Top tips for treating your Irritable Bowel Syndrome (IBS)

What is IBS?

Irritable bowel syndrome (IBS) is a common long-term condition affecting your gut (bowel). The bowel itself is not damaged and may look normal even under a microscope, but there is a problem with the function of the bowel that leads to symptoms such as cramping pain and bloating.

Around 1 in 5 people will experience IBS at some point in their lives, and women are twice as likely to be affected than men. The most common age to develop symptoms of IBS is between 20 and 30 years of age.

Irritable bowel syndrome is different from Inflammatory bowel disease (IBD), which is a set of conditions where the body’s immune system attacks and damages the bowel. IBD includes Crohn’s disease and ulcerative colitis, and a different set of symptoms will be present.

What causes IBS?

The exact cause of IBS is not known, but it is thought to be due to disturbed activity in the gut. Your bowel should contract regularly to push food along its length, but these contractions may become abnormal and lead to discomfort. This may be due to overactive nerves or muscles in your bowel, and it can be worsened by stress or anxiety. Other factors that can bring about IBS include:

• Bacteria – symptoms of IBS tend to be worse after an infection called gastroenteritis, as it may lead to increased sensitivity in your gut
• Intolerance to certain foods and drinks – common triggers include alcohol, caffeinated drinks and fatty or fried food
• Oversensitivity of your digestive nerves – increased signals from the nerves lead to feelings of pain

What are the symptoms?

The symptoms of IBS will be slightly different for everyone, but it typically causes tummy cramps, bloating, and either diarrhoea or constipation. Your tummy pain might be relieved when you pass stool. You may also notice changes in your bowel habit such as a change in frequency, a feeling of urgency, or a sense of incomplete emptying when you have gone to the toilet. Other symptoms include tiredness, nausea, flatulence, backache, headache, or bladder symptoms.

If you notice that you are passing blood in your stool, losing weight unintentionally, or if there is a new lump or mass in your abdomen, you should see your doctor immediately.

How is IBS diagnosed?

As there are no tests for IBS, it is diagnosed based on symptoms. Your doctor will consider the diagnosis if you have been experiencing the above symptoms for at least 6 months. They may also wish to perform blood tests and collect a stool sample to rule out other conditions such as IBD, coeliac disease, or gastroenteritis, as these may cause similar symptoms.

Top tips for treating IBS

There are a number of methods that can be used for treating IBS, but the effectiveness will vary from person to person. IBS treatments may not stop symptoms altogether, but they are often useful in tackling the severity of your symptoms and improving your quality of life.

Diet

Eating a healthy balanced diet and having a regular meal pattern is the first step to treating IBS. Avoiding late-night meals, sitting down to eat, and chewing well can also help to ease your symptoms. You should also aim to drink plenty of fluid.

Since IBS can be triggered by certain types of food, it is worth keeping a food diary to work out which types of food bring on symptoms so that you are able to avoid them or reduce how much you eat. Avoiding excess alcohol, coffee and tea is often beneficial.

Monitoring the amount of fibre that you eat can also be helpful. If you suffer from constipation then increasing your dietary fibre may improve your symptoms, whereas if you suffer from diarrhoea you may wish to cut down your fibre intake.

A special type of diet that avoids foods high in ‘FODMAP’ (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) can also be effective under the supervision of a dietician, and you can ask your doctor for more information about this.

Exercise

For many people, regular exercise helps to relieve their IBS symptoms. The NHS recommends at least 150 minutes of moderate activity (enough to increase your heart and breathing rate) every week.

Stress reduction

As mentioned earlier, stress and anxiety can contribute to the symptoms of IBS. Meditation, physical activity such as yoga, and regular exercise can all be beneficial for reducing your stress levels. If you are struggling to cope with your stress, your doctor may offer to arrange counselling or cognitive behavioural therapy (CBT).

Medications

In addition to the lifestyle changes above, medications can help to relieve symptoms of IBS. Your doctor will generally prescribe them for short periods and they will be most effective if used in combination with lifestyle measures:

• Laxatives can help to ease constipation. Bulk-forming types are often used to soften the stool, making it easier to pass
• Anti-diarrhoeal medications such as loperamide slow down the contractions of your bowel muscles
• Antispasmodics such as peppermint oil may help to relax your bowel muscles
• Low dose antidepressants prevent too many signals being sent by the nerves supplying your bowel. Antidepressants can be effective, however, they do have side effects and will not be used as a first option
• Probiotics can help to reduce bloating and flatulence

Will my IBS get better?

IBS is a long-term condition, and it may be present for your whole life. However, this does not mean that you will necessarily experience symptoms every day. It may come and go in ‘flares’, you may go for long periods without any symptoms, or your symptoms might be mild. By using the treatment tips mentioned here, you can help to keep your symptoms under control and reduce how often they occur.

Summary

Although the causes of IBS are not fully understood, the symptoms can be treated with a combination of methods. By making lifestyle changes you should be able to find what works for you in order to keep your IBS symptoms in check. If you are still having difficulty, speak to your doctor as they will be able to assist you with further therapies or medications.