Inflammatory bowel disease (IBD) is a collective term for chronic inflammation in the digestive tract, namely Crohn’s disease and ulcerative colitis. The main symptoms are pain, diarrhoea, fever, weight loss, fatigue and potentially anaemia. Symptoms may be different for each person and range in severity from mild to more serious, depending on the level of inflammation. Given the similarity to other digestive conditions, several tests usually need to be done to ensure accurate diagnosis. The treatment approach usually involves a combination of diet, medication, lifestyle change and sometimes surgery.
May is Crohn’s and Colitis Awareness Month and World IBD Day is 19 May. For more detailed information and support go to Crohn’s and Colitis Australia
Irritable Bowel Syndrome (IBS) – The gut-brain connection
Irritable bowel syndrome (IBS) is referred to as a functional gut disorder (FGD), characterised by persistent stomach pain or discomfort along with changes in bowel habits, mainly frequency and form. It is divided into three main subtypes, IBS-C (constipation), IBS-D (diarrhoea) and IBS-M (mixed, alternating between constipation and diarrhoea). Diagnosis is usually established once all other potential causes have been ruled out. These generally include IBD, gut infection, food allergies or sensitivities and side effects of medications such as antibiotics.
Those who experience IBS commonly report that flare ups can be painful and embarrassing with occasional or frequent loss of bowel control and involuntary passing of wind. Stress and anxiety may be significant triggers and further aggravate symptoms. Research studies have shown that levels of anxiety and depression are significantly higher, 30-50% and 30% respectively, in those with IBS compared to healthy controls.
Not surprisingly, fatigue is also common with IBS, which can affect motivation and concentration. Fatigue is usually due to a number of factors including pain and inflammation, poor quality sleep and nutritional deficiencies. Those who suffer from loss of bowel control may avoid social functions and withdraw from activities and participation because of this. When they do go out, toilet finding anxiety is also common, with outings needing to be planned around locations of toilets and avoidance of situations where this may be compromised.
Unfortunately, some people with Irritable Bowel Syndrome (IBS) are told “it’s all in the mind” a statement that reflects an element of truth when it comes to understanding the connection between the gut and the brain. Anxiety, stress and depression can cause gut symptoms, but the reverse is also true. Gut symptoms can in turn result in anxiety, stress and depression.
If you’ve ever had a ‘gut feeling’ or experienced the feeling of ‘butterflies in the stomach,’ then you may have felt the gut-brain connection. Our gut has its own nervous system, the enteric nervous system (ENS), which controls our digestive processes. The ENS is in constant connection with our central nervous system (CNS), which in simple terms means your gut affects your brain and your brain affects your gut.
If we feel nervous, anxious or stressed this can impact the motility in the gut, speeding it up for some people who may experience looseness and/or diarrhoea and for others slowing things down, leading to constipation. Similarly, if your gut is upset or irritated this can affect your mood and cause stress and anxiety.
The gut-brain connection helps us understand how mind body therapies such as meditation, cognitive behavioural therapy (CBT) and hypnotherapy can be effective in managing the flare ups and symptoms of Irritable Bowel Syndrome.
If you are experiencing some or all of the symptoms in this article, be assured you are not alone. Poor bowel control can be cured or better managed with the right treatment. Always seek the advice of a healthcare professional to ensure the correct diagnosis, treatment and management.
The Continence Foundation of Australia has several resources including factsheets which are helpful for further information. You can also call the National Continence Helpline on 1800 33 00 66 for free, confidential advice from a Nurse Continence Specialist.