Changes you shouldn't ignore if you have IBS

Although IBS is thought of as a life-long disorder, symptoms may come and go over time, and may be worse at some points than others. However, although your symptoms may not always be there, certain changes, or 'red flags', are important to look out for, as they may be a sign of an underlying or more serious condition. In today's blog, I discuss some changes that you shouldn't ignore if you suffer from IBS.

What are some warning signs when it comes to IBS?

If you suffer from IBS, you are probably aware of what is normal for you regarding symptoms and triggers etc. However, as with many other conditions, there are certain changes and 'red flags' to look out for, which should not be ignored if they develop, such as:

New symptom onset at age 40 or older
Blood in the stools
Unintentional weight loss
Changes in your typical IBS symptoms
Symptoms that wake you up during the night.

Read on to find out why these changes call for special attention.

1. New symptom onset at ages 40 or older

The onset of IBS is most often between the ages of 20 and 30; however, it can actually develop at any age, and may not occur till your 40's or 50's.

The problem with the onset of new symptoms, however, is that some IBS symptoms can be similar to those of more serious conditions or diseases, such as inflammatory bowel disease or colorectal cancer. As the risk of developing many diseases increases with age, in those around 40 or older, any new symptoms or sudden changes should always be investigated.

These symptoms may be something simple like a change in bowel habit, for example, looser and more frequent stools; or they may be something slightly more alarming such as rectal bleeding, or pain in the abdomen. Whatever the symptom, if it is new for you, it is always best to visit the doctor to ensure there isn't something more serious at play.

2. Blood in the stools

Another 'red flag' which calls for consideration is blood in the stools. Although this symptom can be very distressing, most of the time it is connected to a haemorrhoid, or small tear in the anal passage.

Although rare, it could be due to another more serious condition that requires further investigation or treatment. Therefore, blood in the stool always deserves a visit to the doctor, especially if it has come on suddenly and has been apparent for 3 weeks.

Additional things to look out for include:

Your poo has been thinner, longer or softer than normal for 3 weeks
You have a lot of pain around your bottom
You have a pain or lump in your tummy
You are more tired than usual.

Blood in the stool may appear red, but often appears very dark or black with a tarry consistency.¹ It is advised that if your poo is black or dark red, you have bloody diarrhoea, or are bleeding non-stop or have lots of blood with large blood clots, you seek medical advice immediately.

3. Unintentional weight loss

Although it is normal for your body weight to fluctuate slightly, persistent, unintentional weight loss of more than 5% of your weight over 6 to 12 months is usually a cause for concern, especially if combined with IBS symptoms which are new or have worsened.

Certain factors, such as diet, exercise, stress and changes in your personal life, may bring about weight loss, and these may also cause changes to your IBS symptoms. But, if you don't feel your weight loss has an obvious cause, it is important to see your doctor, as you may have an underlying illness that needs treating.

Unintentional weight loss does not always have an identifiable underlying cause; however, there are numerous different conditions which could cause this, including:

Low mood
Alcohol or drug misuse
Heart, kidney, lung or liver problems
Overactive thyroid gland
Undiagnosed diabetes
Dental issues – losing teeth, mouth ulcers etc.
Dysphagia (swallowing problems)
A problem with the gut, such as stomach ulcer, Crohn's disease, ulcerative colitis or coeliac disease.

As there are many causes for unintentional weight loss, it is very important to see your doctor if you are experiencing weight loss with IBS symptoms.

4. Changes in your typical IBS symptoms

If you suffer from IBS, you will know that symptoms can fluctuate over time. However, if you notice a change to your typical symptoms, a new or different kind of pain, or just something that doesn't seem right to you, always get it checked out.

As previously touched on, certain factors can trigger a flare up of IBS, such as stress; anxiety and low mood; diet; caffeine and alcohol intake; and changes in your personal life. So, you may find your symptoms easing if you have been avoiding trigger foods. On the other hand, you may notice symptoms worsening when feeling stressed.

But if you don't think anything has provoked your change in symptoms, get it checked by the doctor.

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5. Symptoms that wake you up during the night

IBS can in fact be associated with insomnia, which includes difficulty falling asleep, waking frequently and feeling unrested in the morning.² The microbiome can actually affect the suprachiasmatic nucleus, a small group of nerve cells in the brain which control sleep patterns; so, having IBS can really mess up your sleep cycle.

However, if you experience abdominal pain which is so severe that it keeps you awake, or are having to make several trips to the toilet during the night, this calls for further investigation by your doctor.