What is Irritable Bowl Syndrome?

About IBS

Irritable bowel syndrome (IBS) is a common, long-term condition of the digestive system. It can cause bouts of stomach cramps, bloating, diarrhoea and/or constipation.

IBS is thought to affect up to 1 in 5 people at some point in their life, and it usually first develops when a person is between 20 and 30 years of age. Around twice as many women are affected as men.

The condition is often lifelong, although it may improve over several years.

IBS symptoms

The symptoms of IBS vary between individuals and affect some people more severely than others. They tend to come and go in periods lasting a few days to a few months at a time, often during times of stress or after eating certain foods.

You may find some of the symptoms of IBS ease after going to the toilet and opening your bowels.

Common Symptoms include:

  • abdominal (stomach) pain and cramping, which may be relieved by having a poo

  • a change in your bowel habits – such as diarrhoeaconstipation or sometimes both

  • bloating and swelling of your stomach

  • excessive wind (flatulence)

  • occasionally experiencing an urgent need to go to the toilet

  • a feeling that you haven't fully emptied your bowels after going to the toilet 

  • passing mucus from your bottom 

Additional problems

In addition to the main symptoms, some people with IBS experience a number of other problems. These can include:

  • a lack of energy (lethargy)

  • feeling sick

  • backache

  • bladder problems - such as needing to wake up to urinate at night, experiencing an urgent need to urinate and difficulty fully emptying the bladder

  • pain during sex (dyspareunia)

  • incontinence

When to see your GP

See your GP if you think you have IBS symptoms, so they can try to determine the cause.

Your GP may be able to identify IBS based on your symptoms, although blood tests may be needed to rule out other conditions.

What causes IBS?

The exact cause of IBS is unknown, but most experts think that it's related to increased sensitivity of the gut and problems digesting food.

These problems may mean that you're more sensitive to pain coming from your gut, and you may become constipated or have diarrhoea because your food passes through your gut either too slowly or too quickly.

Psychological factors such as stress may also play a part in IBS.

Problems with digestion

Your body usually moves food through your digestive system by squeezing and relaxing the muscles of the intestines in a rhythmic way.

However, in IBS it's thought that this process is altered, resulting in food moving through your digestive system either too quickly or too slowly.

If food moves through your digestive system too quickly it causes diarrhoea, because your digestive system does not have enough time to absorb water from the food.

If food moves through your digestive system too slowly it causes constipation, as too much water is absorbed, making your stools hard and difficult to pass.

It may be that food does not pass through the digestive systems of people with IBS properly because the signals that travel back and forth from the brain to the gut are disrupted in some way.

It has also been suggested that problems such as bile acid malabsorption (where bile produced by the liver builds up in the digestive system) may be responsible for some cases of IBS.

Increased gut sensitivity

Many sensations in the body come from your digestive system. For example, nerves in your digestive system relay signals to your brain to let you know if you are hungry or full, or if you need to go to the toilet.

Some experts think that people with IBS may be oversensitive to the digestive nerve signals. This means mild indigestion that is barely noticeable in most people becomes distressing abdominal (stomach) pain in those with IBS.

 

Psychological factors

There is also some evidence to suggest that psychological factors play an important role in IBS.

However, this does not mean that IBS is "all in the mind", because symptoms are very real. Intense emotional states such as stress and anxiety can trigger chemical changes that interfere with the normal workings of the digestive system.

This does not just happen in people with IBS. Many people who have never had IBS before can have a sudden change in bowel habits when faced with a stressful situation, such as an important exam or job interview.

Some people with IBS have experienced a traumatic event, usually during their childhood, such as abuse, neglect, a serious childhood illness or bereavement.

It is possible that these types of difficult experiences in your past may make you more sensitive to stress and the symptoms of pain and discomfort.

 

IBS triggers

Certain foods and drinks can trigger the symptoms of IBS. Triggers vary from person to person, but common ones include:

  • alcohol

  • fizzy drinks

  • chocolate

  • drinks that contain caffeine – such as tea, coffee or cola

  • processed snacks – such as crisps and biscuits

  • fatty or fried food

Keeping a food diary may be a useful way of identifying possible triggers in your diet.

Stress is another common trigger of IBS symptoms. Therefore, finding ways to manage stressful situations is an important part of treating the condition.

Read more about treating IBS.

How is IBS treated?

There is no cure for IBS, but the symptoms can often be managed by making changes to your diet and lifestyle.

For example, it may help to:

  • identify and avoid foods or drinks that trigger your symptoms

  • alter the amount of fibre in your diet

  • exercise regularly

  • reduce your stress levels

Medication is sometimes prescribed for people with IBS to treat the individual symptoms they experience.

Living with IBS

IBS is unpredictable. You may go for many months without any symptoms, then have a sudden flare-up.

The condition can also be painful and debilitating, which can have a negative impact on your quality of life and emotional state. Many people with IBS will experience feelings of depression and anxiety, at some point. 

Speak to your GP if you have feelings of depression or anxiety that are affecting your daily life. These problems rarely improve without treatment and your GP can recommend treatments such as antidepressants or cognitive behavioural therapy (CBT), which can help you cope with IBS, as well as directly treating the condition.

With appropriate medical and psychological treatment, you should be able to live a normal, full and active life with IBS. 

IBS does not pose a serious threat to your physical health and doesn't increase your chances of developing cancer or other bowel-related conditions.