Help & Advice

What is Irritable Bowel Syndrome (IBS)?

IBS is a common condition affecting the large intestine (colon).  In the UK, 1 out of 5 people develop IBS at some stage in their life (usually between the ages of 20 and 30).  It is a chronic disorder of unknown cause, which requires management of symptoms that typically come and go over time. 

Signs and symptoms might include:

  • Abdominal pain and discomfort
  • Cramping
  • Spasms
  • Bloating
  • Wind
  • Diarrhoea
  • Constipation
  • Presence of mucus in stool
  • Heartburn
  • Belching
  • Nausea
  • Decreased appetite or feeling quickly full after eating
  • Resolution of pain after passing stools or wind

It is likely that there will be cyclical periods of very mild or no symptoms followed by bouts of more severe symptoms.  The severity of symptoms, how often a flare up occurs and how long it lasts varies between patients and even with each flare up in the same patient.

How is IBS diagnosed?

Diagnosis of IBS is based on symptoms and by ruling out more serious conditions such as:

  • Crohn’s Disease
  • Ulcerative colitis
  • Cancer
  • Gut infections

Unlike conditions with similar symptoms, there is no inflammation, gut blockages, blood in the stool or increased risk of cancer.

Patients can be divided into three categories:

  • Those who experience pain due to constipation and bloating
  • Those who experience pain due to urgency for the toilet and diarrhoea
  • Those who experience pain due to alternating periods of constipation and diarrhoea

What is the cause of IBS?

The cause of IBS is not fully understood. It can be due to a number of factors:

  • Altered gut motility
    • Constipation is thought to occur when the gut moves food from the stomach to the rectum more slowly than usual because of weak intestinal contractions
    • Diarrhoea could be attributed to stronger and longer intestinal contractions than normal
  • Increased sensitivity of nerves in the gut
    • Flawed communication between the brain and the intestines could be responsible for the body overreacting to normal digestion processes including the presence of wind or stool
  • Triggers that affect some people
    • Foods
      • Certain fruits and vegetables
      • Gluten containing foods (such as wheat, rye, barley)
      • Caffeine
      • Alcohol
      • Lactose (in dairy)
      • Artificial sweeteners
    • Stress
      • Many find that stress aggravates their symptoms
    • Hormones
      • Women are twice as likely to have IBS as men
      • IBS worsens for some women around their menstrual period
    • Other illnesses
      • Overgrowth of bacteria in the gut or gastroenteritis from an infection

What are the treatments for IBS?

The following lifestyle changes may help ease symptoms of IBS:

      • Increased physical activity
      • Management of stress levels

So it’s a good idea to keep a diary of food, lifestyle and symptoms in order to help establish what makes the condition better and what makes it worse.

It is important to introduce certain dietary changes:

      • Avoid any foods found to trigger your IBS symptoms
      • Eat regular meals and drink plenty of water
      • Increased intake of soluble fibre can help those with IBS caused by constipation
      • On the other hand a decreased intake of soluble fibre can help those with IBS caused by diarrhoea
      • Taking probiotics, the “good” bacteria found in dietary supplements and certain foods

What medications are used to treat IBS?

      • Antispasmodics
        • For stomach cramps and spasm-type pains (especially in those who are prone to diarrhoea)
        • Work by relaxing muscles in the wall of the gut
        • Mebeverine (Colofac)
        • Fybogel Mebeverine, contains both soluble fibre and mebeverine
        • Hyoscine
        • Peppermint oil (Colpermin)
      • When constipation is the problem:
        • Increase the amount of soluble fibre
        • Laxatives may be safely used for short periods of time
        • Linaclotide
        • Tegaserod
      • When diarrhoea is the problem:
        • Loperamide
      • When bloating is the problem:
        • Peppermint oil
      • Antidepressants
        • Tricyclic antidepressants such as amitriptyline are particularly effective for relieving the symptoms of pain and diarrhoea
        • Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine may help those who exhibit signs of oversensitivity in the gut but they are only effective if taken daily.
      • Counseling is useful for people who have IBS due to stress, anxiety, family problems or a history of abuse

IBS can have a serious impact on a person’s quality of life.  It can be painful, embarrassing and unpredictable.  Not all individuals seek treatment for IBS but those who do might have to try multiple therapies before finding a treatment that is effective for them.