Irritable bowel syndrome (IBS) is an increasing problem in the community but there is help in the pharmacy to improve quality of life for sufferers
It is estimated that anywhere between 10 and 20 per cent of the Irish population sufferers with IBS, making it a huge problem in community health. Overall, it is the most commonly-diagnosed gastrointestinal problems and places a huge burden on the healthcare system. There is no cure, and women are more likely to suffer with IBS than men, with symptoms sometimes becoming worse during a menstrual cycle.
Studies have shown a link between IBS and mental health, and the symptoms are often exacerbated during times of high stress. There is also a stigma around IBS, with many people reluctant to discuss the problem in the pharmacy due to embarrassment.
Symptoms
According to the HSE, the most common symptoms of IBS are stomach cramps, bloating, diarrhoea, and sometimes constipation. Other symptoms can include bloating, flatulence, tiredness/lack of energy, nausea, backache, bladder issues, incontinence, or passing mucus from the rear end. Triggers for an IBS flare-up include caffeine, alcohol, stress, and some foods, such as very fatty or spicy foods.
Some more serious illnesses can have symptoms that mimic IBS, so it is important to be on the lookout for these. Customers should be advised to seek a medical opinion urgently if the have symptoms similar to IBS, but also have:
- Unexplained weight loss.
- Bleeding from the bottom, or blood in diarrhoea.
- A lump or swelling in stomach.
- Palpitations, pale skin, shortness of breath.
The exact cause is not known, but having a family history increases the risk of being diagnosed with IBS.
Treatment
A medical professional may suggest a course of treatment that combines lifestyle and medications. For example, the low FODMAP diet is based on avoiding food that is difficult to break down in the gut. These can include certain types of wheat products, milk, or fruit and vegetables.
As well as dietary adjustments, IBS sufferers should strive to incorporate regular exercise, hydration, good-quality and quantity of sleep, and measures to manage life stressors. It is sometimes also useful for people with IBS to keep a ‘food diary’ to help them identify the foods that cause them to have a flare-up of symptoms.
Research has also shown the value of pharmacological products in helping to manage the symptoms of IBS. The HSE states that antispasmodic agents can help with the symptoms of IBS and these may contain hyoscine, which relaxes the muscles in the bowel and abdomen to help prevent them from cramping.
The GP may also recommend psychological supports, such as counselling, to help someone with IBS to manage their stress. If a combination of lifestyle, diet, pharmacological and psychological supports have no effect in the medium term, then the customer’s GP may refer them for more specialist tests.
Advice
However, most cases of IBS are managed in the community, and the pharmacy has a vital role to play as a link in the chain of care. Aside from over-the-counter therapies, customers with IBS can be advised to cook homemade meals with fresh ingredients if possible, and should be counselled not to skip meals or eat too quickly. As well as alcohol and caffeine, fizzy drinks may also provoke their IBS, so this is again where a food diary can be useful to identify triggers.
To help with flatulence, cramps and bloating, the HSE advises eating oats regularly, avoiding the sweetener sorbitol, and using an antispasmodic. To help reduce diarrhoea, the Executive recommends cutting down on high-fibre foods, nuts and seeds, and again, avoiding sorbitol can help. There are also over-the-counter medications that can help with diarrhoea. For constipation, it is recommended to increase soluble fibre intake, take plenty of hydration, and perhaps take a laxative.
There is an important role to be played at the pharmacy counter to help provide the best advice and therapies to improve quality of life for IBS sufferers. At the counter, you also have an opportunity to discuss with empathy the symptoms a customer may be living with, to help open the conversation and dispel stigma around the condition.
