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Irritable bowel syndrome (IBS)

Key points

  • Irritable bowel syndrome (IBS) is a condition that affects your digestive system.
  • About two in 10 people in the UK are affected by IBS.
  • It causes symptoms of pain or discomfort in your abdomen (tummy) and a change in your bowel habit.
  • There is no cure for IBS, but treatments can help to control your symptoms.

Featured FAQ

I've heard that a bout of food poisoning can cause irritable bowel syndrome. Is this true?

Yes, some research suggests that you may be at risk of developing IBS if you’ve had a bout of food poisoning (gastroenteritis). Gastroenteritis is a condition caused by an infection that leads to diarrhoea and vomiting.

See all our FAQs about IBS

IBS is a long-term condition that causes pain or discomfort in your abdomen (tummy) and a change in your bowel habit.

About irritable bowel syndrome

IBS is a common condition which affects your digestive system. About two in 10 people in the UK have IBS. Women are twice as likely to get it as men.

IBS can develop at any age, but people usually have their first symptoms between the ages of 20 and 30.

Symptoms of irritable bowel syndrome

Most people with IBS find their symptoms an occasional nuisance but don't feel the need to see a doctor. However, you may find that the condition affects your quality of life. If you find it difficult to cope with your symptoms, speak to your GP.

Symptoms of IBS include the following.

  • Pain or discomfort in your abdomen. This is the most common symptom of IBS. It’s often in your lower abdomen on the left-hand side. You may also get cramps. This pain may ease if you go to the toilet and may get worse after eating.
  • Changes in bowel habit. Your faeces may vary in consistency and can alternate between constipation and diarrhoea. Alternatively, you may just pass small amounts of mucus. At times, you may have an urgent need to open your bowels or this may feel strained. Afterwards, your bowels may feel like they haven't been completely emptied.
  • Your abdomen may look and feel bloated.

These symptoms can come and go – you may not have any symptoms for months and then have a sudden flare-up.

Other symptoms you may get if you have IBS include:

  • feeling tired
  • indigestion
  • feeling sick
  • backache
  • tiredness
  • problems with your bladder, such as needing to urinate more frequently

These symptoms may be caused by problems other than IBS. However, if you have any of them, speak to your GP for advice.

As well as the physical symptoms it causes, for some people IBS can be linked to other problems. For example, you may lose interest in sex or find it painful. It’s also common for IBS to be associated with feelings of anxiety or depression.

You may feel embarrassed about your symptoms and talking about them, but try not to. It’s important to remember that your mental wellbeing is as important as your physical health. Your GP can give you advice about how to manage any feelings of anxiety or depression you may have.

Causes of irritable bowel syndrome

The exact reasons why IBS develops aren’t fully understood at present. It may be a combination of:

  • increased squeezing of the muscles in the wall of your bowel
  • increased sensitivity to pain from inside your bowel
  • inflammation of your bowel, for example after an infection, such as gastroenteritis,
  • your genes – you may inherit IBS

You may find that your symptoms get worse:

  • during times of stress
  • after eating certain foods, for example fatty foods
  • whilst taking certain antibiotics

Diagnosis of irritable bowel syndrome

Your GP will ask about your symptoms and may ask to examine you. He or she will also ask about your medical history.

Your GP will ask you about your pain, when it comes on and what makes it better or worse. He or she will also ask you about your bowel movements. This may include questions about how often you go to the toilet, how easy it is to go, and what your faeces look like. There is no single test to confirm IBS. Therefore, to rule out any other conditions, your GP may also recommend that you have some blood tests.

If you have typical IBS symptoms, it's unlikely you will be offered any other tests. However, if your symptoms could be linked to other bowel conditions, your GP may suggest that you have some further tests.

Symptoms that are linked to other bowel conditions include:

  • unexplained weight loss
  • blood or mucus in your faeces
  • bowel problems that first develop after the age of 60
  • diarrhoea that lasts longer than six weeks
  • anaemia

You may also be advised to have further tests if you’re over 40 and have a family history of bowel or ovarian cancer.

If your GP thinks that your symptoms could be caused by an infection, he or she may ask you for a sample of your faeces. If you have this test, your sample will be sent to a laboratory for testing. This is also known as a stool sample.

Treatment option for irritable bowel syndrome

There are a number of treatment options for irritable bowel syndrome. These are described below. Which treatments you are offered will depend on your personal circumstances. Your doctor will discuss these with you to help you make a decision that’s right for you. Your decision will be based on your doctor’s expert opinion and your own personal values and preferences.

Although there is no cure for IBS, there are many self-help measures and lifestyle changes you can make that may help to improve your symptoms. You may also wish to try medicines and psychological treatments. With the help of your GP, you can decide which is best for you. However, if your symptoms don’t cause you too much trouble or stop you from doing things, you may wish to have no treatment at all.

Self-help

Making lifestyle changes may help to ease your symptoms of IBS.

Diet advice

The following general advice about your diet may help.

  • Eat regular meals and give yourself plenty of time to eat them.
  • Make sure you drink enough fluids. Try to limit your intake of caffeinated drinks, such as tea and coffee, to a maximum of three cups a day. Don’t drink too much alcohol or fizzy drinks.
  • Try to reduce the amount of fibre in your diet. Aim to eat no more than three portions of fruit a day.
  • You may also find it helpful to cut down on foods that are rich in insoluble fibre. These include wholemeal bread, wholegrain rice and cereals that contain bran.
  • Try to limit your intake of processed foods. These may contain 'resistant starch' that is difficult for your body to digest.
  • If you have diarrhoea, you may wish to cut out artificial sweeteners, such as sorbitol. This is used in some sugar-free sweets, drinks and diet products.
  • If you have wind and feel bloated, try eating oats, which are found in some cereals and porridge. You may also find that eating one tablespoon of linseeds each day helps.
  • Probiotics contain helpful bacteria and yeasts and are found in some yoghurts. There is some evidence that certain strains can be helpful for IBS symptoms, but this isn't conclusive.
  • Some studies suggest that a diet low in certain sugars may help. This is known as a low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet. It involves reducing the amount of sugar you eat from milk products and certain fruits such as mangos. Research into how well a low-FODMAP diet works is still ongoing. Speak to your GP or a dietitian for more information.

You may find it helpful to keep a food diary to see if certain foods cause your symptoms. Speak to your GP or a dietitian before making major changes to your diet, or if you’re pregnant or have another medical condition.

Lifestyle advice

Regular exercise is a good way to help reduce your symptoms. Aim to do a minimum of 30 minutes of moderate exercise a day, at least five times a week.

If your symptoms are noticeably triggered by stress, you could try learning a relaxation technique to help you deal with your stress.

You may find it helpful to talk to other people who are in a similar situation to you. You can find details about self-help groups from charities that support people with IBS – some of these will have websites with contact details. Don’t forget, you can also speak to your GP about this. He or she may also be able to give you information about local self-help groups.

If these self-help treatments don't work, see your GP for advice. He or she can help you identify factors that may be making your IBS worse, and suggest other treatments.

Medicines

If your symptoms don’t improve with lifestyle changes, you may wish to try medicines. There are several over-the-counter medicines that may relieve some of your symptoms. Speak to your pharmacist if you’d like more information about your treatment options.

  • Laxatives, such as ispaghula (eg Fybogel), can help if you have constipation. These are known as bulk-forming laxatives. Bowel-stimulating laxatives, such as senna, may also help. However, if you need to take them for more than two weeks, it’s important to speak to your GP.
  • Antispasmodic medicines, such as mebeverine hydrochloride (eg Colofac) and peppermint oil capsules may help with abdominal pain wind. Again, speak to your GP if you find the need to use these often.
  • Antidiarrhoea medicines, such as loperamide (eg Imodium), may help. However, only take them as and when you need them and not on a regular basis.

Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

If these treatments don’t ease your symptoms, your GP may also offer you a low-dose antidepressant. This can reduce the pain of IBS, even if you're not depressed.

Talking therapies

If your symptoms don't improve, your GP may recommend psychological treatment.

Talking treatments, such as cognitive behavioural therapy (CBT), hypnotherapy or psychotherapy may help to relieve the symptoms of IBS. These may help you cope with your condition. Some studies suggest that psychological therapies like these may be helpful in improving the symptoms of IBS, although research is still ongoing. More research is needed to look into how well these treatments work, especially in the long term.

If you would like to try this kind of therapy, ask your GP if he or she can suggest a suitable therapist. You can also look for a therapist yourself. If you do this, make sure you check that they are fully qualified and registered with a relevant professional organisation.

Reviewed by Hemali Parekh, Bupa Health Information Team, April 2014

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For answers to frequently asked questions about this topic, see FAQs.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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