What is Irritable Bowel Syndrome (IBS)?
IBS (Irritable Bowel Syndrome) is a chronic relapsing disorder of gut function, the main features of which are abdominal pain associated with an altered bowel habit, in the absence of any structural pathology.
IBS is one functional disorders of the gut (ie disorder of how the gut works); others include functional dyspepsia, functional diarrhoea or constipation without abdominal pain, and abdominal bloating without a disordered bowel habit
How big is the problem?
IBS is very common and affects, to a varying degree, approximately 15% of people in Australia. IBS is a very common reason for people to see their GP and is responsible for up to 50% of consultations with specialist gastroenterologists.
What is the cause of Irritable Bowel Syndrome?
The cause of IBS is not completely understood. The current (and not mutually exclusive) theories include:
Visceral hypersensitivity ( " a sensitive gut")
Normally most gastrointestinal processes are not felt by the individual. In IBS, these processes are felt as being painful due to the increased sensitivity of the sensory nerve endings in the gut.
Intestinal dysmotility ("a spasmy gut")
The gut can, for reasons that are not understood, go into spasm which can give colicky abdominal pain.
Post infective IBS ("a gut that remains upset")
In over 25% of cases, IBS develops after an episode of infective diarrhoea. Mild persisting chronic inflammation of the gut has been identified in some of these patients, in others it is the infective episode that is thought to make the gut more sensitive.
Psychological factors ("the mind – gut connection")
There are strong associations between psychological distress and IBS. Stressful life events increase the risk of developing IBS, especially after a gastrointestinal infection. A past history of stressful life events is more common in patients with IBS. The symptoms of IBS themselves can cause stress, anxiety and depression – and this can worsen the symptoms leading to a negative feedback loop.
Diet ("dis-comfort food")
Dietary factors can worsen IBS symptoms, through stimulating the gut. Some patients may have specific dietary intolerances that worsen IBS symptoms. Identifying these factors can lead to significant symptom improvement – but can be difficult as the gut responds in a variable way depending upon the presence of other triggers.
What is the SGS Irritable Bowel Syndrome multi - Disciplinary Team?
SGIS is the largest digestive health group practice in South Australia and one of the largest within Australia.
Specialists within this group are based in 4 main locations – Flinders Private, Wakefield Hospital, Tennyson Centre and Western Community Hospital, but do visit other metropolitan and country locations
All gastroenterologists in SGIS have been trained in the management of IBS. However, the gastroenterologists recognise that it difficult cases a team approach involving a dietician, psychologist and gastroenterologist can be very helpful.
To this end SGIS has established links with dieticians and psychologists with an interest in this field.
Dietetics and IBS
There are a number of dietary triggers that can worsen the symptoms of IBS. These can include fatty foods, caffeine, excess fibre, fermentable sugars (FODMAP™), salicylates and amines as well as artificial colours and flavourings.
The dieticians within the IBS Mutlidisciplinary team are able to perform a careful history of diet and food triggers, developing a systematic approach to food withdrawal and challenge with suspect substances.
The dieticians working within the team include:
Flinders Private and Western Community
Nick Wray BSc, Grad Dip Nut Diet, AAPD
Nick also consults outside of SGIS as a Director of Advantage Nutrition.
Tennyson Gastroenterology
Anne Schneyder BSc, Grad Dip Nut Diet, AAPD, AAN.
Anne also consults outside of SGIS as a director of Nutritional Professionals Australia
www.npagroup.com.au
Psychology and IBS
We all experience the mind gut link (hence "butterflies in my stomach" etc. In IBS this link can be used to help understand what is driving the symptoms, and what can be done to improve the symptoms.
The psychologists working within the IBS Multidisciplinary team aim to provide education about stress &the relationship between stress, anxiety, depression & physical health (bowel symptoms).Through this it is hoped to & hence the role of the psychologist, normalise physiological reaction to stress, whilst validating the reality of the symptoms. Psychological techniques that can be used include behavioural techniques – (sleep hygiene; stress reduction; pain management, gut-focussed hypnosis; behavioural activation) as well as cognitive behavioural therapy.
The psychologists working within the team include:
Wakefield Clinic
Mary King BA (Hons Psych).
www.neps.com.au
Research and Audit Activity
SGIS uses an electronic medical record. This enables our clinical activity to be audited to ensure we are delivering quality care to our patients. These audits maybe presented at scientific meetings and medical journals, all data presented is de-identified.
The SGIS IBD Multidisciplinary team does also participate in research studies. You may be approached to participate in these studies. If you receive an offer to participate, please be assured that the study is being run by one of the specialists within the IBD team, that it has been approved by an appropriate ethics committee and that if you chose not to participate it will not affect, in anyway, your ongoing care from the IBD Mulitidisciplinary team and your specialist at SGIS.
SGIS IBD Multidisciplinary Team Contact Details
Your gastroenterologist can be contacted on the following numbers:
SGIS – Flinders Private (08) 8276 9888
- Dr Elizabeth Chow MBBS MD FRACP
- Dr Alex Rodgers MBBS FRACP
- Dr Sam Edwards MBBS FRACP
- Dr Alan Wigg MBBS PhD FRACP
Tennyson Gastroenterology (08) 8292 2370
- A/Prof Peter Bampton MBBS MD FRACP
SGIS – Wakefield Clinic (08) 8359 2411
- Dr Dylan Bartholomeusz MBBS FRACP
- Dr Marc LeMire MBBS PhD FRACP
- A/Prof Chris Rayner MBBS PhD FRACP
Western Gastroenterology (08) 8235 1800
- Dr Laurie Chitti MBBS FRACP
- Dr Mahinda De Silva MBBS FRACP
- Dr Martin Tan MBBS (Hons) FRACP
If you have questions on the research and/or audit activity of the SGIS Multidisciplinary team then please contact:
A/Prof Peter Bampton (08) 8204 4964
Head of Luminal Gastroenterology
Dept of Gastroenterology and Hepatology
Flinders Medical Centre
Bedford Park SA 5042
Further Information on Irritable Bowel Syndrome
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