You know the feeling…you are sat in a crowded room and your stomach groans with peculiar sounds, accompanied by excruciating cramps. You don’t know whether to sit it out or make a dash to the closest toilet and hope nobody is already occupying the adjacent cubicle. This might sound like a humorous situation for a sitcom, but it is a fairly common experience for millions of people who have Irritable Bowel Syndrome (IBS), and it is certainly far from a laughing matter. In particularly, IBS at work can be a deeply distressing thing to try and fight, but can be managed with a proper understanding of the condition and what can be done to ease/avoid an occurrence of symptoms. The gut disorder can result in a variety of symptoms, but common symptoms generally include: bloating, wind, stomach cramps, and most people with IBS have bouts of diarrhoea and/or constipation. Evidence suggests that the majority of people with IBS first begin to develop their symptoms between the ages of 20 and 30. Symptoms often appear and disappear in bouts, commonly after eating certain foods and during times of stress. For one sufferer however, the problems began at a much earlier age. Medical librarian Vicky Grant, 43, has been trying to cope with IBS symptoms since the age of 13. Vicky, then in her 30s, was in a work meeting when she was struck down with the all too familiar feelings of the condition. She recalls: “I didn't know whether to make a dash to the bathroom or just sit it out and hope it would pass. I was coping with up to seven bouts of diarrhoea a day and it was really taking its toll on me. I decided to risk it and stay put, but I was concentrating so hard on staying in control that everything being said in the meeting passed over my head.” Vicky’s life was severely restricted by her IBS. She adds: “I felt bloated, tired and fatigued. My weight was below 7st (I'm 5ft 3in). I'd lost so much weight and looked terrible - I'm sure people thought I had anorexia. It was also making me depressed. I'd tried every drug, complementary therapy and diet under the sun, some things helped a little but nothing made my symptoms manageable. I was just so fed up with being ill all the time.” Vicky is not alone though and a tenth of all doctors’ appointments are for symptoms related to IBS, which many doctors find difficult to treat. After all, the exact causes are still unknown and even though patients suffer with uncomfortable and sometimes distressing symptoms, unlike other bowel diseases IBS does not leave the gut with any noticeable damage. Treatments are often a case of trial and error; changes in diet are often advised and IBS patients are usually instructed to keep a food diary. This can pinpoint the main triggers, i.e. are dairy or wheat products causing a flare-up of symptoms? Psychological therapy is another option for patients, and a lot of people find relief with antispasmodic medicines such as Buscopan IBS Relief and Colpermin 100 Capsules. It took years for Vicky to find the courage to see her GP, finally going to see him in her early 20s. “He told me I did have IBS and that in my case it was due to stress and advised me to tackle the stress,” she says. “I didn't think I was any more stressed than any of my friends and thought the stress I was under was at least partly due to coping with my IBS. I tried meditation, but it made no difference. Over the years my IBS left me feeling totally drained.” Nothing seem to have much effect for Vicky’s symptoms so three years ago she took to the internet to search around for stories of other people’s experiences and what worked for them. One thing that kept being mentioned was vitamin D. Vicky recalls: “One thing that kept cropping up online was how high-dose vitamin D supplements could help. I read one blog then reports from patients on forums talking about this - it was generating a lot of interest.” From things she had read on the internet, Vicky decided to try taking vitamin D2 - a dose of the nutrient (1,000 international units), but she had little success. "Then a work colleague who has multiple sclerosis mentioned that vitamin D3 from fish oils is closer to the type the body makes naturally and was more effective and should be taken at a higher dose," says Vicky. “So I switched to 4,000 international units a day of D3, which is a safe dose. Within days, my symptoms eased and progressively improved over the months. After years of symptoms, my diarrhoea, cramps, pain and bloating disappeared. I started to feel well, put on weight and my depression lifted. It was amazing. My symptoms would flare up again though, if I forgot to take it.” It is believed vitamin D might work by boosting the immune system as well as the gut's barrier. Dr Nick Read, chairman of the IBS Network's medical advisory group, says there is evidence some types of IBS involve a low level of inflammation in nerve endings in the gut. He comments: “Inflammation around the gut's nerve cells may make the intestine more sensitive to food and stress. We can't say vitamin D works as a treatment for IBS yet. Only a properly designed trial will establish whether it works or not.” Julian Walters, professor of gastroenterology at Imperial College, London, says it could be ‘plausible’ that vitamin D has a role to play in IBS treatments, although warns: “We shouldn't assume it will work. It could just be the power of placebo.”