Overview
Irritable bowel syndrome (IBS) is one of the most common disorders of the digestive tract. Estimates suggest that several percent of the population in Germany are affected, women somewhat more often than men. Typical features are recurring abdominal pain, bloating and altered bowel habits – diarrhoea, constipation or alternation between the two – lasting at least three months. IBS is a functional disorder: the symptoms are real and can significantly impair quality of life, yet no structural damage is found in the organs themselves. The diagnosis is one of exclusion, meaning it is made only after other causes such as chronic inflammatory bowel disease, coeliac disease or food intolerances have been ruled out. Once the diagnosis is confirmed, long-term management becomes the focus. This is exactly where the video consultation comes in: dietary changes, a symptom diary and – following medical assessment – symptomatic medicines via private prescription can be managed well remotely, without you having to visit a practice for every appointment.
Common causes
The exact causes of irritable bowel syndrome have not been fully clarified. According to current understanding, several factors interact. A central role is played by disturbed communication between the gut and the brain, the so-called gut–brain axis: the nervous system of the gut reacts oversensitively to normal stretching stimuli, promoting pain and cramps. Gut motility is also frequently altered – accelerated in diarrhoea, slowed in constipation. Further factors include changes in the composition of the gut flora, increased permeability of the intestinal lining and low-grade inflammatory processes. In some patients, IBS begins after a gastrointestinal infection (post-infectious IBS). Psychological strain such as persistent stress, anxiety or depressed mood does not cause the condition on its own, but can markedly intensify symptoms. Certain food components, particularly poorly digestible fermentable carbohydrates (FODMAPs), also trigger symptoms in many patients.
When to see a doctor
Persistent bowel symptoms should always be evaluated by a doctor before a diagnosis of irritable bowel syndrome is made. Visit a practice promptly if warning signs occur: blood in the stool or black-coloured stool, unintended weight loss, fever, nocturnal diarrhoea or pain that wakes you from sleep, anaemia, palpable masses in the abdomen, or first onset of symptoms after the age of 50. A family history of bowel cancer, coeliac disease or chronic inflammatory bowel disease is also a reason for a thorough in-person examination. Sudden severe abdominal pain with a board-like rigid abdomen, persistent vomiting, signs of circulatory failure or massive bleeding from the bowel constitutes an emergency – in that case call the emergency number 112 immediately. For follow-up care once the diagnosis is confirmed, however, the video consultation is usually well suited.