One in five Irish adults suffers the symptoms of irritable bowel syndrome (IBS), but more than half do not seek medical help, according to a new survey. IBS was a major problem but Irish people are perhaps "more stoical or too embarrassed to talk about it because they consider it unsavoury, and not exactly a dinner-table discussion point", according to a medical specialist, Dr Padraic Mac Mathuna.
Dr Mac Mathuna, consultant gastroenterologist at the Mater Hospital in Dublin, says the syndrome is a collection of distressing and debilitating symptoms, including painful and spasmodic tummy cramps, bloating, diarrhoea and constipation. It is more common in women.
At the introduction of the survey yesterday, Dr Mac Mathuna said it was not known what caused IBS.
There might be a genetic predisposition which could be triggered by certain environmental factors such as infection or pollution.
"Contrary to popular belief IBS is not an allergy, is not linked to cancer or colitis and does not respond to excluding certain foods from the diet," he said.
Eating more fibre was "only part of the story" since many people with a healthy diet developed the condition.
People who ate a lot of fast food, or had a sugar-rich diet, were no more likely to develop IBS. Some people believed it was connected with the time they ate, but there was no evidence to bear this out.
Just under half of interviewees said their lives were affected in some way by their symptoms: through suffering embarrassment, and/or taking time off work, feeling depressed, limiting travel and social life, affecting relationships.
Those who had not sought medical advice said they felt "able to put up with it" or did not consider it a recognised condition.
The main symptoms which encouraged people to seek professional advice, according to the survey carried out by the makers of Colpermin, a new over-the-counter treatment for IBS, included unpredictable bowel habits, urgency to go to the toilet, constipation and abdominal pain.
Symptoms do not include weight loss, vomiting, blood in stools or night-time diarrhoea.
Dr Mac Mathuna said management of the condition involved education to dispel the myths around IBS, including dietary changes for certain patients and medication.
While stress did not cause irritable bowel syndrome, it could trigger attacks and worsen symptoms, he said.
"The bowel has the greatest number of nerve endings of all body organs, so not surprisingly stress experienced by an individual can be expressed through the bowel."
IBS was not life-threatening but could have serious implications for the individual, according to Dr John Sheehan, consultant in liaison psychiatry in the Mater Hospital. "IBS has both physical and emotional aspects. It is often triggered by a stressful life event such as death, divorce, job loss, court cases.
"There is a physical predisposition, probably genetic, in IBS sufferers which makes their digestive system more sensitive to such emotional triggers."
He said most people did not make the link between stress and their symptoms, and some were reluctant to do so. But the symptoms brought on by stress were real and were not "all in the head".
"Sufferers who can make a link between IBS and a precipitating life can go a long way to understanding and relieving symptoms. Dealing with stress is important. However, because of the physical symptoms of the condition medication is also needed."
He said that up to half the people with IBS who consulted a specialist with IBS had either anxiety or depression, he said. "It is not clear if the anxiety or depression is the result of the IBS or whether it actually causes it."
About 85 per cent of those presenting with IBS would respond well to standard medical treatment, including explanation and reassurance. Psychological treatments were effective in under two-thirds of the remaining 15 per cent.