Symptoms of irritable bowel syndrome
If you have IBS, your symptoms may just be an occasional nuisance. So you may not feel you need to see a doctor about your IBS again once you’ve been diagnosed. But if your symptoms make it difficult for you to go about your daily activities, you should speak to your doctor. Outlined below are some of the symptoms of IBS.
- Pain or discomfort in your tummy (abdomen). You may feel this in your lower tummy on your left-hand side. The discomfort may vary from a sudden sharp pain to a constant dull ache. You may also get cramps. This pain may ease if you go to the toilet and may get worse after eating.
- Changes in bowel habits. Your stool (faeces) may vary in consistency and can alternate between constipation and diarrhoea. You may also pass small amounts of mucus. Sometimes you may need to go to the toilet urgently, and at other times you may have problems going. After going to the toilet, your bowels may feel like they haven't been completely emptied.
- Your abdomen may look and feel bloated.
IBS symptoms can come and go – you may not have any symptoms for months and may then have a sudden flare-up.
IBS can cause other symptoms too. These include:
- feeling very tired
- feeling sick
- trouble sleeping
- regular headaches
- problems with your bladder, such as needing to pass urine more often
- painful sex
These symptoms may be caused by problems other than IBS. So if you have any of them, contact your GP.
You may feel embarrassed about your symptoms and find it difficult to talk about your IBS. But it’s important to discuss any worries you have with your GP. IBS is often linked to feelings of anxiety or depression, so looking after how you feel is important.
Diagnosis of irritable bowel syndrome
Your GP will ask about your symptoms and may examine you. They’ll also ask about your medical history.
Your GP will ask you about your pain; when you notice it, and what makes it better or worse. They’ll 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 stool looks like.
IBS can’t be confirmed with a test. It’s usually diagnosed if you have typical IBS symptoms. But your GP may recommend you have blood tests, scans, an X-ray or sometimes a colonoscopy to rule out some other conditions.
You’re most likely to have further tests if you have other symptoms:
- unexplained weight loss
- blood or mucus in your stool
- bowel problems that first developed after you turned 60
- diarrhoea that lasts for longer than six weeks
If your GP thinks your symptoms could be caused by an infection, they may ask you for a stool sample. The stool sample will be sent to a laboratory for testing.
Symptom diary for irritable bowel syndrome
If you have, or think you might have IBS, keeping track of certain things can help you and your doctor understand what’s happening.
Use this diary for two to four weeks and then share your completed diary with your doctor. Together, you can find out what’s going on and decide a treatment plan that’s right for you.
Click on the icon below to download the diary (PDF 1MB).
How to help yourself
There’s no cure for IBS, but changes to your diet and lifestyle may help to improve your symptoms.
You may find some of the following dietary measures help.
- Eat regular meals and give yourself plenty of time to eat them.
- Make sure you drink at least eight cups of fluid every day, especially water and drinks that don’t contain caffeine. Try to drink no more than three cups of caffeinated drinks, such as tea and coffee, each day. Don’t drink too much alcohol or fizzy drinks.
- Depending on your symptoms and the type of IBS you have, it may help to either reduce or increase the amount of fibre you eat. If your doctor suggests increasing how much fibre you eat, try to eat soluble rather than insoluble fibres. Soluble fibres include things like oats, or fruits like bananas or apples. If you need to adjust the amount of fibre you eat, your doctor will talk to you about this.
- Try to limit the amount of processed foods you eat. These may contain 'resistant starch' that’s 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, chewing gum and drinks.
- 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 yogurts and food supplements. It’s thought that certain probiotics can help to ease IBS symptoms, but more research is needed to make sure they definitely do. If you decide to try probiotic supplements, stick to one brand and take them at the recommended dose for at least four weeks.
- Reducing the amount of certain sugars in your diet may help your symptoms. This is known as a low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet. Your doctor or a dietitian can give you more information.
You may find it helpful to keep a food diary to see if certain foods trigger your symptoms, especially if you’re prone to diarrhoea. These foods may include dairy products, citrus fruits, caffeine, alcohol, tomatoes and eggs. Your GP can refer you to a dietitian for advice on changing your diet if necessary. Speak to your GP or a dietitian before making major changes to your diet, or if you’re pregnant or have another medical condition.
Regular exercise may help to reduce your symptoms. Aim to do at least 30 minutes of moderate exercise a day, on at least five days each week. If you notice your symptoms are triggered by stress, learning a relaxation technique may help.
You may find it helpful to talk to other people who are in a similar situation to you. There are charities that help support people with IBS and some may organise or suggest self-help groups that you may find useful. If these self-help measures don't work, see your GP for advice. They can help you identify anything that may be making your IBS worse, and suggest other treatments.
Treatment options for irritable bowel syndrome
As well as diet and lifestyle changes, you may also wish to try medicines and talking therapies. The treatments you’re offered will depend on your symptoms and what’s causing them. Your GP will help you decide which treatments are best for you.
If your symptoms don’t improve with lifestyle changes, you may wish to try medicines. Several over-the-counter medicines may relieve some of your irritable bowel syndrome (IBS) symptoms. You may need to take a combination of different medicines to control your symptoms. Speak to your pharmacist if you’d like more information about the medicines available.
- 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, but should only be used for a short while. Speak to your GP if you find you need to use laxatives regularly.
- Antispasmodic medicines, such as mebeverine hydrochloride (eg Colofac) and peppermint oil capsules may help your abdominal pain and wind. Again, speak to your GP if you find you need to use these regularly.
- Antidiarrhoea medicines, such as loperamide (eg Imodium), may help. But don’t take them for more than five days in a row without your doctor’s advice.
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 (eg amitriptyline). This can reduce the pain of IBS, even if you're not depressed.
If your symptoms don't improve, your GP may recommend psychological treatments.
Talking treatments, such as cognitive behavioural therapy (CBT), hypnotherapy or psychotherapy, may help to relieve your IBS symptoms. But research is still ongoing.
If you would like to try a talking therapy, your GP may be able to suggest a suitable therapist. You can also look for a therapist yourself. If you do this, make sure you check they’re fully qualified and registered with a relevant professional organisation.
Causes of irritable bowel syndrome
It’s still not clear why some people develop IBS and others don’t. But it’s thought that IBS may be caused by 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 your symptoms get worse:
- during times of stress
- after eating certain foods, for example fatty foods
- when you’re taking certain antibiotics
FAQ: Can a bout of food poisoning cause irritable bowel syndrome (IBS)?
You may develop IBS after a bout of food poisoning (gastroenteritis). Around one in 10 people with IBS think their symptoms started after having food poisoning.Gastroenteritis is caused by an infection that leads to diarrhoea and vomiting, which usually clears up on its own after a short while. In the UK, about two in 10 people get gastroenteritis each year.
There are several different types of infection that cause gastroenteritis, including viruses, bacteria or parasites. But the treatment is usually the same whatever the cause. Most gastroenteritis is caused by viruses. Norovirus is the most common cause of viral gastroenteritis in adults in the UK. Most bacterial gastroenteritis is caused by food poisoning, specifically:
- Salmonella – often from meat, raw eggs and undercooked poultry
- Campylobacter – from milk and undercooked poultry
- Bacillus cereus – from reheated rice
- Escherichia coli (E. coli) – undercooked beef, milk and vegetables
You can help to prevent gastroenteritis by washing your hands after going to the toilet, and thoroughly cooking and reheating food.
FAQ: How can I help my child who has IBS?
IBS isn’t that common in children. It’s more likely that any recurring tummy pain is because of worries at school. But if your child does have IBS, their symptoms can get in the way; so it’s a good idea to be aware of things you can do to help.
Tell your child's teachers about their IBS. Explain that your child may sometimes need to leave the classroom in a hurry to go to the toilet. It may also help if the school nurse is aware of your child’s condition, so your child can get their medicines (if needed).
Some children may need to take time off school if their symptoms flare up. You may wish to arrange for your child to receive work from their teachers to do at home.
If your child needs to take time off school, try to encourage them to stay in touch with friends. This may help to keep some normality in your child's life and may also distract them from their symptoms.
FAQ: What are probiotics and how can they help my symptoms?
Probiotics contain live bacteria and yeasts that may help to keep you healthy. Some people with irritable bowel syndrome (IBS) find probiotics help gas and bloating.
You can buy probiotics as food supplements (capsules or tablets) from your pharmacist or health food shops. You can also buy probiotics as yogurts or drinks.
Some probiotics may help to relieve IBS symptoms. But whether they actually work isn’t fully known. If you choose to take probiotics, take them for four weeks at the recommended dose to see if they help your symptoms. Always read the patient information leaflet that comes with your supplements. For most people, probiotics aren’t thought to be harmful or have serious side-effects.
FAQ: What’s the difference between irritable bowel syndrome and inflammatory bowel disease?
IBS and inflammatory bowel disease are two different conditions, but they can cause some similar symptoms. Inflammatory bowel disease describes conditions that cause inflammation in your bowel. It usually refers to Crohn’s disease and ulcerative colitis.
Crohn's disease can affect any part of your digestive system from your mouth, down through your stomach and bowel to your anus. It can cause mouth ulcers, an urgent need to open your bowels, tummy pain and diarrhoea (which may be bloody).
In ulcerative colitis, the lining of your large bowel and back passage (rectum) becomes inflamed and develops ulcers. The main symptoms are bloody diarrhoea, an urgent need to go to the toilet and open your bowels and pain in your tummy.
If you have IBS, you don’t have any inflammation in your bowel. Common IBS symptoms include:
- pain or discomfort in your tummy
- constipation and/or diarrhoea (but with no blood)
- passing mucus
- a bloated abdomen
Since IBS and inflammatory bowel disease can cause similar symptoms, it can be difficult to know which condition you have. But if you have inflammatory bowel disease, you will also have other symptoms:
- weight loss
- a fever
- bleeding from your rectum (back passage)
See your GP if you have any of these symptoms. If your GP thinks you may have inflammatory bowel disease or something else wrong with your bowel, you’ll need to have some tests. It’s important to have a correct diagnosis so you can be offered the right treatment.
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