Irritable bowel syndrome (IBS) also known as nervous colon syndrome, nervous bowel syndrome, spastic colitis and mucus colitis, is thought to affect 1 in 5 of us at some point in our lives. The causes of IBS are still unknown, although the disorder appears to affect twice as many women as men. The symptoms of IBS, which may include diarrhoea or constipation, heartburn or discomfort after eating, stomach cramps, abdominal pain, bloating, gas and lower back pain, are often triggered by stress, and tend to worsen after meals. Certain foods are also thought to trigger the symptoms of irritable bowel syndrome.
Although the symptoms can make sufferers feel extremely uncomfortable, IBS tends to be more irritating than dangerous. However, it’s easy to jump to conclusions and mistake the signs of this all-too-common condition for something more serious. While it’s always worth asking your GP for blood tests to rule out other conditions, if you are not experiencing symptoms such as bloody stools, fever or weight loss, IBS is the most likely diagnosis. Bloody faeces, excessive weight loss, increased urination, fever, anaemia and vomiting are not associated with IBS. If you experience any of these symptoms on a persistent or recurring basis, it’s important to see your GP as soon as possible so that an accurate diagnosis can be made. Read on to find out more about the conditions commonly confused with IBS.
The signs of irritable bowel syndrome may be mistaken for:
IBD (Inflammatory Bowel Disease)
IBD is often confused with IBS. However, they’re actually two completely distinct conditions. Inflammatory bowel disease, an autoimmune disorder which causes the digestive tract to become inflamed, affects approximately 1 person in 250 in the UK and is usually diagnosed in the late teens or early twenties. IBD is an umbrella term which covers ulcerative colitis and Crohn’s disease. The symptoms of ulcerative colitis and Crohn’s disease are similar, but Crohn’s can affect any part of the digestive system, whilst colitis only affects the colon (or large intestine). If it’s difficult to tell whether someone has Crohn’s or colitis, a diagnosis of ‘indeterminate colitis’ may be made. Collagenous colitis and lymphocytic colitis are less common forms of IBD – because the inflammation associated with collagenous and lymphocytic colitis can only be seen under a microscope, they are known as microscopic colitis. The symptoms of Crohn’s and colitis include pain, swelling and cramping in the abdominal area, recurrent or bloody diarrhoea, weight loss and extreme tiredness. Less common symptoms include vomiting, anaemia, fever, joint pain, mouth ulcers, irritated skin and eyes, shortness of breath, and a rapid or irregular heartbeat. The symptoms of colitis and Crohn’s may come and go, following a pattern of flare-ups and remission. Unlike IBS sufferers, IBD patients are at an increased risk of colorectal cancer.
The symptoms of haemorrhoids, commonly known as piles, include bleeding or mucosal discharge after passing a stool and itchiness, soreness, redness or swelling of the area around the anus. You may also notice a lump in the area, which may need to be “pushed in” after passing a stool. Haemorrhoids tend to be the result of chronic constipation. They often clear up by themselves, but over-the-counter medication, non-surgical treatments or, in about 1 in 10 cases, surgical intervention, may be required.
5% of us will have diverticulosis by the age of 40, and 50% by age 80, but do you know what it is? Diverticulosis occurs when small bulges or pockets known as diverticula develop in the intestinal lining. 75% of those with diverticulosis have no symptoms. However, if bacteria become trapped inside the diverticula, causing these pockets to become inflamed or infected, symptoms of diverticulitis (or diverticular disease), which can include bloating, lower abdominal pain, diarrhoea and fever, may be experienced. Upping your fibre intake may ease symptoms, but antibiotics or, in rare cases, surgery, may be required.
In rare cases, bowel pain or changes in bowel movements may be caused by tumours. Bowel cancer symptoms include persistent changes in bowel movements (including more frequent bowel movements, looser stools, constipation or blood in the stool), persistent abdominal pain and discomfort or bloating brought on by eating. Colon tumours sometimes obstruct the bowel, causing bowel obstruction symptoms such as weight loss, persistent swelling, vomiting and intermittent abdominal pain which is always brought on by eating. If you experience colon cancer symptoms on an ongoing basis, see a doctor as soon as possible.
The symptoms of ovarian cancer, which include persistent bloating, abdominal and pelvic pain, trouble eating, feeling full quickly and needing to wee more urgently or frequently than usual, may be mistaken for the symptoms of a bowel disorder. Such symptoms may also signal the presence of an ovarian cyst, which may be caused by an underlying condition like PCOS (polycystic ovary syndrome) or endometriosis.
2 million women in the UK are thought to suffer from endometriosis, a condition in which tissue which behaves like the lining of the womb is found outside the womb, for instance in the ovaries, fallopian tubes, abdomen, bowel or bladder. Symptoms such as pain passing stools and blood in the stool are often mistaken for signs of irritable bowel syndrome. Other symptoms include painful, heavy periods, pain in the abdomen, pelvis or lower back, pain during or after sex, bleeding between periods and fatigue. Endometriosis is usually diagnosed between the ages of 25 and 40, and is rare in women who have been through the menopause.
Coeliac disease, also known as celiac disease, is an autoimmune disorder in which the consumption of foods containing gluten causes certain cells lining the small intestine to be destroyed, hindering the absorption of nutrients. Coeliac disease symptoms include abdominal pain, bloating, flatulence, indigestion and constipation or diarrhoea. Some people also experience unusual weight loss or itchy rashes. Although the condition can develop at any age, it’s most likely to be diagnosed during early childhood or between the ages of 40 and 60. Your GP can arrange for you to be tested for the condition.
If you experience symptoms such as bloating, flatulence, stomach cramps, pain or rumbling, nausea or diarrhoea within a few hours of consuming products containing lactose (a type of sugar found in milk and dairy products), you may be lactose intolerant. This means that your body doesn’t produce enough of the lactase enzymes needed to break down lactose. Eliminating or cutting down on milk and dairy products may help.
A parasitic bowel infection caused by intestinal worms such as roundworm (also known as ascariasis or ascaris) or threadworm may cause symptoms of vomiting, diarrhoea or itching around the anus. Giardasis, an infection caused by the Giardia parasite, can cause cramps, bloating, indigestion, flatulence, belching, nausea, weight loss and fatigue.
Clostridium difficile (C. diff)
Clostridium difficile (C. diff) is a type of bacteria which can proliferate when antibiotics kill other ‘good’ bacteria in the gut, allowing it to grow unchecked. Symptoms include painful cramps, fever, loss of appetite, nausea and watery diarrhoea, which may be bloody.
Changes in bowel movements may be caused by thyroid disorder. An underactive thyroid may cause constipation, whilst an overactive thyroid can trigger diarrhoea.
Gallstones are small stone-like objects, usually made from cholesterol, which form in the gallbladder. If they become trapped in an opening (or duct) in the gallbladder, intense abdominal pain (known as biliary colic) may be triggered. Gallstone pain may last from a few minutes to several hours, is constant and is not relieved by going to the toilet or passing wind. It may be triggered by eating fatty foods, but can occur at any time of day, and even wake you during the night. Other symptoms of gallstones and gallbladder problems include diarrhoea, fever or chills, loss of appetite and jaundice.