
  
  
• Avoid foods that are rich in oils/fat such as pastry, butter, cream, fried foods, nuts.
  
  
• If you are prone to constipation, try to increase your fibre intake with food such as fruits, vegetables, wholemeal bread, whole grain cereal products.
  
  
• If you are prone to diarrhoea or bloating, you can consider a low FODMAP diet (Fermentable Oligo, Di, Monosaccharides And Polyols).
  
  
• Regular exercises have been shown to improve symptoms of IBS. Losing weight if you are obese will also help reduce some of the symptoms.
  
  
• Adequate sleep have been shown to improve symptoms of IBS.
  
  
• If you are prone to constipation, you should follow your body’s natural pattern of increased bowel movements in the morning and after meals. Therefore, try to have breakfast at home and leave time for a visit to the toilet. Subsequently, retrain your bowel by following the same routine every day to try and visit the toilet the same time each day.
  
  
• For those with persistent bloating and belly that swells more and more as the day progresses, it can be due to poor coordination of the muscles in your belly in keeping the gas in. In such situations, it may be helpful to consider exercises that have been shown to relieve bloating.

Medical treatment for IBS

Upon confirmed diagnosis of IBS by a doctor, you may be prescribed medications to target specific symptoms. These include:

• Probiotics – Useful for diarrhoea and bloating
• Antibiotics – Useful for diarrhoea and bloating
• Laxatives – Useful for constipation and bloating

Ref: F26 (edit)

Related articles:

IBS in Singapore: More Common Than You Think

IBS: Common Symptoms and Treatments

Have IBS? Try this Low FODMAP Diet

Diet and Lifestyle Tips for IBS

Can Anxiety or Depression Trigger IBS?