Hello Jenny. Thanks for coming to see me. My name is Dr Williams, one of the
doctors of the Gastroenterology Clinic. Hello Dr Williams. Thanks for talking to
me today. That's OK. I see that you have had some tests at the clinic and that
you've been diagnosed with Irritable Bowel Syndrome. Is that right? Yes, that's
right. I had a test and now they're saying that it's IBS, Irritable Bowel
Syndrome. I don't really know much about it. I see. Yes, it is a lot to take in at
once. I'll explain what happens with the condition in a minute but I'd like to
ask you a few questions first. Is that all right? Yes, that's fine. Can you tell
me what's been happening with your bowels? Well I have this awful abdominal
pain. It's like a colicky pain in my stomach...
um and it's actually really embarrassing because I keep passing wind and I keep
going to the toilet as well. Mm-hmm. It must have been very difficult for you.
Can I just confirm with you that you've had a lot of abdominal pain and diarrhoea
and you've also had a problem with wind. Is that right? Yes, it is. It doesn't
happen all the time but when it happens it's very painful. OK. You mentioned
that you have diarrhoea from time to time. Is it only diarrhoea or constipation as
well? What do you mean? You have to have either diarrhoea or constipation, don't
you? Not necessarily. There are a few different types of IBS. Some people just
have constipation and some people have diarrhoea. Other people have both together
which is very unpleasant. Oh right. No I just have diarrhoea but as I said before
it's not all the time. OK, I see. So it's just diarrhoea. How often do you have the
diarrhoea? Well I've had three or four bouts so far. I get terrible cramps as
well. And how long have you had these symptoms? I've had the problem for around
three months. Yes it started around three months ago. Right I'll explain now what
happens when you have IBS. Basically irritable bowel syndrome is a digestive
condition which causes uncomfortable bowel symptoms. People may have loose,
mushy stools when they go to the toilet. I mean, when they have a bowel movement.
Alternatively, they might have hard stools and strain when they go to the
toilet. Do they know what causes it? No they don't know the exact cause. That's
why it is different from other bowel conditions. The structure of the
intestines is quite normal but the intestines appear to be oversensitive at
some times. That's what gives you the bloating and intestinal spasms. I see. Yes
I get bloating a lot. What about my diet? The doctor mentioned something might be
wrong on my diet? Yes that's right. There are certain foods which make the
condition worse. Can you tell me what your diet is like - what kind of foods do
you tend to eat? Actually I always thought that I had a good diet, you know. I try to
eat a lot of vegetables and I like whole-grain bread. I thought that was the
best thing to do but now I don't know what I should eat. A small amount of
fibre in your diet is important to keep your bowels moving properly.
But, you will need to cut out high-fibre foods if you can. It's a good
idea to increase the amount of water that you drink as well. OK. Is the fibre
in my diet giving me the bloating? No. That tends to be from gas-producing
foods like cabbage, for example. I'll give you a patient information leaflet on the
foods which you should avoid to make it easier for you. Then you can try to avoid
foods which cause you problems. I see. They told me that my
intestine was normal after the colonoscopy so it was a bit confusing.
The problem is that the intestines in IBS are overly sensitive and this seems
to result in either constipation or diarrhoea. Some people report that there
are things which trigger bouts of IBS. You mentioned that your symptoms started
around three months ago. Can you think of anything which was happening at that
time? Yes. I started a new job around then. It was really stressful especially at
first. I have a lot of responsibility and I work long hours. I see. So what you
are saying is that the symptoms seem to coincide with your new job? Mm-hmm. Yes, I
suppose they did. Could that have something to do with getting IBS?
Yes it could be part of the reason why you started having the episodes of bowel
problems. When you feel tense and you can't relax it can affect your bowels. Oh.
I see. So apart from watching your diet and avoiding high-fibre and
gas-producing foods it's a good idea to think about some ways that you can
reduce this stress in your life. Yoga and meditation are good ways to reduce
stress. Have you ever tried either of these? No and to be honest I don't think
I'd like to. They don't appeal to me at all. OK. What about going for a walk
after work? Well that sounds a bit better. Doesn't sound very relaxing to me
though. If you listen to some calming music as you walk it can be quite
relaxing. Would you be willing to try it? It really is a good idea to learn to
relax as it has a positive effects on IBS especially after a stressful day at
work . OK. I'll give it a try. Anything to stop those awful cramps. That's great.
I'll give you the leaflet about IBS now. Try to go for some gentle walks and see
if that helps you. There is a phone number on the leaflet for the IBS
support group. You might find that helpful too. Right. Thanks. That might be
very useful.