Half of all people with irritable bowel syndrome (IBS) suffer from insomnia. Many report being woken from sleep by abdominal pain, often several times during the night, and unsurprisingly they say they wake in the morning feeling tired and not rested.
Unfortunately, the problem can become a vicious cycle as poor sleep may lead to a worsening of IBS symptoms the following day, increasing the likelihood of further sleep disturbance that night.
It’s IBS Awareness month in April…so, what is IBS and what can you do if the condition is disturbing your sleep?
What is IBS?
IBS is a chronic condition that affects the gastro-intestinal tract. Sufferers may experience diarrhoea or constipation, or they may alternate between the two. Other symptoms include bloating, cramping, gas and abdominal pain. There may also be mucus in the poo and a feeling of being unable to completely empty the bowels.
The condition is chronic, which means it is long-term and on-going. If you have IBS, you may have periods of respite and times when the symptoms flare up. The precise causes of IBS aren’t known but it is believed that certain factors can predispose you to the condition, including genetics, infection and trauma.
The muscle contractions in the bowel – referred to as colonic motility – become disturbed and the bowel develops an increased sensitivity to food, gas or poo in the bowel. It may react disproportionately to certain factors, such as stress, eating, emotional arousal or gas.
Scientists believe the interaction between brain and gut gets disrupted during IBS, leading to changes in sensation and motility in the bowel. Factors that can play a part in changing the brain-gut axis include:
- Genetics – if you have a family history of IBS you may be more likely to develop the condition.
- Intestinal infection is believed to trigger IBS symptoms in some people.
- Chronic stress or a traumatic life event.
Scientists also believe that changes to gut flora (the bacteria that live naturally inside your gut) may play a part in IBS for some people.
Diagnosis of IBS
IBS can be difficult to diagnose as there is no definitive diagnosis and sometimes this can lead to a delay in diagnosis and treatment. If you have IBS symptoms, your doctor will want to rule out other, more serious conditions such as inflammatory bowel disease or bowel cancer.
Once these have been ruled out, the doctor will use a range of criteria (including the Rome criteria and the Manning criteria) to determine if you have IBS. There are three types of the condition: constipation-predominant; diarrhoea-predominant and mixed.
You may be offered a range of imaging tests to check for infection or problems with nutrient absorption. These include:
- Flexible sigmoidoscopy – an examination of the lower part of the colon using a flexible tube-like instrument.
- Colonscopy – an examination of the entire colon using a colonoscope.
- X-ray or CT scan – your large intestine may be filled with barium to show up any problems on the X-ray.
There is no cure for IBS and the condition can have a significant impact on quality of life, affecting not only sleep but also confidence and even social life, as sufferers may be less willing to participate in social situations when they are experiencing a flare-up.
It is important not to ignore the symptoms as they can be linked to potentially serious health conditions. It’s also important to realise that, while there is no cure, there are many different treatments that your doctor can diagnose to ease your symptoms.
These include anticholinergic medication to relieve bowel spasms, anti-diarrheal medication to control diarrhoea and certain types of antidepressants which can help both with anxiety and depression and inhibit the activity of neurons that control the intestines.
A range of medications is available for IBS depending on your individual pattern of symptoms. Your doctor will also be able to discuss lifestyle changes you can make that may help to control IBS symptoms and help make sleepless nights a thing of the past.