Irritable Bowel Syndrome (IBS)

What is irritable bowel syndrome (IBS)?

Irritable Bowel Syndrome (IBS) is a condition that affects how the digestive system works. If you have IBS, you may experience abdominal pain or discomfort together with changes in bowel habits, such as diarrhoea, constipation, or both. 

Unlike some digestive diseases, IBS does not cause visible damage to the digestive tract. Because of this, there is no single test that can confirm IBS, and it generally diagnosed based on symptoms and medical history. 

Approximately 1 in 10 people worldwide have IBS; women are more likely to develop the condition than men. 

Although IBS does not shorten life expectancy, the symptoms can still have a significant impact on a person’s quality of life.

What are the symptoms of IBS?

IBS symptoms mainly affect the digestive system and often come and go in flare-ups. Common symptoms include:

  • Abdominal pain or stomach discomfort
  • Diarrhoea
  • Constipation
  • Bloating, especially after eating
  • Excess gas
  • A sudden urge to have a bowel movement
  • A feeling that the bowel has not completely emptied after going to the toilet 

Symptoms may last for several days and then improve before returning again. For some people, symptoms are mild, while for others they can interfere with daily activities.

What causes IBS?

There is no single known cause of IBS. Experts believe that several factors work together to affect how the digestive system functions. Some of the main factors include:

The gut–brain connection

The digestive system and the brain are closely linked through what is known as the gut-brain axis. Stress or emotional events can affect this connection and trigger digestive symptoms. 

Changes in gut bacteria

The digestive system contains millions of bacteria known as the gut microbiome. Changes in these bacteria may contribute to IBS symptoms such as bloating, gas, and abdominal discomfort. 

Changes in bowel movement speed

In some people with IBS, the bowel moves too quickly, causing diarrhoea. In others, it moves more slowly, which can lead to constipation. 

The immune system

Subtle immune system changes may cause inflammation in the gut, increasing sensitivity and affecting how the bowel reacts to certain triggers. 

Stress and psychological factors

Stress and anxiety can increase the likelihood of IBS symptoms or trigger flare-ups. 

Genetics

Research suggests that IBS may run in families, indicating that genetic factors could play a role. 

How can you manage IBS symptoms?

Although there is currently no cure for IBS, there are many ways to manage it and improve quality of life. Treatment plans are usually personalised based on the symptoms experienced most often. 

Adjust your diet

Dietary changes are often one of the first steps in managing IBS. A dietitian can help identify foods that may trigger symptoms. Helpful strategies may include:

  • Gradually increasing fibre intake to help with constipation
  • Reducing or avoiding gluten if it worsens symptoms
  • Limiting dairy products if lactose intolerance is suspected
  • Avoiding foods that increase gas, such as beans, cabbage, and brussels sprouts
  • Cutting back on carbonated drinks and chewing gum
  • Trying a low-FODMAP (low in certain types of carbohydrates sugars, alcohols, and fibres) diet with professional guidance
  • Keeping a food diary to identify triggers 

Maintain healthy daily habits

Lifestyle habits can also influence digestive health. Some helpful changes include:

  • Exercising regularly (around 30 minutes of moderate activity five days per week)
  • Practising stress-management techniques such as meditation or yoga
  • Getting 6–8 hours of sleep each night 

Consider psychological support

Because the brain and gut are closely connected, psychological support may help some people manage symptoms. This may include:

  • Cognitive behavioural therapy (CBT)
  • Hypnotherapy
  • Professional mental health support if anxiety or depression are present 

Medication options

If symptoms remain troublesome, a doctor may recommend medication depending on the main symptoms.

These may include treatments for constipation, diarrhoea, abdominal cramps, or medications that help regulate the gut–brain connection. 

When Should You See a Doctor About IBS?

Many people delay seeking help for IBS because they feel embarrassed or believe nothing can be done. However, discussing symptoms with a GP is important so that other conditions can be ruled out and appropriate treatment can be offered. You should see a doctor if you experience:

  • Blood in your stool
  • Unintentional weight loss
  • New bowel symptoms after the age of 50
  • Anaemia
  • A lump or swelling in the abdomen
  • A change in long-standing bowel symptoms
  • Any bowel symptoms if you have a family history of colon cancer or inflammatory bowel disease
  • Any symptoms that worry you 

It is important in women to consider gynaecological conditions which may cause symptoms which may mimic IBS. Pelvic ultrasound and blood tests should be done in these cases. 

Your doctor can review your symptoms and arrange tests if needed before recommending a management plan.