- Altered Gut-Brain Communication: Disruptions in the signalling pathways between the brain and the digestive system can lead to irregular bowel movements and increased sensitivity to intestinal activity.
- Dietary Sensitivities: Certain foods, such as those containing dairy, gluten, high-FODMAP carbohydrates, or strong spices, may trigger or worsen symptoms in susceptible individuals.
- Disruptions in Gut Bacteria: Changes in the balance of intestinal bacteria, often following infections or antibiotic use, may contribute to the onset of IBS.
- Genetic Factors: Having a family history of IBS or similar digestive conditions may increase the likelihood of developing the condition.
Irritable Bowel Syndrome (IBS)
Dr Chong Choon Seng
MBBS | MRCS | Masters in Medicine (Surgery) | FRCS (Edinburgh)
Irritable Bowel Syndrome (IBS) is a chronic gastrointestinal disorder affecting the large intestine. It is characterised by a combination of symptoms such as abdominal discomfort, bloating, and altered bowel habits, including diarrhoea, constipation, or a mix of both. While IBS does not cause permanent damage to the digestive tract, its symptoms can interfere with daily life and require long-term management.
Symptoms of IBS
IBS presents with a variety of symptoms that may differ in severity and pattern. The most common symptoms include:
- Abdominal Discomfort or Pain: Often located in the lower abdomen, this discomfort can vary in intensity and is frequently relieved after passing stools.
- Bloating and Abdominal Distension: A sensation of fullness or visible swelling in the abdomen, which may worsen after meals.
- Diarrhoea: Individuals may experience urgent, loose, or watery bowel movements, sometimes several times a day.
- Constipation: Difficulty passing stools is often accompanied by hard or lumpy stools and a sense of incomplete evacuation.
- Mucus in Stools: White or clear mucus may be visible in stools, which can indicate IBS in the absence of infection.
Causes and Risk Factors
IBS develops due to a combination of factors that affect the digestive system’s function. These include:
Diagnostic Approaches for IBS
Medical Evaluation
Evaluating the frequency, duration, and pattern of symptoms, along with identifying potential triggers and family history, helps assess the likelihood of IBS and distinguish it from other conditions.
Standardised Symptom Assessment
These guidelines (ROME criteria) focus on identifying recurrent abdominal pain occurring at least once a week over three months, combined with changes in stool frequency or consistency, to support an IBS diagnosis.
Exclusion Tests
Blood tests can rule out coeliac disease or anaemia, stool tests may detect infections or inflammation, and imaging studies such as ultrasound or CT scans may be used for cases with severe or atypical symptoms to confirm there are no underlying structural abnormalities.
Physical Examination
A thorough examination of the abdomen checks for tenderness, bloating, or other signs. This process helps rule out conditions like appendicitis, gallbladder problems, or other structural issues.
Food Allergen Tests
Food allergen tests can help identify triggers for symptoms. The food panel that we offer is a comprehensive list of food panels from Asian and Western diets common to our population. It often gives patients a clearer understanding to their chronic symptoms and their common triggers.
Treatment Options for IBS
IBS is managed by non-surgical measures to alleviate symptoms and improve quality of life.
Dietary Modifications
Adjusting the diet is a key approach to managing IBS symptoms. A low-FODMAP diet, which limits foods containing fermentable carbohydrates, can help reduce bloating, abdominal discomfort, and diarrhoea.
Fibre intake should be adjusted based on individual symptoms; soluble fibre (such as psyllium) may help alleviate constipation, while excessive insoluble fibre (such as bran) might worsen bloating or diarrhoea. Identifying and avoiding personal food triggers, such as dairy or spicy foods, can also be effective.
Medications
Medications are often used to address specific IBS symptoms. Laxatives may help relieve constipation, while anti-diarrhoeal agents can reduce the frequency and urgency of loose stools. Antispasmodic drugs may alleviate abdominal cramping and pain by relaxing intestinal muscles. These medications are typically tailored to an individual’s symptom pattern and used alongside dietary and lifestyle changes.
Probiotics
Probiotics, which contain beneficial bacteria, may help improve gut health in IBS patients. Certain strains, such as Bifidobacterium or Lactobacillus, have been shown to reduce bloating, gas, and irregular bowel habits by balancing the gut microbiota. Regular use of a high-quality probiotic supplement may provide relief for some individuals.
Are Your Symptoms Affecting Your Quality of Life?
Consult our MOH-accredited specialist for an accurate diagnosis & personalised treatment plan today.
Prevention and Long-Term Management
IBS cannot always be prevented, but symptoms can be minimised by identifying and avoiding personal triggers, maintaining a consistent and balanced diet, and managing stress. Staying active and keeping a regular bowel routine can also help manage symptoms over time.
Frequently Asked Questions
How is IBS different from IBD (Inflammatory Bowel Disease)?
IBS is a functional disorder affecting how the digestive system works without causing visible damage or inflammation. In contrast, IBD, such as Crohn’s disease and ulcerative colitis, involves chronic inflammation and structural damage to the digestive tract, often leading to complications like ulcers or strictures.
Can IBS symptoms appear suddenly?
IBS symptoms can develop gradually or arise suddenly, often triggered by events like a gastrointestinal infection (post-infectious IBS), significant dietary changes, or prolonged stress, which may disrupt gut motility or microbiota balance.
Is IBS more common in women or men?
IBS is diagnosed more frequently in women than in men, most likely due to hormonal factors. Fluctuations in hormones during menstruation, pregnancy, or menopause can influence bowel motility and sensitivity.
Do I require medications for life?
Most IBS patients do not require medications for life. In fact, many are well managed with simple lifestyle and dietary modifications. Simple medications are the mainstay and help mainly to improve quality of life. Patients with severe symptoms can expect gradual improvement and be weaned off medications over time once they identify the triggers in their lifestyle and diet.
Do I need to do a colonoscopy for IBS?
There is no definite need for a colonoscopy to achieve a diagnosis for IBS. The diagnosis is often made clinically by using standardised criteria, i.e. ROME IV criteria. The colonoscopy is mainly to exclude other causes like Inflammatory Bowel Disease (IBD) or cancer. Typically, there is no need to repeat a colonoscopy, especially if it was performed recently.
When should I be concerned about other conditions or misdiagnosis of IBS?
You should consider further evaluation for other conditions if you have symptoms of IBS along with any of the following: blood in stools, unexplained weight loss, poor appetite, iron deficiency anaemia, a family history of colon, uterus, ovary, or stomach cancer, onset of symptoms after the age of 45, sudden or new changes in bowel habits, or persistence of symptoms despite adequate conservative measures.
Partnered Programmes & Insurance Plans
For Singaporeans, Singapore Permanent Residents and Foreigners. Please speak to our friendly clinic staff about using your insurance plans.
Dr Chong Choon Seng
MBBS (NUS)
MRCS (Edinburgh)
Masters in Medicine (Surgery)(NUS)
FRCS (Edinburgh)
Dr Chong is the former Program Director of General Surgery Residency at NUHS, and has more than 10 years of experience as a colorectal and general surgeon.
As an esteemed professional in minimally invasive surgery, Dr. Chong remains committed to achieving optimal outcomes for all surgical conditions, from piles to cancer treatment.
contact us
Please leave us a message and our friendly clinic staff will get back to you as soon as possible. For urgent or same day appointments, kindly call the clinic to arrange an appointment.
Our Clinic Locations
Ark Surgical Practice – Mouth Elizabeth Medical Centre
3 Mount Elizabeth, #17-01
Singapore 228510
Monday to Friday: 9am – 5pm
Saturday: 9am – 12:30pm
Sunday & Public Holidays: Closed
Ark Surgical Practice – Mount Elizabeth Novena Hospital
38 Irrawaddy Road, #09-34
Singapore 329563
Monday to Friday: 9am – 5pm
Saturday: 9am – 12:30pm
Sunday & Public Holidays: Closed