I don’t write too many proper serious health posts on here. To be honest, that’s my day job and I write this blog for fun – but in the last few weeks I have written three features on bowels for various magazines – and in all of them one big area of digestive-newsdom has been (mostly) cut for space. Which is a shame as I kind of think it might help a lot of people. So in an attempt to get the message out there, I’m going to put the info on here. And my message is….
Grumbly bowels are not always caused by IBS
IBS affects an estimated four million people in the UK – yet it’s estimated that only a half to a third of sufferers are officially diagnosed by their GP. This causes two potential problems – the first is that you get people who merely have a bit of bloating proclaiming they have IBS (which trivialises a condition that can be a nightmare for its sufferers – and if you don’t believe me, visit Sophie Lee’s blog at ibstales.com to see the good, the bad and the ugly) – but more concerning, particularly for those who are in pain is that hundreds of thousands of ‘IBS sufferers’ may actually have a completely different condition to blame for their discomfort – and it could be one that’s more readily controlled with diet changes or medication.
The problem is you can’t test for IBS itself. If you do go to your GP, they will diagnose it by listening to your history and testing for more serious problems like colon cancer, Crohn’s disease or colitis. If all of these are ruled out you get a diagnosis of IBS. But ask a gastroenterologist and they’ll tell you there’s a heap of other issues that can cause similar symptoms and that, depending when you were diagnosed, your GP might not have checked for. Or, if you self diagnosed your issue might not even be aware existed. Here’s four you need to know about….
1) Coeliac disease. Twenty five percent of sufferers of this condition – a reaction to a protein in gluten – were first misdiagnosed with IBS. Latest medical practice means that anyone suspected of having IBS should have a test for coeliac disease, but that hasn’t always happened. ‘So there are definitely people out there thinking they have IBS who actually have coeliac disease,’ says Dr Pritash Patel from Surrey’s St Anthony’s Hospital. Removing all gluten from the diet controls coeliac disease – and while it’s not an easy diet to follow, it will eradicate symptoms. Ask your GP for the blood test if you haven’t had it.
2) Small Intestinal Bacterial Overgrowth (SIBO). Anyone who has seen a probiotic advert with cute little jumping bacteria knows that our digestive system is full of bugs that, in most cases, are good for our digestion. In SIBO though more bacteria than normal start to grow in areas that they don’t normally live. This can trigger problems like bloating, abdominal pain, constipation, wind and diahorrea. Hmmmm, sound like another condition you might have heard of? SIBO can be diagnosed with a test that measures how much hydrogen you’re excreting in your breath – and can be treated with antibiotics and a carbohydrate restricting diet. See siboinfo.com for more details.
3) BAD (Bile Activated Diahorrea): In this condition an excess of bile produced from the liver triggers stomach upsets. This can be treated with a drug called Questran and symptoms can be relieved in a matter of weeks. There’s also a clear diagnostic test for it called SeHCAT (which involves scanning the body to see how much of swallowed substance is retained) – although you might have to fight to get this done (or pay for it privately) as it’s not given as standard on the NHS. Some doctors might also therefore choose to give you Questran as a diagnostic – if you respond it’s likely BAD is part of your problem. You’ll find a really indepth post on BAD over at What’s Up With Your Health – the blog of my fellow health journalist Jo Waters.
4) FODMAP Sensitivity: FODMAPs is the linguistically friendly name for ‘fermentable oligosaccharides, disaccharides, monosaccharides and polyols.’ These are sugars that ferment in the digestive system triggering bloating and diarrhoea in some people and constipation in others. In those who have IBS symptoms, trials on eliminating FODMAPs in the diet have led to relief for up to 76 percent of sufferers. It’s a restrictive diet to follow – FODMAPS are found in a lot of different foods including honey, wheat, apples, pears, onions, garlic, artichokes and stone fruits like plums – so it’s better if your GP can refer you to a dietician for advice. If that’s not possible though food intolerance test manufacturers York Test will launch the first home test for FODMAP sensitivity in April. Find out more then at www.yorktest.com
The upshot is, if you think you’ve got a dodgy digestive system don’t assume it’s IBS – go and see your GP and ask for their help in ruling out the other potential causes. If you’ve already seen your GP, but weren’t tested for the above it might be worth going back for another chat to discuss if you might benefit from further investigation. After all, you might not need to be suffering….