To make a diagnosis of irritable bowel syndrome there should be at least 3 months of continuous or recurrent abdominal pain or discomfort which is relieved with defaecation and associated with a change in either the frequency or the consistency of the stool.
Irritable bowel syndrome is a diagnosis of exclusion which means that, as part of the initial investigation, other serious or life-threatening disorders are first ruled out.
Can anything be done apart from “more fibre, Madam, relax more and have an occasional yogurt” Do any therapies really work for Irritable Bowel Syndrome?Usually it is possible to obtain relief from the symptoms of irritable bowel syndrome using a clinical approach which combines laboratory investigation and treatment of low-grade gut infections and identification of any food intolerances together with the identification of any lifestyle sreessors whish may be worsening the situation.
At a guess I would say that 95% of IBS patients can be  significantly helped by a mixed conventional/ complementary medical approach.
When I see new patient who has come ot me for help with their IBS I prefer it if they have already had a definitive diagnosis of irritable bowel syndrome made by a consultant gastroenterologist. It is important, particularly in certian age groups to exclude serious disease before arriving at a diagnosis of irritable bowel syndrome.
Then, when  serious disease has bene excluded, we can concentrate on improving quality of life for the patient
The irritable bowel syndrome / chronic fatigue syndrome connection: How can a gut infection affect a patient’s overall sense of well-being?
Certain areas of bodily function come up again and again in medical problem lists taken from M.E. / chronic fatigue syndrome patients patients. Very often patients are informed (erroneously, in my opinion) that there is no connection between their fatigue and their abdominal symptoms, despite the fact that the patient may have quite severe abdominal disturbance. In my own clinical experience many patients with chronic (i.e. long-standing) medical conditions, may have low-grade gut infections making a large ‘contribution’ to their lack of well-being. Very frequently my experience is that normalising gastrointestinal function makes a huge contribution to the patient’s overall sense of well being.
How can this happen?
The Bowel contains a lot of immune system tissue. Additionally the bowel should function competently as a barrier between the potentially toxic faecal matter contained in the bowel and the bloodstream forming a reliable separation between the two .
A brief explanation of ‘leaky gut syndrome’
The gut contains a large amount of immune or lymphoid tissue. The bowel wall is thin -just the thickness of an upper eyelid- however it needs to form a competent barrier between the essentially toxic faecal matter, which it contains, and the blood/circulatory system. The bowel has its own blood return system -called the portal venous system- which is a subdivision of the blood and circulatory system. Blood coming from the portal (bowel) circulatory system to rejoin the main circulatory system has to pass through the liver filtration system before doing so. The lumen (hollow) of the bowel contains partly digested food, bacteria, bacterial toxins, moulds or fungi, fungal / myco toxins, enzymes, the bugs that did not get washed off the lettuce with that quick wash you gave it(!)

The average healthy bowel contains a greater number of bacteria than the number of cells in the human body.
It is critical for well-being to maintain the correct bacterial balance in our gutfor a wide variety of reasons not least immune competency. If the gut wall is inflamed and ‘leaky’ and not functioning properly as a barrier, then toxic products and half-digested materials get across this barrier into the blood stream. This may make people feel vaguely but decidedly unwell. This ‘leaky gut syndrome’ which then occurs may cause proteins not not to be broken down properly into their constituent amino acids and as a result larger protein particles, called peptides (a particle composed of of several amino acids), become absorbed across the gut wall into the blood stream causing immune system problems and possibly also contributing to joint pains and various forms of arthritis. Dr Alan Ebringer in London’s Middlesex Hospital has done much in his research to study the role of bowel bacterial infections in both rheumatoid arthritis and ankylosing spondylitis and he has identified certain species of proteus and also klebsiella as potential troublemakers.

The Liver and irritable bowel syndrome connection. The Liver has an important role in detoxifying materials after they enter the bloodstream.
Any toxins that get into the blood stream have to be dealt with by the liver before they are allowed out of the specialised gut blood circulation, into what is called the ‘Systemic Circulation’ (the heart, great vessels, brain, etc.). Relatively frequently the liver may be ‘overloaded’ by gut toxins or it may be sluggish for other reasons and find it difficult to cope with its work of detoxification. Consequently patients may feel somewhat weak and fuzzy-headed. Sluggish liver detoxification also contributes to chemical sensitivity. As one patient told me “I constantly feel as if I’m on the morning after the night before – except there was no night before. I constantly feel fuzzy-headed, as as if I had a skinful last night, except that I didn’t!”.

What kinds of troublesome low-grade gut infections are there?
Gut infections may be fungal, bacterial or possibly worm-like. At the moment conventional medicine is working hard to develop more sensitive means of diagnosing gut infection and advances have been made, especially in terms of diagnosing bacterial gut infection using the Hydrogen Breath Test, but there is still a long way to go in terms of developing reliable investigations that are both relative and specific.

What happens if liver pathways are not running at or near full efficiency.
This does not mean that there is something drastically wrong with the patient’s liver, that is life-threatening. Almost everyone I see has had liver function tests, checked by either family doctor or consultant. These will usually have been totally satisfactory. This is important in that it excludes any serious or life-threatening liver disease. However, the liver may be somewhat sluggish in its normal work of breaking down toxins/old red blood cells/old hormone molecules that are past their sell-by date. A liver that is not functioning optimally may result in its owner fee ling sluggish a lot of the time. It may also result in increased sensitivity to toxins.

As a result of sluggish liver detoxification people may notice food sensitivities and sensitivities to perfume, alcohol, chemicals. People may also notice sensitivity to processed foods.

In any case of irritable bowel syndrome I would stress that there are no ‘magic’ cures and people need to take and be guided by the advice of their general practitioner and gastroentrerologist but, that being said, I feel that using integrative therapies in a thoughtful way is frequently, in my experience, a tremendous help.