Irritable bowel syndrome

Irritable bowel syndrome (IBS) is a condition that affects your digestive system. It occurs in approximately 13 million people in the UK. That equates to roughly 1 in 5 adults. It can cause a lot of discomfort and may have an impact on the quality of your life.¹ But it will not increase your risk of getting other bowel related conditions.²

There isn’t one single cause of IBS. There are a few potential reasons it might happen, for example, if you had an episode of food poisoning or a stomach bug (gastroenteritis) it can trigger IBS.³

Sensitive nerves inside your gut can react to environmental factors, such as stress, overeating or undereating which can also be responsible for triggering symptoms.¹

Symptoms of IBS can be uncomfortable and can sometimes be worse than usual (flare-ups).¹

The symptoms of IBS include:

• Pain in your stomach that is worse after eating and better after doing a poo
• Bloating
• Having a sudden urge to poo or having incontinence
• Diarrhoea
• Constipation
• Nausea
• Having excessive wind
• Needing to wee more and not being able to fully empty your bladder
• Lack of energy.^1,2,3

Everyone experiences IBS differently and you may not get all of these symptoms. If you have any symptoms of IBS, talk to your GP and they will help you with your treatment.

Make an urgent GP appointment if you have also noticed any of the following:

These symptoms may be a sign of bowel cancer, ovarian cancer, coeliac disease, or inflammatory bowel disease so need to be checked by a GP.⁴

Treatment for IBS depends on your symptoms and triggers. If you are unsure what may be causing your IBS, you may want to start a diary of when you get flare ups. Include what happened immediately before the flare up, including what you ate and how you felt, to help identify a cause.

If your IBS is being triggered by your diet, there are ways you can improve symptoms. These include:

• Eating a healthy, balanced diet
• Eating regularly and not skipping meals
• Adjusting the amount of fibre in your diet
• Reducing the amount of caffeine you drink, like tea, coffee and energy drinks
• Avoiding fizzy drinks and alcohol
• Avoiding fatty or spicy food
• Introducing probiotics into your diet such as natural yoghurt or pickled vegetables to help encourage healthy gut bacteria
• Drinking more water (about 8 glasses of water a day).^1,2

If following these steps don’t improve your symptoms, your GP may suggest following a low FODMAP diet.⁵

A low FODMAP diet is where you cut out certain foods that are difficult to digest, such as some carbohydrates, fruits and vegetables.6 If your GP thinks this is the best way to go, they will give you information on how to get started. You may be able to reintroduce some high FODMAP foods later.

If your IBS is triggered by stress, there are things you can do to improve your symptoms. First and foremost, you need to manage your stress. You can do this by:

• Carrying out gentle exercise such as yoga, walking or swimming
• Practicing mindfulness by meditating
• Taking up a new hobby such as gardening, painting, photography or sewing
• Taking up a healthy, balanced diet and reducing alcohol intake
• Practicing good sleep hygiene.⁷

If you can’t manage IBS symptoms at home, speak to your GP. They may be able to help you manage your symptoms with medication.

If your symptoms are triggered by stress or another mental health concern, your GP may also be able to refer you to Talking Therapies, which is a service that helps you look after your mental health.⁷

Approximately one third of people with IBS also have depression. Depression is a mental health condition where you experience low mood, feelings of helplessness and suicidal thoughts.^8,9

The main reason why people with IBS are also likely to have depression is because of how the brain and gut are connected internally.⁸

There is a connection between the brain and gut in the nervous system called the brain-gut axis. This connection can sometimes not work as expected. This means that when something happens internally that affects the brain, it sends messages to the gut, triggering a response and vice versa.⁸

It can be difficult to get a dual diagnosis during your GP appointment as you only have a limited time to discuss your symptoms. If you think you may be experiencing both conditions, you may want to write down your symptoms before your appointment or request back-to-back appointments, so you are able to have enough time to discuss symptoms with your GP.⁸

If you are diagnosed with both IBS and depression, you may be prescribed anti-depressants. Anti-depressants can help with both conditions as they have been shown to reduce stomach pain as well as level out your mood. Your GP will go into detail on the type of anti-depressant you have been prescribed and explain how it should be taken.⁸

If you don’t want to take anti-depressants, there are non-pharmacological interventions you can try. Talking therapies, like counselling or cognitive behavioural therapy, can help reduce feelings of depression. You can be referred for counselling by your GP or you can do a self-referral. NHS waiting times can be long so if you want to access counselling services straight away, you may want to get private care.