IBS - What can an Osteopath do?
So then, you have a diagnosis of Irritable Bowel Syndrome (IBS) or is it? A diagnosis of IBS, unfortunately, equates to more of a lack of diagnosis!
According to the NICE (National Institute for Health and Care Excellence) guidelines, for a diagnosis of IBS you should have had changes in your bowel habit (for example, diarrhoea or constipation), pain or discomfort in your abdomen and a bloated feeling for a period of over 6 months. In addition to this, you should also have abdominal pain or discomfort that goes away when you empty your bowel or abdominal pain or discomfort with a change in how often you empty your bowel or stools that look different from usual.
On top of this, you also need to have 2 symptoms which include a change in how you pass stools or bloating, tension or hardness in your abdomen or a feeling that your symptoms are worse after eating or passing of mucus from the rectum.
In IBS the pain does not usually stay in one place. As part of your changing bowel habit you may experience faecal incontinence, which means having accidents that involve a leakage of faeces. You may also have symptoms such as tiredness, nausea, backache and bladder problems.
You should have also had blood tests to eliminate anaemia, coeliac disease and general inflammation in your body.You will probably also have had an ultrasound, rigid or flexible sigmoidoscopy, colonoscopy or barium enema, thyroid function test, faecal ova and parasite test, faecal occult blood test and hydrogen breath test.
Your GP will be more concerned about Inflammatory Bowel Disease (IBD) as IBS may be a precursor of this. If you get unintentional and unexplained weight loss, bleeding from the rectum or have a family history of bowel or ovarian cancer and if your symptoms change, you should seek advice from your GP ASAP and not worry about seeing your Osteopath! Some symptoms of irritable bowel syndrome are similar to those that could be experienced by women with ovarian cancer (for example, bloating or pain in the abdomen).
So, back to a simple diagnosis of IBS. When you visit an osteopath you will be screened with each appointment for more sinister reasons for your symptoms - just to make sure nothing has changed. You will be asked if you have had blood in your stools, any unintentional weight loss or fever, pain or diarrhoea that awakens you from sleep.
Stress and lifestyle is a massive factor in IBS. When we are very stressed, the diaphragm does not contract properly and as a result of this the abdominal contents do not get massaged as much as they would be normally. An osteopath would work with your diaphragm and also the vertebral connections in your upper lumbar spine, where it attaches, and your neck, where the diaphragm is innervated from.
The body is amazing. it is designed so that if you fracture your neck below the middle you can still use you diaphragm to breath as it is innervated from the upper to mid nerves from the neck.
We will also work on your spine. The area from mid shoulder blades to just above the curve in your lower back innervates your large and small intestines. This may involve HVTs or 'clicks' in your back or gentle stretching.
This all depends on you - your presentation, your circumstances. This is the beauty of osteopathy - it is tailored to you as a person. If you suffer mainly with constipation, we will work more with your upper neck and around the base of your spine where your parasympathetic nervous system is located - to try and speed things up a bit!
We will work on your abdomen. If you suffer with predominantly diarrhoea we will work around the left side of your abdomen (the ascending colon) or with constipation, we will work mainly with the left side, or the descending colon.
There will be other considerations during your treatment such as if your IBS is affecting other areas of your body through muscular tension. Stress is commonly a trigger for IBS type symptoms and osteopathic treatment can be helpful in reducing the side effects of stress on your body.
We can also give practical advice on ways to help relaxation and reduce the amount of stress you feel.