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Easing Pain for IBS sufferers

While there's no cure for IBS, new medicines and research into this debilitating illness are helping sufferers understand the condition and manage the symptoms

As well as agonising stomach cramps, bloating, nausea and constipation, Irritable Bowel Syndrome (IBS) can cause diarrhoea, meaning sufferers often have to find a loo urgently.

Triggers include infections such as gastroenteritis and E-coli. Up to a third of those who get gastroenteritis will develop IBS.

While the disorder commonly develops in puberty, it can also occur in later life after a traumatic event such as a relationship breakdown, bereavement or work problems.

Because they find the condition so embarrassing, many sufferers do not seek professional help, are often reluctant to enter into relationships and do their best to keep it hidden from friends and colleagues. This means no one knows for certain how many people have IBS, but the charity IBS network estimates that as many as 12 million people in the UK suffer from it.

"The majority", says leading gastroenterologist Dr Adam Farmer from the University Hospitals of the North Midlands, don't even see a GP and manage their illness with over-the-counter medications such as Buscopan, an anti-spasmodic- peppermint oil and laxatives."

They could however be missing out on the chance to be prescribed one of the newer medicines now available such as Linaclotide, for the treatment of moderate to severe IBS with constipation.

Dr Farmer, a medical adviser to IBS Network, urges those with symptoms. "See you GP because before you can get a proper diagnosis, we need to rule out other disorders such as inflammatory bowel disease, colitis and colorectal cancel.

"The good news is that in the past 20 years we now have medicines the help relieve the pain and discomfort. We also understand it much better

"Using frontal brain MRI imaging, we can see that the brain of an IBS patient processes signals from the gut in a different way from those without the condition. Studies have shown tahat patients with IBS are much more sensitive to the distension of their digestive tract than other people. There is a genetic predisposition to IBS. Someone who has a first degree relative with the disorder is much more likely to develop it."

It has been long recognised that stress worsens IBS symptoms. In Japan, researchers have discovered that the stress hormone plays a rile in increasing sensitivity to stress and found that people with IBS have more of this hormone.

In Belgium, researchers have been studying the roole of mast cells- white blood cells implicated in inflammatory and allergic conditions- and have discovered that when IBS patients are given medication to stabilise these cells, it relieves symptoms. "One problem, " Dr Farmer says, "is that some GP's can be dismissive and tell patients 'you only have IBS, learn to live with it." But this illness can have a big impact on a persons quality of life and relationships.

"Patients can feel fobbed off by the medical professions, yet this condition can be managed reasonably well with lifestyle changes and medication. 

"The treatment of IBS largely depends on bowel habit and whether that patient has IBS with diarrhoea or IBS with constipation. For those who have IBS with constipation, new drugs such as Linaclotide are available. For those who have IBS with diarrhoea, a new drug, called Eluxadoline is currently being assessed y the National Institute for Health and Care Excellence (NICE) and should be available in the UK by the end of the year."

Some of Dr Farmer's patients participated in a study of this drug.

He says: "We found it slowed down their bowel so it didn't contract as fast and gave them relief from their pain."

In September, he will be involved in a study of another potential treatment funded by the UK's National Institute for Health Research. It will determine whether Ondansetron, a drug already used to treat nausea, can alleviate IBS symptoms.

A side-effect of this drug is that it slows down bowel movements. Anyone interested in participating in the trial should contact the IBS Network. Dr Farmer adds: "The cornerstone of treating IBS is educations, and the IBS Network plays a huge role in this."

He also welcomes initiatives like the one from Asda earlier this year, when for a month its in store pharmacists encouraged people to open up about their digestive health and were given evidence-based advice.

Alison Reid, chief executive of the IBS Network says: "We're working hard to remove the taboo that stops people talking about IBS. We're finding people who have had IBS for 20-30 years and are too scared to go out. It has taken over their lives. Some sufferers tell us they remain single because thier symptoms make them reluctant to get intimate"

To give IBS sufferers the confidence to leave home, the charity issues can't Wait cards that they can show o retailers and others when they need to use the toilet urgently. The size of a credit card, it can be carried in a purse or wallet, Alison says: "It helps people to feel more confident about going out and gets rid of their fear of not knowing where the nearest toilet it."

The charity also advises people to keep a food and mood diary so they can recognise what's happening in their lives and what might exacerbate their symptoms.

She adds: "After doing this for two to three months, one man realised his symptoms were always worse on a Sunday. It then struck him that he was no longer enjoying his job and the prospect of going back to work the next day upset his digestive system. It's a question of learning what your triggers are to you can manage the condition. Although you can't avoid stressful situations altogether, you can learn to deal with them differently. Do something fulfilling, like painting, reading, gardening, or cycling- because this will take your mind off the situation.

Do you find Bowel health too embarrassing to talk about? Want more health information? 

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