Dr Stephen John Middleton MA MD FRCP FAHE

Consultant Gastroenterologist

Irritable bowel syndrome - The Cambridge approach to treating IBS

The underlying problem in irritable bowel syndrome is over sensitivity of the gut (hypersensitivity) and it can affect any part of the gastrointestinal tract but usually most of the symptoms arise from the large intestine.  Most foods are not completely digested by the stomach and small intestine and therefore some residue enters the large bowel where the majority of bacteria reside and  break down the food. We call this process fermentation.  This produces side products  and it is these chemicals that are believed to cause symptoms in patients with irritable bowel syndrome. 

Some patients report specific food intolerances.  Studies have been done to try and test these scientifically, but it  has proven very difficult to get consistent results.  There are however a number of conditions that are caused or provoked by specific food intolerances and are well substantiated such as Lactose intolerance which is an intolerance to milk sugar.  People with this condition lack the enzyme (lactase) to  required to digest   the sugar  lactose (lactase) which is usually present in the small intestine. If they ingest lactose it can not be digested and passes  into  the large bowel  where the bacteria are fermented and cause production of large amounts of gas and acidic by products which produce diarrhoea and bloating, similar to those experienced by those with irritable bowel syndrome.

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