11.JUN.2020 4 MIN READ | 4 MIN READ

Frequent abdominal pain, bloating, constipation and diarrhoea are some of the signs of irritable bowel syndrome (IBS), a chronic disorder that is linked to psychological stress.

Almost 1 in 10 Singaporeans suffer from IBS, a disorder more commonly found in those between 20 – 30 years old. While some may experience only mild or intermittent discomfort, others experience severe symptoms that significantly disrupt their daily lives.  In addition, people with IBS are also likely to experience poorer quality of life, and suffer emotionally with anxiety or depression. A study has also revealed that their partners also suffer from “caregiver burden”. In spite of this, some estimates indicate that up to 70 percent of people with IBS are not receiving treatment.

As a stress-sensitive disorder, IBS may be triggered by stressful situations, such as having to adapt to monumental changes in lifestyles due to COVID-19. For those who unknowingly suffer from this condition, getting diagnosed and seeking proper treatment can help improve quality of life.

Dr Reuben Wong, gastroenterologist at Gleneagles Hospital, gives an overview of this disorder and how to manage the condition.

The Brain-Gut Connection

Stress and IBS go hand in hand because there is a direct link between stress and a gastrointestinal (GI) reaction. IBS can be triggered by both physical factors, such as hormonal changes, strenuous activity, infection or surgery, as well as emotional or psychological stress.

Symptoms of IBS

Irritable bowel syndrome symptoms
A person with IBS may experience any of the following; for some, one symptom may be dominant.

  • Abdominal pain, felt as cramping or spasms, discomfort, or dull aching; ranges from mild to severe.
  • Bloating
  • Constipation occurs when stools are hard, dry and difficult to pass.
  • Diarrhoea or loose, watery stools; this may be accompanied by abdominal cramping or the urgent need to relieve yourself.
  • Excessive flatulence (passing gas), burping
  • Mucus on stools

During the consultation with your doctor, do mention any other symptoms that you may be having, such as fatigue and insomnia, and if you see a link between your symptoms and diet or lifestyle. These may give clues on what may be causing the IBS and how much it’s affecting your life.

Treatment and Management

Although there is no cure for IBS, a combination of stress management, diet and lifestyle adjustments are key to reducing the frequency and severity of symptoms.

Dietary modifications include:

  • Avoid foods that trigger symptoms. This may include caffeine and carbonated beverages or vegetables that cause bloating such as broccoli and cauliflower.
  • Consume foods that are high in fibre
  • Drink plenty of fluids

Other adjustments that may help:

  • Exercise regularly
  • Get enough sleep
  • Learn techniques to manage stress and other psychological conditions such as depression, which may worsen symptoms of IBS

Certain medications can be prescribed to relieve symptoms. These include fibre supplements or laxatives for constipation or anti-diarrhoeal medications for diarrhoea. Medication to control the pain and abdominal cramps may also be used.

Your doctor may want to conduct tests such as an endoscopy to exclude cancer or celiac disease. Breath tests for Intestinal Bacterial Overgrowth or Food Intolerances would also help to identify the underlying cause.

Possible Complications and Concurrent Conditions

Irritable bowel syndrome complication
IBS does not lead to cancer but frequent recurring of symptoms can develop into other complications.

In addition, moderate to severe IBS often impacts quality of life, from frequently needing to use the restroom or avoiding social engagements to missing work days. The disruptions of IBS are also linked to emotional or psychological disorders – according to the Anxiety and Depression Association of America, 50 – 90% of those who seek treatment for IBS also struggle with anxiety or depression.

A study by Wong et al showed that IBS can also affect the well-being and health of the spouses and partners of IBS patients. The more severe the IBS, the worse the strain on the relationship, on multiple fronts.

When to see a doctor

If you are already seeking treatment for IBS, remember to follow your doctor’s advice to manage your symptoms. If you suspect that you may be suffering from IBS, make an appointment to see a gastroenterologist as soon as the situation allows.

When to visit the A&E

If you experience prolonged abdominal pain, vomiting or diarrhoea, or there is blood in your vomit or stools, please seek immediate medical treatment at the nearest hospital’s Accident & Emergency Department.


Article reviewed by Dr Reuben Wong, gastroenterologist at Gleneagles Hospital


Nearly One in 10 Singaporeans Suffers From Irritable Bowel Syndrome. Retrieved on 15 May 2020 from https://www.healthxchange.sg/digestive-system/irritable-bowel-syndrome/nearly-one-ten-singaporeans-suffers-irritable-bowel-syndrome

Signs and Symptoms of IBS. Retrieved on 18 May 2020 from https://www.verywellhealth.com/ibs-symptoms-4014377

Irritable Bowel Syndrome (IBS). Retrieved on 15 May 2020 from https://adaa.org/understanding-anxiety/related-illnesses/irritable-bowel-syndrome-ibs

Stress and IBS. Retrieved on 18 May 2020 from https://www.aboutibs.org/what-is-ibs-sidenav/stress-and-ibs.html

Impact of psychological stress on irritable bowel syndrome. Retrieved on 15 May 2020 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4202343/

Irritable bowel syndrome. Retrieved on 18 May 2020 from https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/diagnosis-treatment/drc-20360064

Siah KT, Wong RK, Chan YH, Ho KY, Gwee KA. (Oct 30, 2016) Prevalence of Irritable Bowel Syndrome in Singapore and Its Association with Dietary, Lifestyle, and Environmental Factors. J Neurogastroenterol Motil. 22(4):670-676. DOI: 10.5056/jnm15148

Wong RK, Drossman DA, Weinland SR, Morris CB, Leserman J, Hu Y, Kelapure R, Bangdiwala SI. (Feb 2013) Partner burden in irritable bowel syndrome. Clin Gastroenterol Hepatol. 11(2):151-155. DOI: 10.1016/j.cgh.2012.07.019

Wong Kong Min Reuben
Gleneagles Hospital

Dr Reuben Wong is a gastroenterologist practising at Gleneagles Hospital, Mount Elizabeth Novena Hospital and Parkway East Hospital, Singapore. His clinical expertise includes the treatment of reflux and swallowing disorders, irritable bowel syndrome (IBS), gut microorganism, chronic constipation and diarrhoea.