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Here, Consultant Surgeon and Senior Lecturer and Surgeon, Colombo North Teaching Hospital and North Colombo Liver Transplant Service, Dr Chandika Liyanage talks about the irritant, who is likely to develop the condition, its symptoms and the manner in which it could be treated. Excerpts... Q: Many people suffer from a variety of long standing bowel complaints. Is IBS one of them? A: Yes Q: Explain what it is in simple laymen language? A: It is a disorder Q: How is it caused? Is it infectious? A: No. It's probably the body's response to stress, resulting from secretions of various chemicals and hormones and also it could be a result of alteration of naturally present bacteria in the gut. The new gas forming flora can cause formation of gas that causes distension of the abdomen. Though it is attributed to stress acting on the gut, modern research shows that patients with IBS have more than normal sensitive guts as well as an imbalance in the bacteria in the gut. The gasses produced by these bacteria, and the contractions of muscles of the bowels as a result of chemicals, cause pain and bloating. Q: What organ or /organs does it affect the most? A: The large bowel. Q: Who are most at risk of getting it? A: Young persons. And two thirds of them are females. Q: Are men or women more vulnerable? A: Women. Q: Are there exceptions? Can children get it? A: Very rarely Q: Is there a new trend that seems to be of concern to health officials? .e.g like younger people being affected? A: We see many younger and younger persons including adolescents and persons in their early twenties complaining of these symptoms. The fact that more young persons are increasingly becoming affected by this condition does not augur well for society in general. It means their work output could be affected and their productivity would be reduced. Those with IBS are often absent from work. IBS also affects mental and physical wellbeing and make the sufferers become isolated as they do not take part in pleasurable activities, which are common at their age. Q: What are the symptoms? A: Bloating. Constipation. Diarrhoea. Or a mixture of both. Q: How are they diagnosed? A. Usually from the symptoms they present. There are no significant signs, excluding other sinister problems, which surface after investigations. Q: What tests do you use? A: Colonoscopy . Upper GI endoscopy to exclude other serious pathology Q: Are there different types of IBS? A: Yes. Q:Name some of them. A: Spastic IBS, Diarrhoea predominant IBS Q: Are symptoms the same? Similar? Or very different? A: Different. Spastic IBS patients have constipation. Q: What are the main complications of the disease? A: No major complications but their lifestyle get affected. Q: What is the treatment? A: Symptomatic treatment and life style modification. Q: Can IBS be prevented? A: Good dietary habits and reduction in stressful life style Q: Is it a lifetime condition? A: No Q: Has allergy anything to do with its cause e.g. allergic reactions to peanuts, dairy foods etc? A: No. But some benefit from gluten free diet and lactose free diet Q: What role does diet play in reducing risks or aggravating the disease? A: More fibre diet with less refined sugar Q: What kind of foods do you usually recommend for people with IBS? A: A high fibre diet as well as a low calorie, low fat , less carbohydrate diet Q: Is IBS linked to pre-conditions like diabetes, cancer, heart disease etc? A: No Q: Does mental stress aggravate it? A. Yes. But it is probably a subconscious effect. For example some believe it could indicate the presence of cancer. If physicians over investigate them, it could further aggravate these fears. Q: What about tablets used for certain illnesses, like anxiety pills etc? A: No. Q: If diagnosed with IBS, what is your advice to a new patient? A. Life style modification and a high fibre diet with low fat and less carbohydrates. It is important that patients seek an advice of a specialist through their general practitioner if there is prolonged abdominal discomfort. This is important as self medication and diagnosis can totally miss a serious medical problem that can mimic IBS. Q: Any new breakthrough or studies done on IBS in recent years? A: There is a theory that it is a disease caused by bacterial imbalance. Q: What are the facilities available for diagnosis and treatment of IBS in Sri Lanka? Are there any specialised units in hospitals? Any doctors specialised in the field? A: Gastroenterologists are qualified to investigate and treat them. Q: What are the gaps you see in this field? A: Patient education. Many people are still not aware about this disease and the more awareness raising we have on IBS, the better, especially in the case of young people, who are now a high risk group. Q: What are the main complications of the disease? A: None Q: What experiences can you share of your own hands on experiences with IBS patients abroad and the way they deal with them? A: We usually advise them to change their life styles. Life style modification and stress reduction go a long way in reducing the risk of IBS. Q: What steps do you think should be introduced to reduce the number of IBS patients in Sri Lanka? A: As I mentioned, awareness raising for potential and already affected patients is important. Also, there is no need for over investigation or extensive treatment. Q: Do you have any proper national data on IBS? Are you planning to in the near future? A: As far as I know I don't think so.
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Tumult
in the tummy 
