People with irritable bowel syndrome (IBS) usually experience a combination of abdominal pain or discomfort, diarrhoea, constipation and bloating. Abdominal pain can occur anywhere in the abdomen, even in the so-called "stomach" or gastric area and the pelvic area. Although the diarrhoea is usually not severe, there may be the need to have a bowel movement after every meal and there is often a very urgent sensation. Constipation is described in the next section. Some patients are more troubled by bloating, stomach fullness, or a feeling of stretching in the abdomen. IBS is a disorder of function rather than physical disease such as polyp, ulcer or diverticula (see below), but it may be triggered off by food poisoning, abdominal surgery such as hysterectomy or cholecystectomy, a major life event, a change in diet and use of antibiotics. Contrary to popular belief, lack of fibre intake does NOT cause IBS. For those who have IBS, the following may make it worse: lack of sleep, stress, menstruation, antibiotics and certain foods. IBS is usually treated with a combination of diet, lifestyle modifications and selected medications. Surgery has no place in the treatment of IBS, and will often make it worse. For more information on IBS, check out www.ibs-support.com.sg. Constipation A person is considered to have constipation when he or she experiences one of the following symptoms: hard or lumpy stools, need to use effort, force or to insert a finger, a feeling of blockage at the anus, a feeling that the bowels are not completely emptied even after a bowel movement, and not having a bowel movement for more than 3 days. Most of the time, constipation is not caused by any life-threatening conditions. Fortunately for most, constipation is shortlived, does not cause too much discomfort and can be easily relieved with laxatives. On the other hand, some people frequently experience constipation for many years. Even this chronic form of constipation is usually not due to any physical or surgical condition. Common causes for this chronic type of constipation include the irritable bowel syndrome, medications and a change in diet. While increasing fibre may help people with mild constipation, those with severe constipation may actually become worse. Rarely, if constipation comes on suddenly, and then persists and pain, fever, bleeding or vomiting develops, a doctor should be consulted urgently. Diverticular disease Diverticula are dimple-like pouches or sacs that form on the inner lining of the intestine. The cause of diverticula is unknown, but lack of fibre has been blamed. Older people are more prone. Diverticula are usually discovered incidentally. Treatment is usually not necessary as most of the time diverticula do not give rise to any discomfort, pain or complications. If a person with diverticula experiences abdominal pain, bloating or constipation, more often than not, the cause is another condition such as irritable bowel syndrome. Rarely, diverticula may bleed or become infected. In diverticulitis (infected diverticula) the abdomen will be very tender when pressed and a fever may develop.