Author Name: Tracey Ward, Head of Business Development & Marketing at Generali UK Employee Benefits
Some chronic conditions – those classed as ‘disabilities’ by the Equality Act 2010 – get a lot more airtime than others. However, they’re all by definition long term and debilitating, with the potential to negatively impact life and work. Irritable Bowel Syndrome (IBS) is no exception. The symptoms can be painful and sometimes downright embarrassing. What’s important for sufferers is to get to know their own needs, to communicate those needs to their line manager, and to check their own self-stigma in terms of how they expect people to react.
“Often people are a lot more accommodating and understanding than you might at first think,” says Paula Allen, Global Leader for Research and Total Wellbeing at LifeWorks, speaking during Generali UK’s recent Wellbeing360 podcast1 on this topic, adding: “Because, let’s face it, every single symptom of IBS has been experienced by every single human being at one time or another. It’s really the frequency and the intensity that’s different.”
The most common gastrointestinal disorder in the world, IBS affects around 1 in 20 people in the UK. That’s equivalent to around 3.2 million people.2 On a global scale, it affects around 10 – 15% of people worldwide.3 And these figures only refer to cases where a diagnosis is known. Many more people could be living with the symptoms; physical and psychological.
It’s a mental health thing too
The physical and the psychological aspects of IBS are intrinsically linked. Indeed, from our own group income protection claims experience, it’s clear that IBS is not usually a primary cause for absence, but when it does appear there is often an element of stress – work related or otherwise – exacerbating the condition. This then has the potential of making absence difficult to manage, particularly if the individual is caught in a cycle of stress causing symptoms and symptoms causing stress.
In these circumstances, assuming stress audits or reasonable adjustments don’t resolve matters, what could be needed is that employers are simply more understanding and flexible – more human – in the way they support all their employees, helping them enjoy a positive experience in work.
That’s why, in partnership with LifeWorks, we have put together this simple introduction to accompany our recent podcast.1
What is IBS?
IBS is a collection of symptoms, diagnosed by pain, excess gas, changes in stool habits, bloating and cramping. “It’s what we call a chronic relapsing condition, which means that it’s there for a long time and it gets worse and better at different times,” says Dr Abby Hyams, a GP for Medicspot, the provider of LifeWorks’ new telemedicine service. “Sufferers can even be symptom-free for short periods. However, it tends to be a lifelong condition.”
How is it diagnosed?
A GP would start with blood tests, explains Abby. The National Institute of Clinical Excellence (NICE) say that where blood tests come back normal – and faced with the symptoms described earlier – IBS might be diagnosed.
“In reality though, if someone is having severe symptoms – such as constant pain and bloating – they would get referred for further investigations; probably a camera to have a look inside their bowel,” adds Abby. “You’d be ruling out something like irritable bowel disease, which is something entirely different and involves ulcers in the bowel [Ulcerative Colitis or Crohn’s disease]. Once you’ve ruled out anything like that, you can give a positive diagnosis of IBS and go on to help the person manage their symptoms.”
IBS might be diagnosed either by a high-street GP, telemedicine provider, outpatient setting or specialist. If dietary restrictions are needed, expert dietician input would be required.
How is it treated?
This varies depending on the severity, from lifestyle advice such as increasing exercise, fluid and fibre intake to food avoidance. Medication might be required. For example, anti-spasmodic medication to help manage the cramps and pain, maybe also a laxative. There’s also a significant group that end up taking anti-depressants, explains Abby.
“There’s also strong evidence for Cognitive Behavioural Therapy [CBT],” says Abby. “That’s about managing and living with your symptoms. Also trying to manage the stress associated with, or causing, the symptoms.”
Help employees help themselves
First and foremost, there tends to be a lot of self-stigma around IBS, says Paula. “Sometimes people think they will be isolated much more than is actually the case. Sometimes we feel embarrassment about things that are happening in our body – things that are happening just because we’re all human. So, I think the first step is to accept yourself and the fact that we’re all dealing with different health conditions.”
Secondly, where a conversation with a line manager is concerned, individuals should focus on what they need to continue to work successfully. “There’s no need to go into deep detail about the symptoms. That’s a conversation to be had with a health practitioner, coach or counsellor,” says Paula.
“Instead, line managers need to know how they can help. Most of what individuals with IBS need from other people is just an understanding that they need flexibility: the ability to move around to help deal with pain, rather than being sat in a chair all the time; the ability to take time off at short notice or work from home, for example.
“Employee Assistance Programme [EAP] services might come in useful here too, to help individuals work through the mental health component of IBS and to put in place coping strategies, along with support in having line manager conversations.”
Paula adds that people with IBS need to really know themselves.
“They need to know about themselves in terms of what triggers them from a mental health perspective and how to deal with it. Know what they need from a physical point of view, in terms of how to manage symptoms so they don’t ever feel out of control. And know things around how to manage their body from a prevention point of view – their diet for example.
“There’s a real opportunity here to take a holistic view. Hopefully that will help individuals coach their spouse and their children too, because everyone can benefit from that knowledge, not only their employer.”
1 To listen to the full 30-min Wellbeing360 podcast for HR and Line Managers, hosted by Generali UK with special guest and wellbeing partner LifeWorks, please go to https://www.generali.co.uk/Media/Podcasts.html