Recurring bouts of tummy upsets can greatly affect quality of life, so learning how to manage an overactive gut is the first step toward keeping pesky bowel symptoms under control.

Many people around the world have some form of recurring gut problems all their lives which are not caused by diseases or abnormalities of their digestive systems. Uncomfortable and disruptive, these symptoms are usually linked to specific causes, like indigestion due to sensitivity to milk, sudden loosening of bowels from an anxiety attack, or a growling, runny stomach after consuming antibiotics. By learning to avoid what causes the attacks, it is easy to keep the conditions in check.

There are, however, individuals whose guts get irritated easily and for different reasons, leading to stomach upsets that vary in intensity, duration and frequency: These sufferers have irritable bowel syndrome (IBS), a condition which the Health Promotion Board summarises as a non-life threatening disorder affecting the colon or large intestine; but which, despite the discomfort, will not cause permanent damage to the colon and does not develop into cancer.

In many cases, IBS is first caused by a particularly bad bout of infective gastroenteritis. When the immune system is further weakened by stress or bad diet habits, the bad bacteria from the gastroenteritis may overwhelm the good bacteria, resulting in bowel spasms, excessive gas and diarrhoea. In a particularly troublesome attack, the signs and symptoms can also include:

• stomach bloating — sometimes so severe that clothes become tight
• a sense of incomplete bowel movement
• mucus in the stool
• headaches and lethargy

The vexing thing about IBS is that the causes of gut over-activity are unclear, and the signs and symptoms overlap, making it difficult to latch on to a single course of treatment. Avoiding or managing common triggers like stress and food sensitivity only work some of the time, as IBS can also erupt from indirect factors like stomach infection, lack of sleep and allergies, and in combination with other symptoms such as runny nose and migraine.

Sufferers who are determined to keep their IBS under control will need to consult an experienced colorectal physician, and be prepared to work patiently with him or her to figure out a regimen to control the many afflictions. These can be lifestyle changes like regular exercise and keeping to specific dietary rules, or prescription of appropriate medications for secific symptoms.

The doctor will first test for and rule out infective and inflammatory intestinal diseases, with stress and food sensitivities also assessed. Lactose intolerance, for example, is a very common cause of IBS as there are all sorts of food products that contain lactose — not just milk, butter or cream.

The treatment regimen thereafter may include a trial of no dietary fibre for a few weeks, supplemented by an intake of medical-grade probiotics to balance gut flora. This simple treatment flow has improved many instances of IBS, and will help to identify those who have more resistant and endogenous conditions. Such patients will then be treated with drugs designed to stabilise the gut contraction, decrease the amount of gas produced and reduce the associated diarrhoea.