Irritable bowel syndrome (IBS)
Irritable bowel syndrome (IBS) is a common digestive condition. Worldwide it is estimated that 10 – 15 percent of the population has IBS. Most people affected by IBS are under 50 but it can affect people of all ages.
Overview | Symptoms | Causes | Why see a specialist? | Diagnosis | Treatment | Video FAQs
Because it is a common condition, some people may be tempted to self-diagnose with IBS if they recognise the symptoms. However, IBS can only be diagnosed by a medical professional (an IBS specialist). Other conditions share the same symptoms as IBS so self-diagnosis is not a good idea.
Symptoms
The symptoms of IBS include bloating, flatulence, tiredness, stomach cramps (especially shortly after eating), diarrhoea or, in some cases, constipation.
For some people IBS symptoms are intermittent. Symptoms may resolve and then come back again. For others symptoms are ongoing.
IBS symptoms can affect people moderately or more severely. Some people find that their symptoms can interfere with daily life. They may need frequent trips to the toilet and may feel exhausted by the condition.
IBS can affect women differently to men. Women may find they have symptoms during their time of menstruation. Or, if they have continuous symptoms, their symptoms are worse at this time.
Causes
Doctors do not fully understand the causes of IBS, however, there is strong association with diet and stress, leading to oversensitivity of the nerves in the gut. This may make the food pass through the gut either too quickly (diarrhoea with urgency) or too slowly (constipation). There may also be hereditary factors that make it more likely for you to develop IBS.
Another possible cause is a previous bacterial infection in the gut. This is known as post-infectious IBS.
Although the cause of IBS is unknown, doctors have some understanding of the physical process in the gut which leads to symptoms.
This process may consist of a slowing down of movements in the large intestine which causes cramping. Abnormal serotonin levels in the large intestine also affect bowel movements.
Why see an IBS specialist?
IBS symptoms can come and go, and last for short or long periods of time. There is no known cure for IBS, and for many sufferers, it becomes a life-long, chronic condition. Fortunately, it can be managed with lifestyle changes and medication.
IBS shares symptoms with other conditions, so it is important to see an IBS specialist if you suspect that you have IBS. An IBS specialist is a gastroenterologist who specialises in diagnosing and treating IBS.
IBS is a diagnosis that’s given when other similar conditions have been ruled out. An IBS specialist will not only diagnose your condition but give you detailed advice on how to manage your condition.
Diagnosis
You will need to tell the IBS specialist about the kinds of symptoms you are experiencing, when they started, and whether they are occasional (and if so, how often) or happening all the time.
You will also need to let them know if your symptoms are worse after eating particular kinds of food. Keeping a food diary plus a note of your symptoms will help you remember this information and manage the problem later.
Because the causes of IBS are unclear, there is no actual test for the condition. Your doctor may run blood tests and take stool samples to rule out an infection, coeliac disease or inflammatory bowel disease. These have similar symptoms to IBS.
Once these other causes are ruled out, your doctor can give you an IBS diagnosis.
Treatment
As with many digestive health issues, diet, exercise and relaxation play an important part in managing chronic conditions, such as IBS. Patients are advised to avoid heavily processed foods (ready meals) and fatty or spicy foods, cut down on caffeine and fizzy or alcoholic drinks, and not to eat too much fruit.
We recommend meals made with fresh ingredients, along with sticking to regular mealtimes, trying probiotic dietary supplements rich in ‘good bacteria’, and not eating too quickly. Also, eating smaller frequent meals rather than 3 main meals. A trial of a low FODMAP diet may also help.
Simple remedies over the counter might also help with symptoms, such as remedies to reduce wind, colic, diarrhoea, or constipation. Your doctor might recommend medications called neuromodulators, such as amitriptyline, to reduce the sensitivity of the bowel, which is thought to cause IBS in some patients.
IBS symptoms can be very stressful and cause high levels of anxiety, which in turn can make the bowel symptoms worse. Therefore, stress reduction and relaxation techniques can often help, such as cognitive behavioural therapy (CBT), gut directed hypnotherapy, and acupuncture.
Book a private consultation
IBS is a chronic condition that requires ongoing management. Some people try to self-diagnose the condition, but it’s essential to perform the right diagnostic tests to rule out other harmful conditions, such as IBD.
Book an appointment with one of our highly trained specialists to confirm your diagnosis and receive tailored recommendations to control your condition.
Tests
Blood tests
Stool tests
Breath tests
Endoscopy
SeHCAT test
Treatments / Symptom Management
Lifestyle modifications (diet, probiotics, weight loss, exercise)
Medications to control symptoms (diarrhoea, constipation, bloating, pain)
Medications to regulate the gut nerves (neuromodulators)
Complementary therapies