Irritable bowel syndrome (IBS)

What is irritable bowel syndrome (IBS)?

IBS causes a problem with the way your gut, or bowel, works. It’s a common condition that affects women more than men, and it’s usually a lifelong problem.

IBS symptoms can be very similar to types of inflammatory bowel disease (IBD), which is why it’s important to speak to a doctor and get checked out.

What are the symptoms of IBS?

The most common IBS symptoms include:

• Stomach pain or cramps which may get worse after eating

• Bloating and gas (flatulence)

• Diarrhoea

• Constipation

• Tiredness

• Mucus in your poo

• Backache

• Needing to pee more than usual

What causes IBS?

The exact cause of IBS isn’t known, but it’s thought to be linked to:

• Irregular muscle contractions in the bowel – When muscle contractions in the bowel are stronger or weaker than they should be, it can make food move too quickly or slowly through the gut

• The nervous system – There could be a disruption in the nerve signals between your brain and your intestines

• An infection – IBS can occur after a severe case of an infection like gastroenteritis, caused by bacteria or a virus

• Changes to the gut microbiome – Upsetting the balance of microorganisms like bacteria and fungi in the digestive tract can cause IBS symptoms

Other factors that can put you at greater risk of developing IBS include:

• Stress and anxiety

• Family history

• Environment

• Having mental health issues like anxiety and depression

What is the difference between IBS and IBD?

Inflammatory bowel disease (IBD) has many similarities with IBS. There are many overlapping symptoms that can be easily confused. The two main types of inflammatory bowel disease are:

• Crohn’s disease – which can affect the whole gut

• Ulcerative colitis – found in the large intestine

The main difference between IBS and IBD is the way the conditions look under the microscope. If you take a small sample of the bowel and examine it in a lab, there are visible changes caused by IBD, while in IBS, the gut looks normal.

Like IBS, IBD is a chronic condition without a straightforward cure. Patients do tend to find that the symptoms come and go over time, and they may experience a flare-up when the disease is more active.

Like IBS, the exact inflammatory bowel disease causes are unknown – but there are a number of contributing factors found to increase your risk. These include age, genetics, problems with your immune system, ethnicity, environmental factors and certain medications.

How is IBS diagnosed?

A doctor will do a physical examination and ask you about your symptoms. It may help to keep a diary of your symptoms for a few weeks before your appointment, making a note of:

• The foods you eat

• The symptoms you experience and how badly they affected you

• When they occur and how long they last

• What you were doing at the time, for example, after eating

There’s no test to see if you have IBS, but the doctor may use tests to check for other problems or causes. These might include blood tests or taking a poo sample for analysis.

How is IBS treated?

Treatment usually involves a combination of medication and changes to your diet and lifestyle. There’s no single medicine that treats IBS, so it can take time and patience to find the right combination to manage your IBS symptoms.

A range of medication can help to relieve different IBS symptoms, like laxatives to treat constipation, antispasmodic medicines for tummy pain and antidiarrheal medicines to reduce diarrhoea. Talk to a doctor or pharmacist to see what they advise.

Lifestyle changes that might help include:

• Getting regular exercise

• Finding ways to manage your stress

If your symptoms are severe and dietary and lifestyle changes are not helping, you may be offered some stronger medication, like certain antidepressants that can help to ease IBS symptoms.

What to eat to relieve IBS symptoms

Some changes to your diet that can help relieve IBS symptoms include:

• Avoiding foods you know trigger your symptoms

• Cooking from scratch with fresh ingredients whenever possible

• Avoiding processed, fatty and spicy foods

• Chewing correctly and not rushing food

• Cutting down on alcohol and fizzy drinks

• Eating regular meals

• Trying probiotics for a couple of months to see if they have an effect

Specialist help and support

It may be helpful to talk to a dietician to get specific dietary advice about treating your IBS. Sometimes this is available on the NHS, but you may need to find a private dietician.

You may also be referred to have further tests to rule out inflammatory bowel disease.

When stress and anxiety are the main cause of IBS, talking therapies like cognitive behavioural therapy (CBT) can help. CBT helps you manage your problems by noticing any negative patterns of behaviour and changing how you think and behave. Talk to your doctor if you think this could be helpful for you.

How long does IBS last?

IBS is usually a lifelong condition, but symptoms tend to come and go and can generally be well managed. Many people have long periods with no symptoms and only use medication when their symptoms flare-up.

How can Livi help?

A Livi doctor will ask you questions about your symptoms. They’ll make an individual assessment, recommend a treatment or refer you to a specialist if needed.