Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome (IBS) is a long-term (chronic) condition of the gastrointestinal tract that involves frequent abdominal pain (tummy ache) and/or bowel symptoms. These symptoms include abdominal (tummy) cramps, bloating, and constipation or diarrhoea or both.

Irritable bowel syndrome (IBS) is a common condition. Around 1 in 5 people in the UK will experience IBS at some point in their lives. It can affect anyone at any age but it often first develops in young adults, in their teens or twenties, and can continue from time to time throughout life.

Women are twice as likely than men to have IBS. Many women find that signs and symptoms are worse during or around their menstrual periods.

IBS does not increase the chances of bowel cancer and does not make a person more likely to develop other colon conditions, such as colitis, Crohn’s disease, or other cancers. However, if you think you may have IBS, you should see a doctor. IBS may need long-term care and management.

What causes IBS?

The cause of IBS is not known. Some IBS experts think it relates to changes in how the bowel moves and contracts or changes in how it senses pain. IBS is a functional disorder, which means that the digestive system looks normal but it doesn’t work properly. IBS may also be called spastic colon or spastic bowel.

Diet, stress, poor sleep and changes in the bowel bacteria may all trigger symptoms of IBS. However, these triggers are different for each person. This makes it difficult to find out which foods or activities people should avoid.

Symptoms of IBS

The symptoms of IBS can vary from person to person. These can also change in the same person at different times. Such symptoms include:

• Abdominal cramps (tummy cramps)
• Bloating
• Diarrhoea
• Constipation
• Excess gas (wind in the stomach)
• Mucus in the stool
• Hormones (in women)

Sometimes people experience underlying symptoms which may appear unrelated but may be signs of IBS. These may include:

• Trouble urinating, especially if it feels like you can’t finish
• Incontinence
• Parts of the day where your energy levels feel like they’re dropping
• An increase in flatulence
• Aches in the lower part of the back

These symptoms are sometimes referred to as Manning criteria for IBS.

Some people may find themselves with some of these less common symptoms on top of the main symptoms previously mentioned.

Changes in bowel habits may also be associated with IBS. These include:

• Straining to empty your bowels
• Infrequent stools (poo)
• Hard or lumpy stools (poo)
• A feeling that the bowel does not empty completely
• A feeling of a ‘blockage’ preventing you from passing stools

Some people have occasional mild symptoms, while others have more severe symptoms (flare-ups) over a longer time period. In some cases, these signs and symptoms may improve or disappear completely.

Diagnosis of IBS

There are no laboratory tests or imaging tests that can confirm a diagnosis of IBS. So an IBS diagnosis is based on an in-depth medical history and a physical examination. Your doctor will start by asking you about your symptoms.

IBS is diagnosed when repeated abdominal pain (tummy ache) lasts for at least 6 months, combined with weekly abdominal pain for 3 months. This diagnosis also involves a combination of tummy pain that is associated with changes in the frequency or form of your bowel movements.

Also, tell your doctor about any personal or family history of gastrointestinal diseases that you have, such as cancer, bowel cancer, stomach cancer or inflammatory bowel disease (IBD).

Your GP may /digestive-health/gastrointestinal-conditions/ibd/refer you to an IBS specialist who can help you identify your triggers, symptoms and discuss ways to manage your symptoms.

OneWelbeck Digestive Health in London can provide you with fast, high-quality-services to investigate the signs and symptoms of irritable bowel syndrome. OneWelbeck also provides private gastroscopy and colonoscopy procedures, without the need for overnight stay.

IBS Tests

Although IBS cannot be confirmed with a test, your GI specialist may recommend some tests to rule out other diseases, such as inflammatory bowel disease (IBD), ulcerative colitis, Crohn’s disease, coeliac disease, cancer of the ovary or a gut infection.

Symptoms of these other diseases can be similar to IBS and may lead to the wrong diagnosis. These additional tests include:

• Blood and stool samples
• Ultrasound
• X-ray
• Computer tomography (CT scan)
• Sigmoidoscopy
• Colonoscopy

IBS patients who come to our clinic are matched with leading digestive health specialists who use the latest technologies to help understand IBS on an individual level. Our patient-centred clinic is attuned to each patient’s needs, delivering an experience that works just for you, to get the best results.

IBS is a lifelong condition, therefore knowing how to adapt and live a healthier life can have vast improvements on quality of life.

Treatment for IBS

IBS is not a life-threatening condition; however, it can affect your quality of life. While no treatment is likely to remove IBS symptoms completely, it can often help to ease symptoms, improve your bowel function and improve your quality of life.

Treatments of IBS can include dietary changes, lifestyle changes, psychosocial therapy and medicines.

Dietary Changes

Some people find that certain foods can trigger the symptoms of IBS. However, the specific foods that lead to symptoms can vary from person to person.  Making the following changes in your diet may help to reduce symptoms:

• Increase soluble fibre in your diet (oats, wholemeal bread, fortified breakfast cereals)
• Cut down on caffeine, alcohol and fizzy drinks
• Reduce processed foods in your diet, such as crisps, oven chips, biscuits and cakes
• Increase fluid intake (mostly water) to at least 8 cups each day
• Avoid the artificial sweetener sorbitol if you have diarrhoea

Specific diets have shown benefits for some IBS patients. These include

• The ‘low FODMAP’ diet – a diet that is low in certain fermentable sugars. This diet should be tried with the help of a dietician.
• The gluten free diet – a diet that excludes certain proteins that are found in many grains

Working with a dietician can be helpful to better understand your possible food triggers and identify diets that exclude certain foods to reduce these triggers.

Lifestyle Changes

General recommendations for IBS lifestyle changes include:

• Get regular exercise
• Get more sleep
• Psychological therapies
• Keep a daily diary for 2-4 weeks of your symptoms, what you eat, your medicines and your activities to identify and avoid things that trigger your IBS

Psychological Therapies

Stressful situations, such as family problems, work stress or examinations, may trigger symptoms of irritable bowel syndrome (IBS). Psychological therapies can be effective for some people with IBS. Examples of psychological therapies are cognitive behavioural therapy (CBT), hypnotherapy and psychotherapy.

Medications for IBS

Many medicines for IBS are available over-the-counter from pharmacies. However, remember that treatment of one IBS symptom may make another symptom worse. For example, medicines for diarrhoea can cause constipation and increase pain and bloating.

Speak to your pharmacist about the most suitable over-the-counter treatment for you.

Your GP may refer you to an IBS specialist if you have severe IBS symptoms and other medicines haven’t helped. At OneWelbeck, you can also refer yourself to our private centre to confirm your IBS diagnosis and find out how to treat and manage your symptoms.