Irritable Bowel Syndrome (IBS)

What Is Irritable Bowel Syndrome?

Irritable bowel syndrome (IBS) is a common and often lifelong condition that affects the digestive system. It consists of stomach pain or discomfort often accompanied by changes in bowel habits. The cause is not known and there is no cure for IBS. 

IBS is twice as common in women than men and estimates say between 10% to 20% of people may suffer from IBS. Symptoms tend to begin in teenagers and young adults, although people of all ages can be affected. 

The Cause of Irritable Bowel Syndrome

Unfortunately, the specific cause of IBS is not known but a lot of research is being conducted to help us understand the condition.

When we eat food it travels through several organs which make up the digestive tract. The body uses muscle spasms or contractions to push the food through the digestive tract. In people with IBS, these contractions are often more severe. 

These contractions can give rise to the discomfort, cramping or pain patients may feel in the abdomen, as well as the symptoms of diarrhoea or constipation.

Research into IBS has shown that some patients have overly sensitive nerves in the digestive tract which makes them feel stronger pain sensations compared to healthy people and possibly makes them more sensitive to even normal contractions of the digestive tract.

Some research has shown contracting an infection called gastroenteritis may increase your risk of developing IBS.

Stress and diet are important factors that can worsen or improve symptoms of IBS.

Diagnosis of Irritable Bowel Syndrome

When examining patients who may have IBS, doctors have to rule out other causes or diseases first. A diagnosis of IBS normally occurs when no other causes of the symptoms can be found and symptoms have been present for at least 6 months.

To rule out other conditions doctors may: 

• Feel your stomach to look for any lumps that may be causing symptoms
• Perform a blood test
• Ask for a stool sample to run tests on

Doctors will ask about your symptoms to help make a diagnosis. They may ask how long you have had symptoms, what your symptoms are, what your stools look like and other questions. Some people may find it embarrassing to discuss their symptoms with a doctor but it is important that you mention any symptoms you have because this can help your doctor to diagnose IBS.

Patients may find it easier to keep a diary of their symptoms to help remember them when discussing with a doctor.

Other conditions with similar symptoms are:

• Coeliac disease
• Bowel cancer
• Inflammatory bowel disease (ulcerative colitis and Crohn’s disease)

Treatment of Irritable Bowel Syndrome

Medication

Treating IBS involves medications that relieve a number of symptoms:

Antispasmodics - These are used to relieve abdominal pain and cramping. Our doctors can prescribe Mebeverine (in normal release and modified-release formulations) and Peppermint Oil capsules. In our shop section, you can buy another antispasmodic called Buscopan (Hyoscine).

Laxatives - These can help patients who suffer IBS with constipation as a symptom. If you are suitable for treatment, our online doctor can prescribe Fybogel Mebeverine sachets which contain a laxative as well as the antispasmodic mebeverine. We offer other laxatives on the constipation page of our shop section.

Antimotility (diarrhoea) medication - These can help patients who suffer from IBS with diarrhoea as a symptom. Loperamide (Imodium) is the most common of these and is effective at stopping diarrhoea. This and other antimotility drugs can be found on the diarrhoea page of our shop section. Make sure to stay hydrated if you are suffering from diarrhoea.  

Diet

The biggest step to ease symptoms is to ensure you follow a healthy, balanced diet as demonstrated by the NHS Eatwell guide.

The Eatwell Guide is a general guide with suggestions for the whole population so some people with IBS may have to adjust it to add or remove foods that agree or disagree with their stomachs.

Other tips include:

• Not eating meals too quickly, making sure to chew your food well
• Keep regular mealtimes, avoid skipping or delaying meals when possible
• Avoid eating late at night
• Avoid fizzy drinks or alcohol and limit consumption of tea and coffee to under 3 cups a day
• Keep a diary of what you eat and your symptoms to help identify your personal triggers
• Drink at least 8 cups of water a day

The IBS Network website has other useful tips.

A low FODMAP diet is a specific diet sometimes used to help IBS patients. It is a diet that restricts certain types of carbohydrates which can trigger symptoms in sensitive individuals. These specific carbohydrates are not absorbed in the small intestine which leads the bacteria in our large intestine to ferment them. This fermentation process can cause or worsen many symptoms of IBS.

The FODMAP diet can be very effective for reducing the symptoms of some patients but speak to a dietician before following the diet to make sure you still consume a full range of nutrients. There is also an app called the ‘Food Maestro FODMAP’ that can provide further information.

The NHS has a video that provides more information on IBS and diet, including information on FODMAP.

Stress

High-stress levels can often worsen or trigger IBS symptoms. Patients may find reducing stress levels improves their symptoms and/or reduces how often symptoms flare-up. Some patients may try psychological treatments such as cognitive behavioural therapy (CBT) for IBS. These can be especially helpful if symptoms are triggered by stress and anxiety.

The NHS website has tips for reducing stress levels.

Exercise

Exercise may be beneficial to help reduce stress levels and may improve constipation symptoms by improving digestion. See the NHS website for information on physical activity guidelines for adults.

Probiotics

Some patients may find probiotics improve their symptoms. Currently, more research needs to be conducted to test how effective probiotics are in IBS but the UK National Institute for Health and Care Excellence (NICE) describes probiotics as ‘a reasonable self-management option for people with IBS’. The NHS website suggests trying probiotics for a month to see if they help.

If patients try probiotics, they should use them for at least four weeks before expecting to see results.

Symptoms of Irritable Bowel Syndrome

There are a number of signs and symptoms which indicate you may be suffering from IBS.

These include

• Stomach pain, discomfort or cramping often improved by passing stools
• Changes in bowel movements like diarrhoea or constipation
• Bloating, a feeling that your stomach is full or uncomfortable

Some people find they switch between having diarrhoea and constipation with IBS. People may find their symptoms are made worse by eating.

Patients may suffer from other symptoms including:

• Nausea (feeling sick)
• Tiredness
• Backache
• Needing to pass stools but not being able to 
• Passing stools without meaning to do so (incontinence)
• Flatulence (passing wind)
• Needing to pee more often
• Passing mucus in your stools

These symptoms can be long term and affect the quality of life of patients. Some people may also suffer from depression and anxiety as a result of IBS and associated symptoms.