Is irritable bowel syndrome on the rise in Singapore?

According to doctors, there is evidence that irritable bowel syndrome (IBS) is on the rise in Singapore. IBS is a chronic gastro-intestinal disorder with symptoms such as abdominal pain and bloating, which affects a significant proportion of the population.

“Research suggests that the prevalence of IBS in Singapore is increasing,” says Dr Wang Yu Tien, consultant in the Department of Gastroenterology & Hepatology at Singapore General Hospital (SGH). “A recent community study found that 20.9 per cent of the Singapore population has IBS. It can affect the young or old, and the median age at presentation is in the 40s.”

In 1998, IBS prevalence in Singapore was 2.4 per cent; in 2004, it was 8.6 per cent.

In addition to abdominal pain and bloating, symptoms of IBS include:

  • Altered bowel movement

  • Incomplete bowel clearance

  • Diarrhoea

  • Constipation

Symptoms may come and go, and may even flare up suddenly after a meal or a specific trigger food, or during a stressful period.

What causes IBS?

The exact cause of IBS is unknown. A variety of factors, from gut sensitivity to digestive tract problems to psychological disorders such as anxiety and depression, can play a part in its development.

Your doctor will rule out other medical conditions with similar symptoms before diagnosing IBS. An IBS diagnosis is made on the basis of clinical history and routine tests.

IBS cannot be cured

Rather, the treatment of IBS focuses on relieving its symptoms. Stress and lifestyle management, and avoiding trigger foods, may be sufficient for most sufferers to control their symptoms. Those with severe symptoms may also require medication.

Spicy food can trigger IBS.
Spicy food can trigger IBS.

Diet and lifestyle tips for managing IBS

  • Avoid oily, spicy foods

  • Avoid dairy products

  • Avoid alcohol, caffeinated and carbonated beverages, fructose-rich fruit juices

  • Eat small and frequent meals rather than large ones

  • Eat slowly and chew food well

  • Drink plenty of water

  • Manage stress with relaxation techniques

  • Maintain a positive attitude

  • Exercise regularly

  • Get adequate sleep

A diet low in FODMAPs can help

Reducing intake of FODMAPs, a group of short-chain carbohydrates, may be particularly helpful for IBS sufferers. These carbohydrates are poorly absorbed in the small intestine and can cause excessive wind and bloating because of bacterial fermentation in the large intestine.

Some examples of foods high in FODMAPs are garlic, onion, apple, pear, barley, wheat, milk, soft cheeses, and legumes.

“A diet intervention which reduces the intake of fermentable carbohydrates (FODMAPs) has been shown to improve IBS symptoms in 75 per cent of patients,” says Dr Wang.

While there is as yet no cure, SGH is researching Traditional Chinese Medicine (TCM) as a possible treatment for IBS-related constipation. The Department of Gastroenterology & Hepatology is looking for volunteers meeting certain criteria to participate in a research study. Participants will be compensated for their time and travel. They must be Chinese, have “bothersome” constipation, and meet certain age requirements. Interested parties can contact the SGH Department of Gastroenterology & Hepatology at 8207-1191.