There are a few cornerstones of good health. Having a healthy mind, body and soul is The Holy Grail. Achieving this balance isn’t easy and can ebb and flow depending on what’s going on in our life.
Sometimes we can’t control periods of ill health and disease but there are simple things we can do to help ourselves along. Getting restful and restorative sleep, eating healthily, regularly exercising, surrounding yourself with positive people and enjoying your job have long been recognised as cornerstones of good health. (Look up the “Biopsychosocial model of good health” to read more on the importance of your social surroundings for good health). However, in recent years, having a healthy gut and happy microbiome (bacteria in your body) have also been coming to the forefront as major players in our overall physical and mental health. I’m here today to talk about gut health and the most common gut problem, Irritable Bowel Syndrome (IBS). (Of course, it goes without saying that not smoking, sensible alcohol intake and responsible sun exposure are the foundations of disease prevention but I digress).
IBS is defined as recurrent abdominal pain, on average, at least one day per week in the last three months, associated with either constipation or diarrhoea and/or a change in stool appearance. The main subtypes are “constipation predominates IBS”, “diarrhoea predominates IBS” and “IBS with mixed bowel habit”. Check out The Bristol Stool chart if you are someone that inspects stool appearance. It can be really helpful in letting you know if you’re constipated or not; I use this a lot at work to talk to people about their IBS symptoms. It’s very handy. Bloating, passing mucus and a feeling of incomplete emptying is also commonly reported. In fact, there’s not a week that goes by without a patient reporting bloating to me. It’s a nuisance that influences our wardrobe choices at best and a debilitating symptom that interferes with our activities of daily living and lands us in hospital at worst. It is associated with chronic fatigue, anxiety and depression too. It’s no wonder really; who can feel happy, healthy and confident with a bloated and sluggish gut?
This syndrome is quite common; the prevalence in The Western world is estimated to be about 10-15%, with women being affected more commonly than men (It’s a man’s world eh?!). Women tend to be more prone to it due to monthly hormonal changes that can affect the bowel. This is a topic close to my heart as I suffer from IBS myself and I personally get particularly bad flares during my premenstrual phase. There’s a reason I’m fond of a flowy gúna.
Diagnosis of Exclusion
It must be remembered that IBS is a diagnosis of exclusion, meaning that all other causes of your symptoms have been ruled out first. In this case, it means ruling out diseases like Ulcerative Colitis, Crohn’s disease and Coeliac disease.
I’m often asked if there’s a test for IBS and the answer is no. If you report bloating or a change in bowel habit to your doctor, he/she will discuss your symptoms further and examine you. He/she may look at your eyes and nails for signs of anaemia and/or liver disease and examine your skin for rashes associated with gastrointestinal problems; the skin and eyes can tell so much.
Depending on exam findings, blood tests and camera tests (colonoscopy to look at the bowel and gastroscopy to look at the stomach) may be needed. Your GP will make a decision about what is needed. Once all serious pathology is ruled out, a diagnosis of IBS can then be made. For this reason, reaching the diagnosis can often be a lengthy process spanning across months or even years.
Don’t believe everything you read
I see so much advice on bloating in the general media and it does kind of bother me because a lot of it isn’t “evidence-based”. Evidence-based means medical practice based on peer-reviewed scientific research and evidence. Sometimes remedies that aren’t evidence-based may work; I accept that but I won’t recommend them. It’s bad medicine and irresponsible.
What works for one person may not work for another which is why it pains me when I see people promoting health products and saying “this skinny tea really works for me” etc. That’s just one person. In order to make a change to your life and invest your money in your health, you need to base it on more than one person’s experience. I enjoy Instagram and social media but this aspect of it troubles me a bit.
Treatment of IBS
There are treatments and lifestyle changes that can help with IBS and I will write about those in my next instalment so stay tuned. There’s no quick fix and you really have to take responsibility for your diet and lifestyle if you’re serious about combating the symptoms.
Good health is a privilege and we have to work hard to try to keep as healthy as we can. I will also touch on non-coeliac gluten sensitivity which is also being recognised in the evidence lately. If you think you have IBS, talk to your GP.