IBS specialist Perth

The power of a multidisciplinary approach to managing IBS

First published: 13 March 2023

Unfortunately, there is no test to definitively diagnose IBS or irritable bowel syndrome. In most cases, IBS is diagnosed by ruling out other possible disorders which is the gastroenterologist’s job. Once you’ve been diagnosed with IBS, Wexford Gastro’s multidisciplinary approach enables patients to be followed up by professionals along their journey. Let’s explain that in more detail.

IBS symptoms | IBS Specialist Perth

Exclude other diseases to diagnose IBS

Have you experienced abdominal pain and discomfort at least one day a week in the last three months? Did this pain lead to defecation, a change in the frequency of defecation, or a change in stool consistency?

If yes, chances are you have IBS. To be absolutely sure, we need to rule out other possible disorders. Generally, we do this by taking your history, and performing an examination and a gastroscopy or colonoscopy.

So if your GP suspects IBS, it is normal that they will refer you to see an IBS specialist.

Some gastroenterologists consider it their role solely to exclude other conditions, such as bowel cancer and Crohn’s disease. Once these have been excluded, gastroenterologists may refer you back to your GP. At Wexford Gastro, we pride ourselves on our multidisciplinary approach and are able to deliver care after you have been diagnosed with IBS.
Dr Callum Pearce, Gastroenterologist at Wexford Gastro

Given how common IBS is and given the severity of the symptoms and the misery it sometimes causes - we try to approach each aspect of the disease here at Wexford Gastro. This includes the gut itself, the diet and the brain.

Of those who seek medical care, IBS has been reported to be a more common disease in women, with a female-to-male ratio between 2.5:1 and 2:1.

Although there is a difference in numbers between male and female IBS patients, it is unclear whether these differences have to do with physiologic differences or simply differing medical care-seeking behaviour between men and women. Women are more likely to go to the doctor, and more likely to be able to discuss bowel symptoms.

It has been proposed that hormones may be a factor that affects these differences in patients, as well as the connection between IBS symptoms and the varying hormonal phases that women are subjected to such as menstrual cycle phases, pregnancy, and menopause.

Irritable bowel syndrome is falling out of fashion to describe these symptoms. Often the word “functional” is used; this generally means persistent and troublesome symptoms:

Associated with impairment or disability
Where the origin of the symptoms is related to problems with the functioning and communication of the body systems (as opposed to disease affecting the structure of organs or tissues)

And this describes IBS quite well.

The problem with the phrase IBS is that there is no evidence of irritation and the symptoms do not form what is generally understood to be a medical syndrome.

Given there is often a strong psychological element to the symptoms, some people think that labelling the patients may hinder their recovery. As such the phrase disorder of gut-brain interaction is sometimes used.

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A sensitivity problem in the gut

Rather than a medical disorder, IBS may be understood as a sensitivity problem in the gut with underlying inflammatory contributors.

Like with IBS, there are several disorders in which we see amplified symptoms arising without obvious tissue damage, such as fibromyalgia and myalgic encephalomyelitis (chronic fatigue).

All of these conditions generate genuine symptoms and are not psychological disorders in any way. Unfortunately, they can be affected by behavioural and psychological factors such as work/activity levels and stress. Managing these issues well can reduce symptom amplification and improve coping.
Carl Graham, Clinical Psychologist at Wexford Gastro

Rather than a medical disorder, IBS may be understood as a sensitivity problem in the gut with underlying inflammatory contributors.

Like with IBS, there are several disorders in which we see amplified symptoms arising without obvious tissue damage, such as fibromyalgia and myalgic encephalomyelitis (chronic fatigue).

The impact of IBS on our mental health

IBS symptoms, and the interference they cause in day-to-day life, put pressure on sufferers and impact on the ability to cope. It is normal for this to generate even more stress which in turn increases anxiety and puts ongoing pressure on a person’s mood.

Treating anxiety and mood issues that have arisen over time is important, both to help individuals cope with those issues and also to reduce the potential inflammatory exacerbation of symptoms that are associated with the presence of anxiety and depression.

Do psychological problems cause IBS?

There is no direct evidence that psychological problems cause IBS. However, there will usually be interactions between any existing psychological difficulties and IBS symptoms. Pre-existing anxiety or mood issues will make the management of disorders with underlying inflammatory contributions, like IBS, more difficult.

Panic disorder:

Panic attacks are discrete episodes of intense fear or apprehension accompanied by the rapid onset of symptoms including:

palpitations or increased heart rate
sweating
trembling
shortness of breath
chest pain
dizziness or lightheadedness
chills
hot flushes
fear of imminent death

Obsessive compulsive disorder:

Obsessive compulsive disorder is characterised by the presence of:

persistent obsessions
compulsive obsessions are repetitive persistent thoughts, images, or impulses that are intrusive, unwanted, and are commonly associated with anxiety.
attempts to ignore or suppress obsessions or to neutralise them by performing compulsions

Compulsions are repetitive behaviours including repetitive mental acts that the individual feels driven to perform in response to an obsession, according to rigid rules, or to achieve a sense of ‘completeness’.

PTSD:

Is characterised by:

re-experiencing a previous traumatic event in the present in the form of intrusive memories, flashbacks, or nightmares.
avoidance of thoughts and memories of the prior event and avoidance of activities, situations, or people reminiscent of the event
hypervigilance and an enhanced startle response to unexpected noise or movement.

Depression:

Is characterised by:

a diminished interest in activities that lasts the whole day for a period of at least two weeks.
difficulty concentrating
feelings of worthlessness or excessive guilt
hopelessness
recurrent thoughts of death or suicide
changes in appetite or sleep
increased fatigue

Treatment:

Patients who have these issues in addition to IBS will benefit from assistance that targets these issues and the interactions between them.

IBS dietitian Perth

How can a dietitian help with IBS?

As people with IBS have a highly sensitive gut, ‘stretching’ the intestinal wall causes exaggerated sensations of pain and discomfort. Certain factors can ‘trigger’ attacks in susceptible individuals, such as food intolerances.

Research shows that the low FODMAP diet can improve symptom control in 75% of people that are affected by IBS. FODMAPs are a collection of short-chain carbohydrates (sugars) that aren’t absorbed properly in the gut, which can trigger symptoms in people with IBS.
Ele Stojanoska, Gastrointestinal Dietitian at Wexford Gastro

FODMAPs are found naturally in many foods such as fruit, vegetables, nuts, grains and beverages.

So, yes, diet plays a key role in the management of IBS. Our Specialised IBS to Gut Health Program here at Wexford Gastro, is a three-step comprehensive treatment that includes a short-term elimination diet to achieve symptom control followed by systematic identification of your food intolerances with a focus on optimising gut health.

IBS naturopath Perth

How can naturopathy help with IBS?

There is evidence that an imbalance of the gut microbiome is associated with IBS, and this imbalance can have immune consequences. The balance of anti-inflammatory and pro-inflammatory bacteria is a major regulator of immune system function, and a microbiome imbalance can alter gut barrier function- a potential contributor to IBS and food intolerances. Herbal medicine can act to increase beneficial gut bacteria and reduce problematic bacteria.

Herbal medicines are best prescribed on an individual basis, as each person diagnosed with IBS may have varied causes and symptoms.
Tim O’Grady, Clinical Naturopath at Wexford Gastro

Herbs can be used symptomatically to promote proper movement of the stomach and intestines, improve the secretion of digestive enzymes and bile, and reduce pain-causing spasms. Herbs can also be used to treat potential causes of IBS such as an imbalance of the gut microbiome, small intestinal bacterial overgrowth, and anxiety.

IBS clinic Perth

Book an appointment

If your GP suspects IBS and wants to rule out other diseases, it is recommended to ask for a referral to Wexford Gastro. Our multidisciplinary approach enables continuity of care, long after you have been diagnosed with IBS. At Wexford Gastro, we understand the severity of your symptoms and the misery IBS may cause on many levels.

Book an appointment here and please bring your GP referral.

The power of a multidisciplinary approach to managing IBS

The power of a multidisciplinary approach to managing IBS

Exclude other diseases to diagnose IBS

A sensitivity problem in the gut

The impact of IBS on our mental health

Do psychological problems cause IBS?

Panic disorder:

Obsessive compulsive disorder:

PTSD:

Depression:

Treatment:

How can a dietitian help with IBS?

How can naturopathy help with IBS?

Book an appointment

Any questions? Let us help you.

Address

The power of a multi­disciplinary approach to managing IBS

Exclude other diseases to diagnose IBS

A sensitivity problem in the gut

The impact of IBS on our mental health

Do psychological problems cause IBS?

How can a dietitian help with IBS?

How can naturopathy help with IBS?

Book an appointment

The power of a multidisciplinary approach to managing IBS