Irritable bowel syndrome

IBS is a chronic (long-term) condition that affects approximately one in five adults and is more common in women than men. IBS can occur at any age but IBS symptoms often appear in your teens or twenties.

IBS symptoms vary but are most commonly stomach pain and bowel problems, including diarrhoea and/or constipation. You may find that your symptoms sometimes disappear, only to flare-up when you’re stressed or after eating certain foods.

In some cases, IBS symptoms like abdominal pain can be difficult to deal with, especially if they’re severe.

There’s no cure for IBS. However, lifestyle changes, diet and, if required, medication and counselling can help control IBS symptoms.

The common symptoms are:

• Stomach pain or cramps – often most painful after you’ve eaten, easing after going to the toilet
• Bloating and flatulence
• Diarrhoea and/or constipation – you may have bouts of diarrhoea or constipation or you may have bouts of both
• Small, hard stools which may contain mucus
• Sudden and sometimes uncontrollable need to pass stools
• Anal bleeding
• Anal discharge
• Bowel incontinence
• Vomiting

You may also have bowel pain, experience pain during sex, have backache, bladder problems, fatigue, lethargy and nausea.

If you think you have IBS, make an appointment to see your GP. Although there’s no cure for IBS, your GP will be able to recommend IBS treatment to relieve your IBS symptoms.

Your GP will begin by discussing your symptoms with you, including any bowel problems and bowel pain.

There’s no specific test for IBS. Your GP will begin by ruling out conditions with similar symptoms, such as:

• Inflammatory bowel disease – including Crohn’s disease and ulcerative colitis
• Coeliac disease
• Gastrointestinal infections
• Ovarian cancer

After examining your stomach, your GP may arrange:

• Blood and stool tests
• Flexible sigmoidoscopy – an examination of your bowel (large intestine/colon) using a flexible, illuminated tube
• Colonoscopy – an examination of your bowel using a small, flexible tube

If required, your GP will refer you to a gastroenterologist, a consultant who specialises in the digestive system.

The exact cause of IBS is unknown although, for some people, there might be a genetic link. You’re also at a higher risk of developing IBS if you’ve had:

• Gastroenteritis
• Trauma or upset
• A course of antibiotics

Most people with IBS have a sensitive digestive system. As a result of this sensitivity, your bowel reacts to stress, change and/or food by triggering IBS symptoms.

Although there’s no cure for IBS, IBS treatment will help to relieve your symptoms, including bowel problems.

Lifestyle

• Exercise regularly
• Find a way to reduce your stress levels
• Keep an IBS Diary – writing down when symptoms occur should help you identify what triggers your flare ups
• Sleep well

Diet

Your GP will be able to suggest dietary changes and IBS foods to avoid or might refer you to a specialist dietitian. You could also try:

• Avoiding food and drink that trigger your IBS symptoms
• Eating high-fibre foods
• Drinking lots of fluids

Medication

Your GP will advise you about medication that might ease your IBS symptoms, whether over-the-counter or on prescription. Medications include:

• Antispasmodics – to relieve stomach pain and cramps
• Laxatives – your GP may recommend short-term use to help with constipation
• Antidiarrhoeals
• Antidepressants – can sometimes be prescribed as a form of pain relief
• Fibre supplements – to relieve constipation

Counselling

If stress triggers your IBS symptoms, your GP might refer you to a counsellor for cognitive behavioural therapy. Alternatively, your GP might recommend mindfulness training.