Do you have severe spasms or cramps in the tummy due to irritable bowel syndrome (IBS)? If so, you’re not alone. About one in five people has IBS.

Dr Ling Khoon Lin, Head and Senior Consultant from the Department of Gastroenterology and Hepatology at Singapore General Hospital, gives detailed answers to your questions.

Question by turquoise

Hi Dr Ling,

I've been diagnosed with IBS & advised to have colonscopy done, however, am afraid of the risks & also am suffering from depression & anxiety. Is there any other alternative test?

I have several bowel toilet visits daily before & after meals, why is this so? Mostly, it's watery & occassionally accompanied by some hard stools.

I feel easily bloated & gaseous. I've tried taking smaller meals.

Is there any specific food to avoid or treatments to improve as it's very distressing. Thank you.

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

It will be most appropriate to discuss with your doctor what alternative tests there are to colonoscopy.

If you have IBS, then alternating loose and hard stools may be a symptom of IBS.

Question by vltoo

Hi I have a problem that my stomach will get a bitpain, bloating and gassiness about 30 mins after my each meal. Any treatment can be done?

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

You might want to talk to your doctor what the most appropriate treatment is availabe.

Question by tanny

Hi Dr Ling, Thank you for your time in reading this question. I have been drinking a traditional chinese medicine everyday and it is supposed to expel the toxins from my body through solid waste. However, my stomach just feel weird and i keep experiencing flatulence and most of the waste is watery. the practitioner said that after i stopped having this symptoms it means that my toxins are all out and i am said to be healthy after that. my concern is, is this way dangerous? will it affect anything?

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

It will be difficult for me to answer this question. It is best to present this question to the person giving you this treatment.

Question by mosmos

I am not sure whether I am having IBS. Everytime I have a slightly heavier meal at home or outside, after about 30 minutes to an hour, I will have stomach cramps and diarrhea with loose, watery stools. This diarrhea will last for 2-3 times to the toilet. I have seen a GP before and she said I did not get any food posioning.

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

I would suggest you discuss this with your doctor. It is difficult to come to a diagnosis online.

Question by octane

Is there any food to avoid eating at each meals to prevent IBS? Or are there any food which eat together will caused IBS? I tend to avoid drinking fizzy drinks as the next moment I will get bloated stomach and watery stool the next day.

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

Fizzy drinks should be avoided if you have a bloated abdomen. Other things to avoid will be beans, broccoli and cauliflower.

Question by ktphua

Dear Dr Ling,

I had abdominal pain since mid'08 and despite gone through many scans but proved fruitless.

Scans History

13.09.08 Barium enema (no colonic lesions detected)

05.01.09 CT abdomen (CGH)

01.03.10 Blood Test (CGH)

10.03.11 Colonoscopy (CGH)

23.08.11 X-ray abdomen (cGH)

Medicines : omeprazole capsule/domperidone tablet/meteospasmyl/probiotics 112.5 billion capsule

Despite taking all the above medicines still left abdominal pain does not goes away. Sometimes burning sensation at left abdomen cavity and most of the times gawning pain.

According to finding it due to abdomen musle sensitive.

Is this due to IBS/G.E.R.D or others?

Please advise, thank you.

rdgs,
phua kok too

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

Usually when doctors way that you have a sensitive abdomen, we are referring to IBS. But it is best to check with your doctor if you have IBS or GERD or something else.

Question by Alice

I just want to find out if:

• Root of IBS is due to diet and lifestyle ?
• Does people who suffer from gastric have the likelihood to suffer from IBS ?
• I feel bloated and gaseous usually during a lunch/dinner (but not breakfast). Is this IBS related ?

Thank you for your time in advance.

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

There are many theories about what causes IBS. Theories include those on diet, stress, the bacteria in our intestines, the brain gut axis and the immune system.

Many people with ‘gastric’ actually have something called non-ulcer dyspepsia. This is a condition which is related to IBS. Some people can have both IBS and non-ulcer dyspepsia.

The bloating after lunch or dinner may be IBS related. But this is best discussed with your doctor.

Question by pinkiechloe

Hi Dr Ling I had endoscopy done 6 years ago and was diagnosed with IBS. It was due more to stress rather than food intake. I had been trying to take more fiber but my stomach still bloated and my bowels movements is like every 4/5 days a week. What is the recommended period to do endoscopy test again? And how to reduce IBS if related to stress and depression?

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

I would suggest you discuss this with your doctor. The appropriate period for endoscopy depends on factors like age, family history etc

Question by anggielow

I have persistent lower abdominal pain. Nothing seems to relieve the pan. I have a history of ovarian cyst. The abdominal pain does not seem to be triggered by any food. I was dignose with chronic pelvic pain. Some doctors say it's due to gynea problem, but the gynea say is due to constipation/digestion problem. I've done all scans & results are normal. Sometimes I feel very bloated. Most of the time I don't have the urge to pass motion & the doc say is constipation so I keep taking laxatives. but it does not relieve the pain. Do I have IBS?

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

I would suggest you discuss this with your doctor. It is difficult to come to a diagnosis online.

Question by sandy_ylk

Dear Dr Ling,

I have been troubled by spasms/cramps in the tummy, diarrhea after every meal, for almost 12 years. I have all the symptoms of IBS but no doctor has ever diagnosed me of it. All I have been given is gastric medication but my bloated tummy problem never ever subsides.

Every time when I have the runs, I will always feel that I have never cleared the bowel fully yet and most of the time ended up in the toilet for more than 30 mins and cramps starts and I break out in cold sweat.

Also, condition seem to have worsen now when I start experiencing weight gain by a lot and also bleeding in stools. I would like to know if it is advisable for me to do a gastroscope or colonscope?

What can I do to improve the situation?

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

I would suggest you discuss your diagnosis and the need for endoscopy with your doctor.

Question by hobt1112

HI Dr Ling I have self diagnosed IBS myself from a magazine 3 years ago and have been taking lactulose bought OTC twice daily. I feel laxative dependant and do not wish to continue but it feels annoying because I do not pass motion every day. Also i get noticeably bloated when I drink caffeine but it does help me in going to the toilet. Pls advise! thanks

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

Normal bowel habit can be anywhere from 3 times per day to once in 3 days. However, whether you should (or need to) pass motion everyday should be best discussed with your doctor.

Question by chime07

Dr Ling,

I am 36 this year, male.

I was suffering from depression and mood swings from June 2011 till September 2011, and during this said period I have been ultra senstitive to stomach activites, left abdominal discomfort, right abdominal discomfort and sometimes coupled with diarrhoea or loose stools. All this added to my worries of colorectal cancer or stomach cancer during the period.

I had history of acid reflux as well.

Seek medical advice in July/August period given some medication to help relieve the "feelings" around the tummy, the doctor mentioned it is IBS likely caused by my depression and mood swings. True enough, as my mood swings and depression goes away the situation improved.

Question is i still do have bloatedness occassionally after food and "FEELS" the activities in my stomach sometimes. My bowel habits remain the same throughout about 2 times a day sometimes 3. Is it due to acid reflux then?

And is IBS related to acid reflux?

how long does it usually take to recover from IBS?

Btw,I am on Nexium for acid reflux and it does relieve me of bloatedness each time i take it.

Thank you.

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

IBS is not related to acid reflux. IBS goes through a relapsing and remitting course, meaning that it goes through bad and good periods when symptoms get worse or better. Please discuss with your doctor about which medicine would be appropriate for you.

Question by [email protected]

Dear Dr Ling

I suspect my husband is suffering from IBs, he is always complaining of feeling bloated. Besides the dietary changes mentioned in the article, should we also consult a doctor or a specialist? Is there any danger that IBs can lead to other conditions?

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

IBS does not lead to other problems. But please consult a doctor to see if your husband indeed has IBS.

Question by Liting

I have the symptoms as you describe in the article but how do I know if I'm suffering from irritable bowel syndrome (IBS) instead of maybe Gastric acid lead to the abdominal pain.

Is there any test and/or X-ray to show the different between IBS and Gastric?

Liting

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

It will be useful to check with you doctor if you have IBS or an acid related problem. Your doctor should be able to discuss with you the difference between IBS and ‘gastric’

Question by osh

I've stapled hemorrhoids surgery one year ago which resulted in stricture and thus have difficulty in passing motion. However the colorectal surgeon said that my stricture should not be the cause of my constipation. Went for colonscopy and result was fine.

Thereafter, I was diagnose with IBS because of the frequent constipation, bloating and feeling of incompleteness. The colonrectal surgeon has suggested for a test for the anal muscle to determine if that's the cause of my frequent constipation and incomplete evacuation.

May I know if you would suggest the same for me?

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

This test is certainly something to consider.

Question by janusue19

hi Dr Ling,

I have bloated stomach and it was protuding outwards as if Im pregnant. I have gone to my company doctor for a ultrasound scan and the result is that they say there are fats around the liver and there is alot of gas and also there is a small cyst in both my ovaries. The doctor told me for the cyst i do not have to do anything at the moment as its too small but unless my stomach keeps growing or it becomes painful to come back. She has told me to avoid certain foods like fried foods etc. Do you think I also have IBS as the bloating persists and eventhough I have avoided certain food sometimes i feel so bloated that I am out of breath when i walk up and down the stairs. Should I go for further tests? Please advice. Thanks Doctor.

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

Bloating is one of the symptoms of IBS. However, please discuss with your doctor if you have IBS as there are other possible causes of bloating.

Question by hyleong2000

Hi Dr Ling How can you tell if I am suffering from IBS, just gastric problem or flatulence/diarrhea.TCm tells me that I have gas in stomach, I have soft stools mant times that I can go to the toilet 5 times once, to finish the irritated stomach. Thanks.

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

I’m afraid it is difficult to do consults online. Please consult your doctor instead regarding your question.

Question by my

Dear Doctor My mother has IBS but she enjoys spicy food. Is there a way to work around this problem or she would have to change her diet? Also, is IBS hereditary? What are my chances of developing it? Thank you.

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

Based on current knowledge, IBS is not hereditary. While spicy food may bring on the symptoms of IBS, I sometimes tell my patients that if they need to eat it, then go ahead and eat. Just be mentally prepared that your symptoms may return.

Question by bernard68

Does one have irritable bowel syndrome (IBS)can still take spicy food or need to avoid it?

Regards
Ng Poh Chye

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

While spicy food may bring on the symptoms of IBS, I sometimes tell my patients that if they need to eat it, then go ahead and eat.

Just be mentally prepared that your symptoms may return.While spicy food may bring on the symptoms of IBS, I sometimes tell my patients that if they need to eat it, then go ahead and eat. Just be mentally prepared that your symptoms may return.

Question by premasubramania

Hello Dr Ling.

Does lactic acid (milk) intolerance cause IBS?

Thank you.

Prema

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

Dear Prema Lactose intolerance can cause IBS like symptoms. However, it is not IBS.

Question by pstephlow

Hi Dr Ling,

Why is it that whenever I take chocolates, I get the bloatedness until it hurts? Is this triggering my IBS? I take Librax to relieve the bloatedness but sometimes one tablet doesn't work and I need to take 2 or 3 tabs. I had very bad cramping on three occasions lasting an hour after my lunch - does Yakult really helps in regulating my bowels? I started taking Yakult everyday and it seems to improve and no cramping but when I stop taking and took yoghurt drink instead, the cramping came back. What should I do?

Stephanie

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

Dear Stephanie You should probably discuss medical treatment with your doctor. I usually advise my patients to avoid foods which trigger off their IBS symptoms.

Question by [email protected]

Dear Dr Ling

I have been experiencing IBS for a few years. I have a sensation of incomplete bowel clearance. Sometimes i need to go to clear my bowels 3 - 4 times a day, when this happens, the following day, I will experience giddiness and the giddiness will last 2 - 3 days. Has this got to do with my IBS? Your advice is appreciated. Thanks

L Y Yong

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

I would suggest you consult your doctor about this giddiness problem.

Question by hyleong2000

Hi Dr Ling, My anus smell always and I found stools leak out to my anus with liquid stools. With solid stools, I found out that it just collects in the rectum and gives off a bad smell. Of course if I do not do my business in one day, no urge to go, people around me would say that I stink. I would go to the toilet and sure enough, there is stools at the anus already.I think I have bowel incontinence but how can you tell if it is it, when even my underwear don't soil. I went for a colonscopy which is normal and no piles is found. I can take a few times (at least twice daily, and once fives times to clear my business in a day)Because I have never soiled my underwear, I am recently then dianosed as suffering from IBS. What is the cause of IBS, how can I stop and get heal from this? Is there a cure or help for me?Thank

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

Doctors are not sure what causes IBS. There are many theories about what causes IBS. Theories include those on diet, stress, the bacteria in our intestines, the brain gut axis and the immune system

Please speak to your doctor regarding the different types of treatment you could try.

Question by fate-destiny

Dear Doctor, I Have A Very Bad Irritable Bowel Syndrome.Every Morning I Will Visit The Loo To Pass Motion A Least Three Times.I Always Have Good Dinner In The Night And I Also Eat Supper Before Sleep.Sometimes When I Feel Anxious,I Also Have A Feeling Of Stomache And Wanting To Pass Motion.Sometimes When This Feelings Comes,I Can't Pass Motion. Thanks.

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

Patients with IBS may have either diarrhea or constipation. Please speak to your doctor whether your difficulty with passing motion when anxious is due to IBS.

Question by anggielow

i have very bad lower abdominal pain (maybe due to endometriosis), chronic constapitation (no urge to pass motion at all, taking large laxative, abt 5 to 10 Bisacodyl everyday, sometimes more), bad bloatedness. I'm really desprate for once & for all cure. no more meds.. any operation options to consider.. All text done shows normal results. all docs at govt hospial just ask it's nothing, it's all in my head. taking large amount of laxative have affected my life alot, can't go out, abdominal pain worst, etc.... any surgerical option.. Please help...

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

I’m afraid it is difficult to do consult online. Please consult your doctor instead regarding your question.

Question by raviishanks

Hi Dr Ling, Greetings. I'm not sure whether i have IBS or not. My problem is I used to spend at-least 30 mins in the toilet 2/3 times a day. Especially in the morning, i used to have the sensation that the small intestine is not flushed out fully. And hence before having my lunch i used to pass motion and again before dinner i used to go to the restroom. Nowadays i also have a feeling that i have excess gas in my belly and i hear the gas sound from the abdomen after 2-3 hrs having lunch. This is becoming a show stopper nowadays. I also tried to have more fiber but it does'not helps always. Will be more greatful for any suggestion to overcome this issue. Many Thanks. - Ravi

Answered by Dr Ling Khoon Lin Senior Consultant Dept of Gastroenterology and Hepatology Singapore General Hospital

I’m afraid it is difficult to do consult online. Please consult your doctor instead regarding your question.

Ref: U11