How you can manage your IBS

IBS or irritable bowel syndrome is a common condition affecting the gut. Around one in five adults in the UK have IBS and consequently experience gastrointestinal symptoms such as bloating, diarrhoea, constipation and abdominal pain. 

Unlike other conditions affecting the gut, there is no specific test for IBS. It is, therefore, diagnosed by excluding other causes of gastrointestinal symptoms, such as an infection or inflammatory bowel disease (ie Crohn’s disease and ulcerative colitis). This usually involves testing a stool sample, taking a detailed medical history and in certain cases, depending on your age and symptoms, performing a colonoscopy to rule out bowel cancer. 

There is no single cause for IBS but rather a collection of triggers that contribute to its development. This includes stress, anxiety, disturbances to the healthy bacteria that live in your gut (eg due to taking antibiotics), gut infections and food intolerances. 

Here, we will explore how IBS is treated medically and how you can manage your symptoms at home. 

IBS treatments

If your IBS causes constipation, your doctor may prescribe laxatives (eg lactulose or macrogol) to help soften your stools. 

If you have bloating and abdominal pain, your doctor may prescribe an antispasmodic medication. 

As certain foods often worsen symptoms of IBS, your doctor may also recommend dietary changes and/or taking probiotics. This may include recommending a FODMAP diet. 

The FODMAP diet involves avoiding foods containing short-chain carbohydrates, namely, fermentable oligosaccharides, disaccharides, monosaccharides and polyols. In some people, these short-chain carbohydrates are not easily absorbed through the gut and can, therefore, cause gastrointestinal symptoms, such as bloating and discomfort. 

A low FODMAP diet can be quite restrictive in the initial stages and, therefore, difficult to follow without professional support. Your doctor may, therefore, refer you to a dietitian for detailed advice and meal plans to help you follow a low FODMAP diet or make other dietary changes. 

In some cases, foods that trigger your symptoms may need to be removed from your diet altogether for a certain length of time and then gradually reintroduced.

Seven tips for managing your IBS

1. Exercise regularly 

Regular exercise is good for your general health and wellbeing and can play an important part in managing your stress levels. As stress can worsen symptoms of IBS, trying to incorporate around 150 minutes of moderate-intensity exercise into your weekly routine may help ease your symptoms. 

However, it is important to note that if you are an athlete, particularly if you are an endurance runner or take part in intensive exercise regimens, vigorous exercise can lead to diarrhoea after a workout. This is because exercise reduces blood flow to your gut, which affects your digestion. 

2. Avoid known food and drink triggers

Diuretics, that is, substances that increase how much urine you produce, can dehydrate your body and, therefore, worsen IBS symptoms. Alcohol and caffeine are both diuretics so reducing how much you consume can help manage your IBS symptoms. 

Dairy products, such as milk, cheese and ice cream, can also trigger or worsen IBS symptoms. This is because they contain high amounts of the sugar lactose and some people do not produce high enough levels of the enzyme (lactase) that breaks down lactose so it can be easily absorbed by the gut. 

However, yoghurt does not tend to trigger IBS symptoms in individuals who usually develop symptoms after eating dairy products. This is thought to be because yoghurt contains live cultures (good bacteria) that can break down lactose in your gut.

Other foods that often trigger or worsen IBS symptoms and, therefore, should be avoided include highly processed, sweetened and fatty foods. 

3. Stay hydrated

Make sure you drink around six to eight glasses (1.5–2 litres) of fluids every day or more if you are exercising or if the weather is hot. If you become dehydrated, your gut will absorb more water from your stools into your bloodstream. This can cause constipation and abdominal pain. 

However, make sure you avoid drinking fizzy drinks and high-fructose drinks (eg juice and soft drinks) as these can worsen IBS symptoms. 

4. Try probiotics

Over-the-counter probiotics contain live bacteria, such as Lactobacillus and Bifidobacterium, which can help restore the balance of healthy bacteria in your gut and, therefore, combat the overgrowth of harmful bacteria such as Clostridium, E.coli and Streptococcus. 

This can help reduce the amount of gas produced in your gut to ease bloating and slow down how quickly your stools pass through your gut to help with diarrhoea. 

5. Eat more fibre

In general, a healthy digestive system needs both soluble fibre and insoluble fibre. Soluble fibre dissolves in water to form a gel-like substance that helps bulk up your stools and prevent diarrhoea. Insoluble fibre does not dissolve in water but draws water into your gut to help soften your stools and prevent constipation. 

It is important to find the right balance of fibre in your diet. While both types of fibre are essential for healthy bowel movements, too much of either can worsen your gastrointestinal symptoms. 

Insoluble fibre, in particular, is often not well-tolerated and is found in higher amounts in raw vegetables — cooking vegetables helps break down insoluble fibre, which can make digestion easier for those who do not tolerate insoluble fibre well. 

It is important to try out different amounts of fibre in your diet to find which balance eases your IBS symptoms the most. 

6. Note down trigger foods

Try to keep track of what foods you eat that worsen your symptoms. A food diary can help with this as it can draw attention to patterns in your symptoms that relate to your diet that you may otherwise not notice. 

Once you identify a potential food trigger, you can remove this specific item from your diet for one to two weeks to see if your symptoms improve. However, it is important not to suddenly remove an entire food group (eg all protein, carbohydrates, meat or dairy) without first consulting a dietitian. 

7. Develop ways to destress

The brain and gut are closely linked and communicate with each other — it is called the gut–brain axis and is known to affect both physical and mental wellbeing. This is why feelings of stress, worry or anxiety that originate in your brain can have a direct impact on your gut. 

It is, therefore, important to look after your mental health and invest time in relaxation strategies. This may include yoga, mindfulness and breathing exercises, or other hobbies or activities that relax you. Your bedtime routine is also important when it comes to reducing your stress levels as a healthy bedtime routine can ensure you get a good night’s sleep.