Irritable bowel Syndrome (IBS)
One of the most common presenting problems that patients bring to therapy is their fear of not being able to control bowel movements and not locating a toilet in time. As a result, their lives are governed by knowing where the nearest toilet is situated and if this is not possible, they will often avoid going out or even resort to swallowing handfuls of diarrhoea controlling tablets.
Visits to the GP often lead to the diagnosis of Irritable bowel Syndrome (IBS) driven by food intolerance. Patients therefore either do not eat at all before going out or limit their intake to bland foods, in the hope that the sudden urge to use the toilet will subside. Life revolves around this symptom and meetings at work or travelling on the Underground trains becomes a major fear.
Functional gastrointestinal disorders (FGIDs), including IBS, are disorders of brain-gut interaction. This means that there is a problem with the way the central nervous system (the brain and spinal cord) and the enteric nervous system (the nervous system of the gut) communicate information back and forth about our digestion, appetite, thoughts, and emotions. The pathway between the brain and the gut is called the brain-gut axis, and it relies on chemical messengers, including serotonin, for communication.