20+ years
of experience
5000+ scopes performed
Fellowship-trained colorectal surgeon
500+ filipinos treated in singapore
IBS is a common gut-brain disorder that causes recurring abdominal discomfort together with changes in bowel habits despite the absence of structural bowel disease.

At a glance

Common symptoms

Abdominal pain, bloating, diarrhoea, constipation

Diagnosis

Rome IV criteria and investigations to exclude other conditions

Treatment

Diet, lifestyle changes and medications

Long-term outlook

Symptoms can usually be managed with appropriate treatment

Irritable Bowel Syndrome (IBS) is a chronic disorder of gut-brain and gut-food interaction that affects how the intestines function. It commonly causes recurring abdominal pain, bloating (link to bloating & excessive gas) and changes in bowel habits, including diarrhoea, constipation (link to constipation) or alternating episodes of both.

Unlike inflammatory bowel disease (IBD) or colorectal cancer, IBS does not cause visible inflammation or structural damage to the intestines. However, its symptoms can significantly affect daily activities, work productivity, travel and overall quality of life.

IBS is a common digestive condition in the Philippines. Because its symptoms often overlap with other gastrointestinal disorders, persistent or worsening bowel symptoms should be properly assessed to confirm the diagnosis, exclude more serious conditions and guide appropriate long-term management.

A note from Dr Aaron Poh

It’s important to understand that IBS is not 'nothing'. It is a recognised disorder of gut-brain and gut-food interaction that can significantly affect quality of life. However, because many gastrointestinal conditions share similar symptoms, it is important not to assume that every episode of abdominal pain, bloating or altered bowel habits is caused by IBS. 

A thorough assessment helps confirm the diagnosis and ensures that other conditions requiring different treatment are not overlooked.

Dr Aaron Poh

Consultant Surgeon
& Colorectal Specialist
Alpine Surgical Practice · Singapore
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Types of irritable bowel syndrome

IBS is classified according to the predominant bowel habit, which can help guide treatment and symptom management.

  • IBS with diarrhoea (IBS-D) – characterised by frequent loose or watery stools, urgency to pass motion and episodes of diarrhoea that may be accompanied by abdominal pain or cramping
  • IBS with constipation (IBS-C) – characterised by infrequent bowel movements, hard stools, straining during defecation and a sensation of incomplete bowel emptying
  • Mixed IBS (IBS-M) – involves alternating episodes of diarrhoea and constipation, sometimes occurring over weeks or months
  • Unclassified IBS (IBS-U) – symptoms are consistent with IBS but do not fit clearly into the other recognised subtypes

What causes irritable bowel syndrome?

IBS is considered a disorder of gut-brain and gut-food interaction, where communication between the digestive tract and nervous system becomes disrupted. This altered communication can affect how the intestines move, respond to normal digestive processes and process sensations, leading to recurring abdominal pain, bloating and changes in bowel habits.

Although the exact cause of IBS is not fully understood, several factors are believed to contribute to its development, including:

  • Altered gut-brain signalling – communication between the intestines and the brain becomes more sensitive, causing normal bowel activity to trigger discomfort or pain.
  • Increased intestinal sensitivity – people with IBS often experience heightened sensitivity to normal stretching or movement within the intestines, resulting in abdominal pain or cramping.
  • Abnormal intestinal motility – the intestines may contract too quickly or too slowly, contributing to diarrhoea, constipation or alternating bowel habits.
  • Changes in the gut microbiome – alterations in the balance of intestinal bacteria may influence digestion, bowel function and symptom severity.
  • Previous gastrointestinal infections – some individuals develop IBS after recovering from food poisoning, gastroenteritis or other intestinal infections, a condition known as post-infectious IBS.
  • Stress and psychological factors – stress, anxiety and poor sleep may influence gut function through the gut-brain axis and trigger symptom flare-ups in susceptible individuals.

No single factor is responsible for IBS in every individual. Instead, the condition is thought to result from a combination of biological, environmental and psychological influences that affect the normal function of the digestive system.

What are the symptoms of irritable bowel syndrome?

IBS commonly causes abdominal pain, bloating and changes in bowel habits that may persist for months or years.

The symptoms vary between individuals but commonly include:

  • Abdominal pain or cramping –often improves after passing stool and may fluctuate throughout the day
  • Bloating and abdominal distension –many patients report excessive gas, abdominal fullness or visible bloating
  • Diarrhoea –frequent loose stools, urgency or the need to rush to the toilet may occur in IBS-D
  • Constipation –hard stools, infrequent bowel movements or difficulty passing stool may occur in IBS-C
  • Mucus in stools –large amounts of mucus, which can be visible during passing motion
  • A sensation of incomplete bowel emptying (link to incomplete bowel emptying)– some individuals continue to feel the urge to pass stool even after a bowel movement

Who is at risk of developing irritable bowel syndrome

Although IBS can affect anyone, factors associated with a higher likelihood of developing symptoms include:

  • Age – IBS often develops before the age of 50 and frequently begins in adolescence or early adulthood, although symptoms can occur at any age
  • Family history –genetic and environmental factors may influence susceptibility, particularly if close family members also experience functional gastrointestinal disorders.
  • Gender –IBS is diagnosed more frequently in women than men, possibly due to hormonal influences and differences in gut sensitivity
  • Chronic stress –work-related stress, family responsibilities and emotional strain may affect gut-brain communication and contribute to symptom flare-ups
  • Anxiety and mood disorders – psychological factors can influence intestinal sensitivity, bowel function and symptom perception
Now accepting patients from the Philippines

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Irritable bowel syndrome (IBS) vs Inflammatory bowel disease (IBD)?

IBS and IBD may share similar symptoms but are different conditions that require different treatment approaches.

FEATURE

IBS

IBD

Underlying problem

Altered gut-brain interaction and bowel function

Chronic inflammation of the digestive tract

Structural damage

No

Yes

Common conditions

IBS-D, IBS-C, IBS-M

Crohn's disease, ulcerative colitis (link to colitis)

Rectal bleeding

Uncommon

More common

Weight loss

Uncommon

May occur

Colonoscopy findings

Usually normal

May show inflammation, ulcers or narrowing

Cancer risk

Does not increase colorectal cancer risk

May increase risk with longstanding disease

Treatment focus

Symptom control and trigger management

Controlling inflammation and preventing complications

Many patients assume IBS and inflammatory bowel disease (IBD) are the same condition because both can cause abdominal pain, diarrhoea and changes in bowel habits.

However, IBS is a functional gastrointestinal disorder that affects how the intestines work, whereas IBD involves ongoing inflammation that can damage the intestinal lining and lead to serious complications if it is left untreated.

Why should ongoing symptoms not be ignored?

Many patients assume recurring bowel symptoms are simply IBS. However, symptoms such as abdominal discomfort (link to stomach pain & discomfort), diarrhoea and altered bowel habits may also occur in other gastrointestinal conditions.

These include:

  • Chronic intestinal infections
  • Coeliac disease
  • Colorectal cancer
  • Colorectal polyps
  • Inflammatory bowel disease (IBD)
  • Microscopic colitis

Medical assessment becomes particularly important when symptoms are accompanied by:

  • Family history of colorectal cancer
  • Iron deficiency anaemia  
  • Persistent night-time symptoms  
  • Rectal bleeding
  • Unexplained weight loss
  • New symptoms developing after age 50

This is particularly relevant because colorectal cancer incidence continues to rise throughout many parts of Asia, including the Philippines, making proper diagnosis increasingly important.

How is irritable bowel syndrome diagnosed in Singapore?

As there is no single test that can definitively confirm IBS, the diagnosis is made based on a combination of investigative processes.

One of the most widely used diagnostic frameworks is the Rome IV criteria, which help identify IBS based on characteristic symptoms. In general, IBS is considered when a person experiences recurring abdominal pain over the preceding months, together with at least two of the following:

  • Symptoms that are related to bowel movements
  • A change in how often bowel movements occur
  • A change in the consistency or appearance of stools

Dr Aaron Poh will also consider other investigations where appropriate to exclude conditions that may mimic IBS:

  • Colonoscopy– may be recommended when warning signs such as rectal bleeding, unexplained weight loss, anaemia or a family history of colorectal cancer are present.
  • Gastroscopy – occasionally performed if symptoms overlap with upper digestive conditions such as gastritis, reflux disease (link to heartburn & reflux) or peptic ulcers.
  • Imaging studies –computed tomography (CT) scans or other abdominal imaging may be used when an alternative abdominal condition is suspected.
  • Blood and stool tests –help identify infection, inflammation, anaemia or other medical conditions that can resemble IBS
Diagnosis focuses on recognising characteristic IBS symptoms while excluding other gastrointestinal conditions that can cause similar complaints.

How is irritable bowel syndrome treated in Singapore?

Treatment for IBS is highly individualised and depends on the predominant symptoms, the severity of the condition and the specific triggers identified. In many cases, a combination of dietary, lifestyle and medical interventions is required for effective symptom control.

  • Dietary modification –identifying and reducing foods that trigger symptoms may help minimise bloating, abdominal discomfort and bowel irregularity. Common triggers include fatty foods, spicy meals, caffeine and alcohol
  • Low-FODMAP dietary approach –some patients benefit from reducing fermentable carbohydrates that are poorly absorbed in the intestines. This dietary strategy may help decrease gas production, bloating and diarrhoea symptoms
  • Optimising fibre intake –increasing soluble fibre intake may help regulate bowel movements and improve both constipation and overall bowel function in selected patients
  • Maintaining adequate hydration –drinking sufficient fluids helps support normal bowel function and is particularly important for individuals experiencing diarrhoea or constipation
  • Stress management –because IBS is closely linked to gut-brain interactions, improving sleep quality, managing stress and addressing anxiety may reduce symptom frequency and severity
  • Medications for diarrhoea-predominant IBS –anti-diarrhoeal medications and other symptom-targeted therapies may help reduce stool frequency, urgency and abdominal discomfort
  • Medications for constipation-predominant IBS –laxatives, stool-softening agents or prescription medications may be used to improve bowel movements and relieve constipation-related symptoms

Planning your visit from the Philippines

For patients travelling from the Philippines, arrangements can often begin before arriving in Singapore.

Online consultation

A teleconsultation with Dr Aaron Poh may be arranged before travel. This allows your symptoms, medical history and previous investigations to be reviewed in advance, so that appropriate assessments can be planned before your visit.

To prepare for your consultation, it will be helpful to have:

  • A summary of your symptoms and when they began
  • Previous colonoscopy reports
  • Blood and stool test results
  • Imaging studies, if performed
  • A list of current medications
  • Questions you would like to discuss

Coordination and travel support

The Alpine Surgical team can assist with coordinating consultations, investigations and follow-up appointments within your intended travel period to help make your visit more efficient.

Patients from the Philippines can begin IBS evaluation and treatment planning before travelling to Singapore.

Why choose Alpine Surgical Practice for IBS assessment?

Many patients from the Philippines seek specialist evaluation after experiencing months or years of recurring bloating, abdominal discomfort, diarrhoea or constipation without a clear explanation.

At Alpine Surgical Practice, Dr Aaron Poh takes a structured approach to understanding your symptoms, reviewing previous investigations and identifying whether IBS is the most likely diagnosis or whether additional assessment is required to exclude other colorectal conditions. For patients travelling to Singapore, consultation and investigation planning can often be coordinated efficiently, helping to reduce uncertainty and provide a clearer path towards symptom control.

If recurring bowel symptoms are affecting your quality of life, arranging an appointment may help provide greater diagnostic clarity and a more personalised treatment plan.

Care focuses on identifying the cause of persistent bowel symptoms and developing a practical long-term management strategy.

Frequently Asked Questions (FAQs)

Everything you need to know about your medical journey
Yes, some individuals experience daily symptoms, while others have intermittent flare-ups
Although IBS primarily affects the digestive tract, some patients report back discomfort during symptom flare-ups due to abdominal cramping, bloating and increased pain sensitivity. Persistent or severe back pain should be medically assessed to exclude other causes.
Bloating is one of the most common IBS symptoms and may result from altered bowel function, increased intestinal sensitivity and changes in gut bacteria.
People with IBS may experience stools that vary in appearance depending on the subtype of IBS. Some individuals pass loose or watery stools, while others experience hard, pellet-like stools. Stool consistency may fluctuate over time, particularly in mixed IBS (IBS-M).
Some individuals with IBS experience nausea, particularly during flare-ups involving abdominal pain, bloating or altered bowel habits. Persistent nausea may warrant further assessment to exclude other gastrointestinal conditions.
Yes, increased gas production, bloating and abdominal distension are common IBS symptoms and may be triggered by certain foods or alterations in gut bacteria.
IBS itself does not typically cause significant unintended weight loss. If unexplained weight loss occurs, further evaluation is recommended to exclude other gastrointestinal conditions.
Yes, stress, anxiety and sleep disruption can influence gut-brain communication and trigger symptom flare-ups.
Not always. However, colonoscopy may be recommended if symptoms are associated with rectal bleeding, weight loss, anaemia or other warning signs.
Symptoms such as rectal bleeding, unexplained weight loss, anaemia, persistent night-time symptoms, severe abdominal pain or a family history of colorectal cancer warrant further medical assessment to exclude other gastrointestinal conditions.
No, IBS itself does not increase the risk of colorectal cancer, but persistent bowel symptoms should still be assessed to exclude other conditions.
Common triggers include fatty foods, spicy meals, caffeine, alcohol, artificial sweeteners and certain fermentable carbohydrates. Triggers vary between individuals.
There is no single IBS diet that works for everyone. Many patients benefit from identifying individual trigger foods, eating regular meals and, in some cases, following a low-FODMAP dietary approach under professional guidance.
Post-infectious IBS occurs when symptoms develop after recovery from food poisoning or gastrointestinal infection.
Many patients seek a more comprehensive assessment when symptoms persist despite repeated medications, dietary changes or previous consultations. Access to specialist colorectal evaluation, colonoscopy and diagnostic investigations may help provide greater clarity and a more structured treatment plan.
Prompt medical evaluation is recommended if symptoms are associated with rectal bleeding, unexplained weight loss, persistent vomiting, anaemia, night-time symptoms or a family history of colorectal cancer.
There is currently no permanent cure for IBS. However, symptoms can often be effectively managed through dietary modification, lifestyle adjustments and targeted medical treatment.

Dr Aaron Poh

Consultant Surgeon & Colorectal Specialist
Alpine Surgical Practice · Singapore
Meet our doctor

About Dr Aaron Poh

Dr Aaron Poh is a fully accredited General Surgeon with dual subspecialties in Colorectal Surgery and Trauma Surgery, recognised by Singapore’s Specialist Accreditation Board and Ministry of Health. He is the Medical Director of Alpine Surgical Practice, with clinics located at Mount Elizabeth Hospital, Parkway East Hospital, and Farrer Park Hospitals.

Dr Aaron Poh has extensive experience, having performed over 5,000 endoscopic procedures. He is a strong advocate for early detection through colonoscopy, particularly for individuals at risk of colorectal cancer. His expertise includes advanced endoscopic techniques such as Endoscopic Mucosal Resection (EMR) for complex polyps and colonic stenting for obstructed cancers, which help patients avoid major emergency surgery.

When surgery is required, he specialises in minimally invasive laparoscopic colorectal cancer surgery, offering patients faster recovery with less pain and scarring. In addition to cancer care, he manages a wide range of anal conditions including haemorrhoids, fistulas, fissures, and abscesses, providing comprehensive colorectal treatment.

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