IBS is a common condition that affects the digestive system. It causes symptoms like stomach cramps, bloating, diarrhoea and constipation. These tend to come and go over time, and can last for days, weeks or months at a time. It’s usually a lifelong problem, can be very frustrating to live with and can have a big impact on everyday life. There isn’t a cure, but diet changes and medicines can often help control the symptoms. The exact cause is unknown – it’s been linked to things like food passing through the gut too quickly or too slowly, oversensitive nerves in the gut, stress, and a family history of IBS.
The main symptoms of IBS are:
- Stomach pain or cramps – usually worse after eating and better after doing a poo
- Bloating – your stomach may feel uncomfortably full and swollen
- Diarrhoea – you may have watery poo and sometimes need to poo suddenly
- Constipation – you may strain when pooing and feel like you can’t empty your bowels fully
There may be days when symptoms are better and days when they’re worse (flare-ups) which may be triggered by food or drink.
What can trigger IBS symptoms
IBS flare-ups can happen for no obvious reason, but sometimes they have a trigger like:
- Certain foods – such as spicy or fatty food
- Stress and anxiety
IBS can also cause:
- Farting or flatulence
- Passing mucus through the back passage
- Tiredness and a lack of energy
- Feeling sick or nausea
- Problems urinating such as needing to pee often, sudden urges to pee, and feeling like the bladder is not fully emptied
- Not always being able to control when to poo which can lead to incontinence
If IBS is suspected, the first route is to see the GP. They can check for IBS and do some tests to rule out other problems.
Ask for an urgent appointment if there is:
- Weight loss for no reason
- Bleeding from the back passage or bloody diarrhoea
- A hard lump or swelling in the stomach
- Shortness of breath, noticeable heartbeats (palpitations) and pale skin
Any of these symptoms could be signs of something more serious.
The GP will ask about the symptoms, such as:
- What symptoms there are
- If they come and go
- How often they happen
- When they happen (for example, after eating certain foods)
- How long they’ve been happening
They may also feel the abdomen to check for lumps or swelling.
Tests for IBS
There’s no specific test for IBS, but doing some other tests can rule out other possible causes of symptoms.
- A blood test can check for problems like coeliac disease which is an intolerance to gluten
- Checking poo samples for infections and inflammatory bowel disease
What happens after diagnosis?
There’s no single diet or medicine that works for everyone with IBS. But there are lots of things that can help.
- Cook homemade meals using fresh ingredients whenever possible
- Keep a diary of foods eaten and any symptoms. This will help to understand that triggers IBS
- Try to find ways to relax
- Get plenty of exercise
- Try probiotics for a month to see if they help
Probiotics are live bacteria and yeasts promoted as having various health benefits. They’re usually added to yoghurts or taken as food supplements, and are often described as “good” or “friendly” bacteria. Probiotics are thought to help restore the natural balance of bacteria in the gut including the stomach and intestines when it’s been disrupted by an illness or treatment.
There’s some evidence that probiotics may be helpful in some cases, such as helping prevent diarrhoea when taking antibiotics, and helping to ease some symptoms of irritable bowel syndrome (IBS).
Although the evidence is sketchy, probiotics appear to be safe so they may be worth a try. They’re not advised in people with a weakened immune system.
- Delay or skip meals
- Eat too quickly
- Eat lots of fatty, spicy or processed foods
- Eat more than 3 portions of fresh fruit a day (a portion is 80g)
- Drink more than 3 cups of tea or coffee a day
- Drink lots of alcohol or fizzy drinks
Low FODMAP diet
A dietitian may recommend a diet called a low FODMAP diet. This stands for:
Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. Which are a collection of poorly absorbed simple and complex sugars that are found in a variety of fruits and vegetables and also in milk and wheat.
The IBS Network has more about FODMAPs here: https://www.theibsnetwork.org/diet/fodmaps/
The GP may prescribe Amitriptyline or Citalopram which are antidepressants, but they can also help ease IBS symptoms. They may take a few weeks to start working but could cause other side effects.
Living with IBS
For many living with IBS it is a case of finding what works best for you in regards to diet and lifestyle choices, as certain foods or situations can improve or worsen the condition. For many IBS is debilitating due to the fear of needing the toilet urgently and potentially not being able to find somewhere to go. You can buy a key from The IBS Network shop or Disability Rights UK shop that can help you access public toilets if you get symptoms while away from home.
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