Hello, Jenny. Thanks for coming to see me. My name is Sarah. I'm the clinic nurse at
the Gastroenterology Clinic. Hello, Sarah. 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 are 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 ..Um..I have this awful abdominal
pain. It's like a colicky pain in my stomach.
It's actually really embarrassing because I keep passing wind and I keep
going to the toilet. 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 3 months. Ah yes.. it started around 3 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 with 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 3 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 responsibilities and I
work long hours too. I see. So what you are saying is that the symptoms seem to
coincide with your new job. Yes, I suppose they did. Could that have
something to do with getting IBS? Yes, it could be part of the reasons 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 the 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. It 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 effect on IBS especially after a stressful day at work.
OK. I will 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 may find that helpful too. Right, thanks. That might be very useful.