[Common Diseases] Irritable Bowel Syndrome (IBS)
🥼 What is IBS?
Irritable bowel syndrome (IBS) is a functional intestinal disease , in which the intestine has no obvious structural lesions but abnormal functions, leading to long-term symptoms such as abdominal pain, bloating, and changes in bowel habits.
IBS is very common in Hong Kong and around the world. According to the Hong Kong Society of Gastroenterology, the local prevalence is estimated to be around 5-10% , with slightly more female patients than males, and is more common in young to middle-aged people.
🔍 Common causes and triggers in Hong Kong
Although the exact cause of IBS is not fully understood, it is generally believed to be related to the following factors:
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Abnormal intestinal motility
- The intestine contracts too quickly or too slowly, causing diarrhea or constipation.
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Gut-Brain Axis Dysfunction
- The intestinal nerves interact abnormally with the central nervous system, and stress and emotions directly affect intestinal function.
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Intestinal flora imbalance
- Hong Kong people have a Westernized diet that is high in sugar, fat, and fiber, which can easily affect the proportion of beneficial bacteria in the intestines.
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Food sensitivities or intolerances
- Lactose intolerance, sensitivity to FODMAP foods, etc.
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Sequelae of intestinal infection
- Some people experience persistent IBS symptoms after recovering from gastroenteritis.
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Psychological factors
- Long-term stress, anxiety, and depression can aggravate the condition.
⚠️ Common symptoms
According to the Rome IV Criteria, the main symptoms of IBS include:
- Recurrent abdominal pain (at least 1 day a week in the past 3 months)
- Symptoms related to changes in bowel habits
- Accompanied by diarrhea, constipation, or alternating between the two
- Abdominal distension and increased flatulence
- Abdominal pain that improves after bowel movements
Classification (according to the main bowel habits):
- IBS-D: Diarrhea as the main symptom
- IBS-C: Constipation as the main symptom
- IBS-M: Alternating diarrhea and constipation
- IBS-U: Not Well Classified
🏥 Treatment of IBS in Hong Kong
Editor's note : Although IBS does not cause bowel cancer or ulcers, it can have a long-term impact on quality of life. Treatment requires a multi-faceted approach and cannot be completely cured by medication alone.
1. Lifestyle and diet adjustments (basic treatment)
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Low FODMAP diet
- Reducing fermentable oligosaccharides, disaccharides, monosaccharides and polyols (such as onions, garlic, beans, apples, dairy products, artificial sweeteners, etc.) can help reduce bloating and diarrhea.
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Avoid common irritants
- Coffee, alcohol, carbonated drinks, fried and spicy foods.
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High-fiber diet (suitable for IBS-C)
- Focus on soluble fiber (oats, chia seeds, bananas) and reduce insoluble fiber (wheat bran) to avoid increasing bloating.
- Eat regularly and drink plenty of water
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Stress Management
- Meditation, yoga, regular exercise.
2. Drug treatment (targeting symptoms)
Doctors in Hong Kong will choose medication based on the type of IBS:
IBS-D (diarrhea-predominant)
- Antidiarrheal drugs : Loperamide
- Intestinal antispasmodics : such as peppermint oil capsules and hyoscine butylbromide
- Bile acid adsorbents (effective in some patients)
IBS-C (constipation-type)
- Bulking laxatives : such as psyllium
- Osmotic laxatives : such as polyethylene glycol (Macrogol)
- Prokinetic drugs (used after evaluation by a doctor)
IBS-M (mixed)
- Adjust the drug combination according to changes in symptoms.
Other supportive medications
- Probiotics (can reduce bloating and pain in some patients)
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Low-dose tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs)
- Used to improve gut-brain axis disorders and chronic abdominal pain (doctor's prescription required).
3. Psychotherapy and complementary therapies
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Cognitive behavioral therapy (CBT)
- Helps alleviate the vicious cycle of anxiety and intestinal symptoms.
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Hypnotherapy
- Some international studies have shown that it is effective for IBS.
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Traditional Chinese Medicine Acupuncture and Herbal Medicine
- Some patients in Hong Kong will combine Chinese and Western medicine, but they must ensure that the source is safe and the dosage is appropriate.
🏥 Hong Kong Examination and Diagnosis Process
Although IBS is a functional disorder, doctors usually rule out other intestinal disorders first:
- Blood tests (checking thyroid, inflammation markers, anemia, etc.)
- Stool examination (occult blood, parasites, inflammatory markers)
- Colonoscopy (if there are warning symptoms, such as bloody stools, rapid weight loss, or a family history of colorectal cancer)
Public healthcare : General outpatient referral to gastroenterology and hepatology department
Private healthcare : Faster arrangements for colonoscopies and food intolerance tests
🚨 Warning symptoms (serious illnesses must be ruled out)
- Bloody or black stools
- Unexplained weight loss
- Fever or nighttime abdominal pain
- Family history of colorectal cancer or inflammatory bowel disease
If you experience any of the above symptoms, you should seek medical attention immediately because it may not be simple IBS.
💡 Editor's Tips
- Dietary adjustment is the key , and low FODMAP diet is now provided by registered dietitians in Hong Kong.
- Keep a symptom journal to identify any connections to food or lifestyle habits.
- Do not take medication on your own for a long time , especially antidiarrheal drugs and laxatives.
- Stress management and sleep quality are equally important because the gut-brain axis can amplify symptoms.
- Communicate more with your doctor . Although IBS is chronic, there are many ways to reduce the frequency of attacks.
💬Editor’s summary :
While irritable bowel syndrome isn't fatal, long-term distress can severely impact personal and work life. Hong Kong's treatment strategy emphasizes a multifaceted approach , encompassing diet, lifestyle, medication, and psychological adjustments. With a personalized plan, most patients experience significant improvement in their symptoms and can resume a normal life.
📌 Disclaimer <br>This article is for reference only and does not constitute any medical advice. It is sourced from major medical articles.
