IBS and urgency

Bowel urgency as a result of IBS


Alison Cullen
Nutritional Practitioner, BA (Hons), DN, DNT (Distinction)
@AVogelUK
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An introduction to IBS and urgency

Urgency is a sudden, desperate need to go to the toilet and is most commonly associated with diarrhoea dominant IBS. Incontinence may even be experienced in severe cases.

Feeling an uncomfortable urgency to use the toilet is often regarded as one of the most distressing aspects of irritable bowel syndrome (IBS). This situation may happen unexpectedly and if caught off guard, can be extremely stressful.  Recurrent distressing situations of this nature must be addressed as they can lead to more serious issues such as anxiety or panic attacks.

Why does IBS cause urgency?

Abnormal and uncoordinated bowel contractions are characteristic of IBS, so often constipation, diarrhoea or both are regularly experienced. Urgency to use a toilet is often a result of sudden changes in bowel movements and is usually associated with diarrhoea dominant IBS.

Unco-ordinated contractions can mean that faeces arrives in the rectum more frequently than normal, however this feeling of needing to go to the toilet suddenly, rather than just more often, is common in IBS suggesting there may be something specific causing it.

It is possible IBS sufferers have a hypersensitive gut and rectum so feel an urgency to go to the toilet more pronounced than your average person would feel.

Mental issues such as anxiety may make you more aware of your need to go to the toilet, and may actually exacerbate the situation further.

There could also be a more functional issue evident such as sphincters in the rectum not working as they should. Peristalsis, or movement of waste along the digestive tract, becomes voluntary at the point of the external rectal sphincter so we can go to the toilet at our convenience. If, for some reason, this sphincter is damaged through time or not working properly, urgency or incontinence may be a result.

What can I try at home for urgency?

There may be a few techniques you can try at home to try and improve the urgency associated with IBS:

  • Keep calm: In a state of stress or panic, the ‘fight or flight’ response is activated which redirects blood to the peripheral skeletal muscles ready for action. Unfortunately, this state redirects focus away the digestive system meaning you might have less control over it. Practice breathing exercises, and reassure yourself that the likelihood of actually having an accident is low
  • Train your bowels: If you run to toilet at the first twinge of needing, you may be training your bowels and mind to become over-responsive. Try sitting calmly when faced with a desire to run to the loo and you may find you can ease the situation. As faeces stays in the gut longer, excess water is reabsorbed and it becomes stiffer. In the case of recurrent diarrhoea this will be useful and may allow for the condition to settle.

How can herbal remedies help me?

There are some herbal remedies which may help you deal with the urgency associated with IBS.

  • AvenaCalm: AvenaCalm is a licensed herbal remedy containing avena-sativa made from the oat plant. This herb has been used traditionally to address mild stress or anxiety which is often associated with urgency in IBS.
  • Tormentil: Tormentil can be taken for a direct action at the site of the intestine. It helps to calm the nerves in the gut and may ease the erratic contractions that make you squirm and need to find a toilet fast!

How can my doctor help?

If home and herbal remedies aren’t offering you the help you need, you may want to speak to your doctor. They might suggest some talking therapies, such as support groups, which can help to address any psychological issues that are making episodes of urgency worse. You can speak to people with similar experiences and share tips and techniques to address your issues. If urgency or incontinence has become a serious issue some physical examinations may be necessary.

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