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Irritable bowel syndrome (IBS)

 

This factsheet is for people who have irritable bowel syndrome (IBS), or who would like information about it.

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

About irritable bowel syndrome

IBS is one of the most common problems of the digestive system. About two in 10 people in the UK have IBS and it’s twice as common in women than men.

IBS can develop at any age, but most people have their first symptoms between the ages of 20 and 35.

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, some people find that the condition affects their quality of life. If you find it difficult to cope with your symptoms, see your GP.

Symptoms of IBS include the following.

  • Pain or discomfort in your abdomen. This is the most common symptom of IBS and it’s often in your lower abdomen on the left-hand side. You may also get stomach cramps. The pain may be mild or severe and may ease if you open your bowels. You may find that the pain gets worse after eating. You may feel pain at a particular time of day, often in the evening. Women often find the pain relates to their menstrual cycle.
  • A change in bowel habit is another common symptom. Your faeces may vary in consistency and may alternate between constipation and diarrhoea. Alternatively, you may just pass small amounts of mucus. At times, you may feel an urgent need to open your bowels or this may feel strained. Afterwards, you may feel that your bowels haven't been completely emptied.
  • Your abdomen may feel bloated and may look swollen. This is more common in women.

These symptoms may 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 sick
  • indigestion
  • a headache
  • backache
  • tiredness
  • problems with your bladder, such as needing to urinate more frequently
  • problems with your sex life, such as pain during or after having sex, or a lack of interest in sex
  • anxiety
  • depression

These symptoms may be caused by problems other than IBS. If you have any of these symptoms, see your GP for advice.

Causes of irritable bowel syndrome

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

  • more frequent or stronger squeezing (contractions) of the muscles in the wall of your bowel – this can happen if the signals that travel from your brain to your gut when food passes through your digestive system are disrupted
  • increased sensitivity to pain from inside your bowel
  • inflammation of your bowel, for example an infection such as gastroenteritis
  • your genetic make-up – you may inherit IBS

You may find that psychological factors, such as stress, may trigger your symptoms. Your symptoms may also get worse after eating certain foods, for example fatty foods.

Antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (eg Nurofen) and diclofenac (eg Voltarol), can also make your symptoms worse.

Diagnosis of irritable bowel syndrome

Your GP will ask about your symptoms and 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 about your bowel movements, such as how often you open your bowels, how easy it is to go, what your faeces look like and if it has blood or mucus in it. 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 need 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 may include:

  • weight loss
  • blood or mucus in your faeces
  • bowel problems that first develop after age 50
  • a family history of bowel problems
  • diarrhoea that lasts longer than six weeks
  • anaemia

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. This is also known as a stool sample. If you choose to have this test, your sample will be sent to the laboratory for testing.

Treatment option for irritable bowel syndrome

There are a number of treatment options for irritable bowel syndrome, as 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 treatments that can help to improve your symptoms. These include making changes to your lifestyle, taking medicines and psychological treatments. With the help of your GP, you can decide which is best for you. However, if your symptoms don’t interfere with your daily routine, you may wish to have no treatment at all.

Self-help

You may wish to make lifestyle changes to help ease your symptoms of IBS. For most people with IBS, making some lifestyle changes is the best way to improve their symptoms.

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. When possible, try to limit the amount of alcohol and fizzy drinks you have.
  • 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, such as 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 can help.
  • Probiotics contain helpful bacteria and yeasts and are contained in some yoghurts. There is some evidence that certain strains can be helpful for IBS symptoms, but this isn't conclusive.

You may find it helpful to keep a food diary for two to four weeks to see if certain foods cause your symptoms. Always speak to your GP before changing your diet as advice may differ depending on your symptoms. If certain foods still seem to bring on your symptoms after trying this diet advice, it may help to see a dietitian.

Lifestyle advice

Regular exercise is a good way to help reduce your symptoms. It helps keep your bowel movements regular and reduces stress. 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 stress management or relaxation techniques.

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 take medicines. There are several over-the-counter medicines available from your pharmacist that can relieve some of your symptoms of IBS..

  • 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.
  • Laxatives, such as ispaghula (eg Fybogel), can help if you have constipation. These are bulk-forming laxatives. Stronger laxatives called bowel-stimulating laxatives, such as senna, may also help. However, if you find you need to take them quite often it’s important to speak to your GP.
  • Antispasmodic medicines, such as mebeverine hydrochloride (eg Colofac) and peppermint oil capsules may help with stomach cramps and wind. Again speak to your GP if you find you need to use these often.
  • If you would like pain relief, you can take over-the-counter painkillers such as paracetamol. It’s best not to have ibuprofen (eg Nurofen) or aspirin as they may make your symptoms worse.

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 of IBS, your GP may offer you some prescription medicines. These include prescription-only versions of the medicines mentioned above. Your GP may also offer you a low-dose antidepressant as this can reduce the pain of IBS, even if you're not depressed.

Talking therapies

If your symptoms don't improve after a year of treatment, your GP may offer you psychological treatment.

Talking treatments, such as cognitive behavioural therapy (CBT), hypnotherapy or psychological therapy can help relieve the symptoms of IBS. These are often useful for people who have personal difficulties to deal with. Your GP can refer you to a suitable therapist.

 

Produced by Stephanie Hughes, Bupa Health Information Team, March 2012. 

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

For sources and links to further information, see Resources.


  • 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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