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... see  updated version (pdf August 02) .. also AGI sheet

Irritable bowel 

What is it?

An irritable bowel (also known as irritable colon or irritable digestive system) is one that does not work smoothly and causes abdominal problems such as colicky pain and disturbed bowel actions. The bowel is a muscular tube that propels the food along in waves (called peristalsis). This muscular action may become overactive and cause tight contractions rather like a cramp in the leg muscles.

What are the causes?

The main cause is considered to be emotional stress, especially in those people who tend to 'bottle things up inside'.

Other possible causes are:

• infection of the bowel
• food irritation (e.g. spicy food)
• food allergy (e.g. milk)
• lack of bulk in the diet
• overuse of laxatives
• pain-killing drugs and antibiotics

What are the symptoms?

• The main symptom is a cramp-like pain in the abdomen (in the centre or lower left side). This pain is usually relieved by passing wind or by a bowel movement.
• Diarrhoea or constipation may occur, and sometimes the motions will be like small, hard pellets.
• You may also feel mildly nauseated, off your food, bloated or flatulent (windy).

How common is it?

At least 1 person in every 1000 has it, and many simply learn to live with it.

What are the risks?

The irritable bowel is harmless, but it is common for those with it to worry that they have cancer. It is usual to carry out investigations to ensure that there is no disease in the bowel.

What is the treatment?

Self-help

• Anyone with an irritable bowel should try to work out the things that make the symptoms worse. If you recognise stresses and strains in your life, try to develop a more relaxed lifestyle. You may have to be less of a perfectionist in your approach to life.
• Try to avoid any foods that you can identify as causing the problem.
• You may have to cut out smoking and alcohol.
• A high-fibre diet may be the answer to your problem. This can be achieved by adding 2 teaspoonfuls of unprocessed bran to your diet each day.

Medical help

If self-help measures are not controlling the problem, your doctor will be able to give you medicine to settle the painful spasm of an irritable bowel. You should avoid taking any medicines not recommended by your doctor.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia