Irritable bowel syndrome is an uncomfortable, distressing and difficult condition which unfortunately affects many Australians of all ages.
However, due to its embarrassing symptoms, many Australians with IBS do not seek help. In fact, some people who have had IBS for a long time may not even recognise the condition. But there are a few standout symptoms of IBS, as well as treatments.
"IBS is a condition that affects mostly the gut," Chloe McLeod, an accredited practising dietitian and sports dietitian who specialises in IBS and the low FODMAP diet, told The Huffington Post Australia.
"Around 20 percent of people have IBS in Australia. It's surprising that such a large number of people suffer from it.
"It can be a bit embarrassing for people to come and talk about their bowel habits, and I think a lot of the time people think it's just normal. I've had clients come in and say they've been dealing with IBS for 20 years, and now suddenly their whole lives have changed after taking charge. It's a very satisfying area to work in."
The exact cause of IBS is still unknown, but there are two main answers as to why this debilitating condition occurs.
"There are many thoughts about the exact triggers of IBS and how it develops, but for many people it seems to happen for almost no apparent reason," McLeod said. "That said, the most common reason for it to occur is due to stress levels. Unfortunately, stress exacerbates symptoms of IBS.
"We can look at the 20 percent of Australians who suffer from IBS, but we can also look at it from another perspective -- how stressed and overworked many of us feel. It's unsurprising that so many people are experiencing IBS."
On top of day-to-day stress, McLeod said the stress associated with a traumatic or difficult event, such as a loved one passing away, can sometimes result in IBS.
"The other reason is sometimes if you've been overseas and caught a parasite or stomach bug, it can actually develop after you've been unwell. Once the parasite has been dealt with, often we find IBS develops. That's often call post-infectious IBS."
Other possible reasons IBS can occur include poor diet and certain medications.
We've all experienced these five main symptoms of IBS, but it's when these symptoms become the norm that it's a good idea to seek help.
"It's always worth checking," McLeod said. "If we look at the signs and symptoms, they're not very nice.
"Bloating is a main symptom. One of the most common things people with IBS say is that they feel pregnant, or occasionally people ask them when they are due. It's an embarrassing experience.
People are needing to know where every single bathroom is in the city so that they don't have an accident.
"Then there's constipation, as well as diarrhea and really urgent bowel motions. People are needing to know where every single bathroom is in the city so that they don't have an accident.
"Feeling quite nauseous and feeling gassy are other main symptoms. These are the top five symptoms of IBS."
Everyone experiences IBS differently, and there are other symptoms that can affect people's digestion and overall energy.
"Cramping in the abdominal region is another symptom. This often goes hand-in-hand with diarrhea, bloating and wind," McLeod told HuffPost Australia.
"Sometimes just feeling lethargic and low in energy is common, so much so that you can't concentrate. Feeling foggy headed is another symptom.
"Often we'll go off the symptoms. Previously, and still to some extent now, it's a process of elimination -- a case of 'we've tested for everything else and it's come back negative, so it's IBS'."
If you suspect you may have IBS, it's important to check in with your GP. A dietitian can then help you identify your dietary triggers.
"Often IBS can be managed through making some food changes," McLeod said. "What the research shows is the best way of managing IBS is through trialling a low FODMAP diet. It is recommended to get checked for coeliac disease before starting this, though."
What's a low FODMAP diet?
"FODMAP is an acronym which stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols. Basically, they are different types of carbohydrates that don't digest or absorb properly in the gut, and that can then often result in them fermenting and causing different symptoms of IBS," McLeod said.
- Oligosaccharides -- Fructans and galacto-oligosaccharides (GOS)
- Disaccharides -- Lactose
- Monosaccharides -- Fructose in excess of glucose
- Polyols -- Sorbitol, Mannitol, Maltitol, Xylitol and Isomalt
"The way we would normally deal with that is to remove the high FODMAP foods from the diet, see if there's an improvement of symptoms, and if there is, we go through a series of challenges so we can determine what the individual triggers are."
Examples of high FODMAP foods
Fructose -- Apple, boysenberry, fig, mango, pear, tamarillo, watermelon, asparagus, artichoke, sugar snap peas, fruit juices, dried fruit, high-fructose corn syrup, honey
Fructans -- Custard apple, nectarine, white peach, persimmon, tamarillo, watermelon, artichoke, garlic (and powder), leek, onion (and powder), spring onion (white part), barley, rye, wheat
Lactose -- Custard, condensed milk, dairy desserts, evaporated milk, ice cream, milk, milk powder, unripened cheeses (e.g. ricotta, cottage, cream, mascarpone), yoghurt
Galacto-oligosaccharides -- Chickpeas, legumes (e.g. baked beans, kidney beans, borlotti beans), lentils, pistachio nuts, cashews
Polyols -- Apple, apricot, blackberry, lychee, nashi pear, nectarin, peach, pear, plum, cauliflower, mushrooms, snow peas, Isomalt (953), Maltitol (965), Mannitol (421), Sorbitol (420), Xylitol (967).
Worried about what little foods are left to actually eat? Don't fret, following a low FODMAP diet is short term.
"Most people don't react to absolutely all FODMAP foods. Usually it's one, two or three. It is important to go through that process, and to also not stay strictly low FODMAP long term," McLeod said.
"It's not like you can never eat any high FODMAP foods ever again because it's unnecessary and over restrictive, and most people with IBS can tolerate high FODMAP foods in small quantities. It's about removing them during the elimination phases to help find a clearer answer.
"If you feel like something's not right -- if you're feeling tired and sick all the time and you're having to rush to the bathroom -- go and have a chat to your GP or a dietitian. They will be able to help you with managing it."
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