What Is Irritable Bowel Syndrome (IBS) – What Are the Symptoms and Treatment?
Irritable Bowel Syndrome (IBS) is a common, long-term condition affecting the digestive system. Though not life-threatening, it can significantly impact a person's quality of life. Characterised by abdominal discomfort, bloating, and altered bowel habits, IBS is often misunderstood and misdiagnosed.
In this comprehensive article, we explore what IBS is, its symptoms, causes, and treatment options, as well as effective strategies for managing it through diet, lifestyle, and medical care.
What Is Irritable Bowel Syndrome (IBS)?
IBS is a functional gastrointestinal disorder, meaning there’s no structural abnormality visible in tests, but the bowel doesn't work as it should. The exact cause remains unknown, but it’s believed to involve a combination of factors like gut-brain interaction, stress, hormones, and diet.
IBS is a chronic condition that often comes and goes. While it does not cause lasting damage to the colon or increase the risk of more serious conditions, it can still lead to significant discomfort and disruption in daily life.
Common Symptoms of IBS
The symptoms of IBS can vary in type and severity from person to person. The most common include:
- Abdominal pain or cramping: Usually relieved by passing stool or gas.
- Bloating and gas: A sense of fullness or pressure in the abdomen.
- Diarrhoea: Frequent loose stools, often urgent.
- Constipation: Infrequent, hard, or difficult-to-pass stools.
- Alternating diarrhoea and constipation: A common subtype called mixed IBS.
- Mucus in the stool
- Fatigue and sleep difficulties: Sometimes linked with chronic discomfort.
Types of IBS
- IBS-C: IBS with predominant constipation.
- IBS-D: IBS with predominant diarrhoea.
- IBS-M: Mixed symptoms of constipation and diarrhoea.
- IBS-U: Unclassified — symptoms don’t clearly fit into the other subtypes.
What Causes IBS?
The exact cause of IBS is unclear, but several factors may contribute:
- Abnormal muscle contractions: Stronger or weaker intestinal contractions may cause diarrhoea or constipation.
- Nervous system dysfunction: Poor coordination between the brain and gut can lead to discomfort and irregular bowel movements.
- Gut microbiota imbalance: A disrupted balance of gut bacteria may influence symptoms.
- Infections: Some individuals develop IBS after a bout of gastroenteritis (post-infectious IBS).
- Stress: Psychological stress plays a major role, especially in flare-ups.
- Food intolerances: Certain foods and drinks may trigger or worsen symptoms.
Risk Factors
- Being under 50 years of age
- Being female (hormonal changes may play a role)
- A family history of IBS
- Existing mental health issues such as anxiety or depression
How Is IBS Diagnosed?
IBS is typically diagnosed through a combination of symptom evaluation, medical history, and ruling out other conditions. Tests may include:
- Blood tests to check for anaemia, inflammation, or coeliac disease
- Stool tests to rule out infection or inflammation
- Colonoscopy or sigmoidoscopy in severe or atypical cases
The Rome IV criteria are often used in diagnosis, requiring recurrent abdominal pain for at least one day a week over the past three months, associated with changes in stool frequency or appearance.
Treatment and Management of IBS
There’s no single cure for IBS, but symptoms can be effectively managed through a combination of lifestyle, dietary, and medical approaches.
1. Dietary Adjustments
Diet plays a central role in managing IBS. Helpful strategies include:
- Low FODMAP Diet: Reducing fermentable carbohydrates such as lactose, fructose, and polyols that cause bloating and gas.
- Fibre Management: Soluble fibre (like oats and psyllium) can ease constipation; insoluble fibre may worsen bloating in some people.
- Identifying Trigger Foods: Keep a food diary to pinpoint foods that aggravate symptoms. Common culprits include caffeine, alcohol, spicy foods, and dairy.
2. Lifestyle Changes
- Stress Reduction: Practise yoga, mindfulness, or meditation to reduce stress-related flare-ups.
- Regular Exercise: Physical activity improves digestion and mood.
- Sleep Hygiene: Consistent and restful sleep is essential for digestive health.
3. Medical Treatments
- Antispasmodics: To relax intestinal muscles and relieve cramping (e.g., mebeverine).
- Laxatives: For IBS-C, but use under medical supervision.
- Anti-diarrhoeal medications: Such as loperamide for IBS-D.
- Probiotics: May help balance gut bacteria and reduce symptoms.
- Antidepressants: Low-dose tricyclics or SSRIs may reduce pain and manage coexisting anxiety or depression.
4. Psychological Therapies
Mental health is closely tied to gut function. Cognitive Behavioural Therapy (CBT), gut-directed hypnotherapy, and counselling have shown positive results for IBS sufferers.
Living With IBS
Living with IBS can be frustrating, especially when flare-ups seem unpredictable. However, with education, support, and effective management, many people go on to lead full, active lives.
Joining support groups or forums (online or local) can be empowering, offering tips and emotional support from those who understand the struggle.
When to See a Doctor
See a healthcare provider if you experience:
- Unexplained weight loss
- Rectal bleeding
- Persistent or severe pain
- Symptoms that start after age 50
- Night-time diarrhoea or other concerning symptoms