IBS is classed by the medical profession as a 'functional disorder' – in other words there's nothing medically or organically wrong with the body. The cause of IBS is unknown but there are many contributing factors including long courses of antibiotics, the extended use of laxatives, trauma, stress and surgical procedures.
IBS is also classed as a 'condition of exclusion', because the medics may have excluded all other possibilities.
Once established, three factors keep the IBS in place – stress, diet and psychology (anxiety, etc).
Variants of IBS
There are three main variants of IBS:
Functional diarrhoea. Often frequent, rapid, urgent, explosive, painful and windy (up to 7 times a day). In its most severe form sufferers are confined to their homes.
Spastic Colon. It is the colon which is primarily affected. Lower abdominal pain with relief of pain occurring with defecation; the onset of pain associated with the passage of looser than normal stools. Abdominal distension, mucus in the stools. Constipation which can require hospitalisation in severe cases.
Primary Foregut Motility Disorder. Commonly affects women. Abdominal pain, often on right side. Bloating. Nausea. Loss of appetite. Feeling of very full after even small meals, then very hungry. Change in bowel habit between the two presentations above (ie diarrhoea and constipation at the same time)
GPs usually use the Rome II Criteria to diagnose IBS:
For at least 12 weeks in the preceding 12 months the patient will have experienced abdominal pain plus two of the following:
Pain relieved with defecation, and/or
Onset associated with change in frequency of stool, and/or
Onset associated with change in form/appearance of stool.
The following symptoms together support the diagnosis of IBS:
Abnormal stool frequency more than 3 times a day and less than 3 times a week
Abnormal stool form: lumpy and hard or loose and watery
Abnormal passage: straining, urgency, incomplete evacuation
The passage of mucus
Bloating or feeling of abdominal distension
NOTE: Acid reflux could be due to a hiatus hernia, so you should ensure you have been checked for this.
In addition to the symptoms, IBS raises control issues with sufferers; "If I can't control my own bowels, what's in store for the rest of my life?" You are adults, responsible for what you do – or don't do – so I usually ask you to make a contract with yourselves to take control of your IBS. That is me – and you - must realise you have to actively participate in your healing process.
These need to be dealt with swiftly, or the IBS will return. But what are secondary gains? They are the 'benefits' you may receive from being ill. I know that sounds strange when the last thing you want is to be feeling this way, but at a sub-conscious (and often conscious) level there may be much to be had from being ill:
People make allowances for you where they otherwise may not
You can avoid certain unwanted social and work situations by pleading illness
You enjoy the fuss and attention you receive
Having this problem makes you 'special' in some way
Coping StrategiesFinally, you need to deal with inappropriate coping strategies, such as excessive smoking, eating the 'wrong' foods, and taking drugs unneccesarily.
One of the first things I do is explain the mind/body connection, showing the immediate physical effect the mind has on the body, something that many people, up to that moment, had no idea about.
I then teach you how to take deep breaths, not big breaths, which helps them to regain control.
Next I explain energy balance to you – one third 'battery' (to be called on when needed), one third 'core' (that keeps us functioning) and one third 'disposable' (that we can use for all sorts of purposes). Emotional upsets drain energy away from the core. I explain that the past has gone; they need to learn to deal with the emotion, not the memory, and save that energy to heal.
I will then go on to use hypnotherapy to help deal with the stress that keeps you in the same Stress, IBS attack, Stress, IBS attack cycle that you've suffered for so long, and also to enable you to discover techniques that can help you to alleviate the IBS when your having an attack.
Eventually, I hope to achieve a point where the IBS attacks become far fewer and markedly less severe – and may dissipate altogether. This is achievable in most (but not all) cases.
By Penny Samuels
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