Irritable bowel syndrome (IBS)

What is IBS (irritable bowel syndrome)

• IBS (irritable bowel syndrome) is a common condition that affects the digestive system.
• It causes symptoms like stomach cramps, bloating, diarrhoea and constipation. These tend to come and go over time, and can last for days, weeks or months at a time.
• It's usually a lifelong problem. It can be very frustrating to live with and can have a big impact on your everyday life.
• Diet changes and medicines can often help control the symptoms.
• The exact cause is unknown – it's been linked to things like food passing through your gut too quickly or too slowly, gastroenteritis, oversensitivity in your gut, stress and a family history of IBS.

Symptoms of IBS (irritable bowel syndrome)

The main symptoms of IBS (irritable bowel syndrome) are:

• stomach pain or cramps – usually worse after eating and better after doing a poo
• bloating – your tummy may feel uncomfortably full and swollen
• diarrhoea – you may have watery poo and sometimes need to poo suddenly
• constipation – you may strain when pooing and feel like you cannot empty your bowels fully

There may be days when your symptoms are better and days when they're worse (flare-ups). They may be triggered by food or drink.

What can trigger symptoms of IBS

IBS flare-ups can happen for no obvious reason. Sometimes they have a trigger like:

• alcohol
• caffeine
• certain foods, such as spicy or fatty food
• stress and anxiety
• regular antibiotic use

Other symptoms of IBS

IBS can also cause:

• farting (flatulence)
• pooing mucus
• tiredness and a lack of energy
• feeling sick (nausea)
• backache
• problems peeing, like needing to pee often, sudden urges to pee, and feeling like you cannot fully empty your bladder
• not always being able to control when you poo (bowel incontinence)

Getting diagnosed with IBS (irritable bowel syndrome)

What happens at your GP appointment

If the GP thinks you may have IBS (irritable bowel syndrome) they'll ask some questions, such as:

• what symptoms you have
• if they come and go
• how often you get them
• when you get them (for example, after eating certain foods)
• how long you've had them for

The GP may also feel your tummy to check for lumps or swelling.

Before your appointment, it might help to write down details of your symptoms to help you remember them.

Tests for IBS

There's no test for IBS, but you might need some tests to rule out other possible causes of your symptoms.

The GP may arrange:

• a blood test to check for problems like coeliac disease
• tests on a sample of your poo to check for infections and inflammatory bowel disease (IBD)

You will not usually need further tests in hospital unless the GP is not sure what the problem is.

What happens if you're diagnosed with IBS

If the GP thinks you have IBS, they'll talk to you about what it is and what the treatment options are.

It might be difficult to take in everything they tell you.

If you're unsure about something afterwards, write down any questions you have and make another appointment to go over them.

Guts UK has more information on IBS.

Diet, lifestyle and medicines for IBS (irritable bowel syndrome)

There's no single diet or medicine that works for everyone with IBS (irritable bowel syndrome).

But there are things that can help if you have been diagnosed with IBS, to help improve your symptoms or avoid making them worse.

Other ways to help IBS symptoms

How to ease bloating, cramps and farting

To help reduce symptoms like bloating, cramps and farting:

• eat oats (such as porridge) regularly
• eat up to 1 tablespoon of linseeds (whole or ground) a day
• avoid foods that are hard to digest (like cabbage, broccoli, cauliflower, brussels sprouts, beans and onions)
• avoid products containing a sweetener called sorbitol
• ask a pharmacist about medicines that can help, like Buscopan or peppermint oil

How to reduce diarrhoea

To help prevent diarrhoea, you can:

• cut down on high-fibre foods like wholegrain foods (such as brown bread and brown rice), nuts and seeds
• avoid products containing a sweetener called sorbitol
• ask a pharmacist about medicines that can help, like loperamide (Imodium)

How to relieve constipation

To help ease constipation, you can:

• drink plenty of water to help make your poo softer
• increase how much soluble fibre you eat – good foods include oats, pulses, carrots, peeled potatoes and linseeds (whole or ground)
• ask a pharmacist about medicines that can help (laxatives), like Fybogel

Further help and support for IBS (irritable bowel syndrome)

Seeing a dietitian for IBS

A GP may refer you to an NHS dietitian if general changes to your diet and lifestyle have not helped your IBS (irritable bowel syndrome) symptoms.

They can suggest other changes to your diet that may help your symptoms.

Low FODMAP diet

A dietitian may recommend a diet called a low FODMAP diet.

This involves avoiding foods that are not easily broken down by the gut, such as some types of:

• fruit and vegetables
• milk
• wheat products

Private dietitians

If you want to see a dietitian privately, make sure they're registered with the British Dietetic Association (BDA).

IBS medicines from a GP

If pharmacy medicines are not helping with your symptoms of IBS, a GP may prescribe a stronger medicine, such as:

• amitriptyline
• citalopram

These are antidepressants, but they can also help ease IBS symptoms.

They may take a few weeks to start working and can cause side effects.

A GP may refer you to a specialist if you have severe symptoms and other medicines have not helped.

Psychological therapies for IBS

If you have had IBS for a long time and other treatments are not helping, a GP may refer you for a talking therapy, such as cognitive behavioural therapy (CBT).

This can help if stress or anxiety is triggering your symptoms. It can also help you cope with your condition better.

You can also refer yourself directly to an NHS talking therapies service without a referral from a GP.

These offer therapies like CBT for common mental health problems like stress, anxiety and depression.

Find out more about NHS talking therapies