Irritable bowel syndrome

Irritating Bowel Syndrome, the name I want to give to the well-known disease called Irritable Bowel Syndrome(IBS).


Ideas and thoughts on IBS, written in a simple and easily understandable manner.




I call it 'irritating' because it is irritating to the bowel, irritating to the patient (more of a nuisance) and irritating to the doctor (patient keeps returning to gastro clinic) - this is totally my opinion. The statement might be irritating as well.


I shall actually discuss Irritable Bowel Syndrome(IBS). Do not confuse with IBD(Inflammatory Bowel Disease) which is a more serious condition (Crohn's disease/Ulcerative colitis).


Diarrhoea-predominant IBS (DPIBS)- the most common type

Constipation-predominant IBS(CPIBS) - less common

Alternate diarrhoea and constipation may also occur.




1. Young females are commonly affected.


2. Diarrhoea is mainly in the morning. Opening bowels soon after breakfast.


3. No diarrhoea at night


4. No blood with stool. Mucus may be present.


5. Abdominal cramps.


6. Bloated feeling.


7. Appetite normal but may be afraid to eat.


8. No weight loss.


9. Looks otherwise well.


In some, frequency of bowel action may be more frequent and unpredictable, so much so that they are scared to socialise. They tend to find out first whether a toilet is available nearby. The condition is rather difficult to treat.




The patient may have episodes of rather severe anal pain, mostly at night, will feel like opening bowel and after sometime he may be able to pass small amount of narrow-calibre stool, rather soft with symptoms easing after a few more minutes. At other times, constipation with passing of narrow ribbon like or pellet like stools associated with abdominal discomfort or pain. They respond fairly well to treatment.


Some suffer with mainly diarrhoea alternating with constipation.


Remember, normal bowel action can be from twice a day to once a week!


Diarrhoea is passing of loose stools 3 or more times per day.


Constipation is infrequent bowel action or the motion which is difficult to pass.


After a rather large bowel action, it is normal to have one or two days gap before bowels open again, because the colon has to be fuul and reach rectum before the urge to empty bowel will be felt.


Treatment of IBS :


Diet - In DPIBS - Avoid salads, raw fruit and vegetables, cabbage, radish, fizzy drinks. Uncooked food is difficult to digest in presence of diarrhoea and it cause more diarrhoea and flatulence. Fybogel may help trap excess bowel secretion and give body to the stool.

In CPIBS - high fibre diet with plenty of fluid is needed. Bulk-forming agents like Fybogel, Ishfagul husk are beneficial.

Yoghurt, doi at the end of a meal or probiotic drinks like Yakult may provide good bacteria in the gut. 


Medication - mainly for symptom relief. Antidiarrhoeal like Loperamide(Imodium) after a motion. Antispasmodic like Colofac, Buscopan (doctor can prescribe it).

Anti-depressants may help as well.


Stress management - by relaxation, hypnosis etc. Follow healthy lifestyle.


Spontaneous remissions can occur.


If you pass blood with motion, lose appetite, lose weight, feel ill, others say you look unwell etc, see your doctor for evaluation. IBS is a diagnosis by exclusion of organic bowel disease.