Learn more about irritable bowel syndrome: introduction
- Irritable bowel syndrome (IBS) is a common condition that affects the digestive system.
- It causes symptoms like stomach cramps, bloating, diarrhoea and constipation. These tend to come and go over time, and can last for days, weeks or months at a time.
- It's usually a lifelong problem. It can be very frustrating to live with and can have a big impact on your everyday life.
- There's no cure, but diet changes and medicines can often help control the symptoms.
- The exact cause is unknown – it's been linked to things like food passing through your gut too quickly or too slowly, oversensitive nerves in your gut, stress and a family history of IBS.
Learn more about irritable bowel syndrome: symptoms
The main symptoms of IBS are:
- stomach pain or cramps – usually worse after eating and better after doing a poo
- bloating – your tummy may feel uncomfortably full and swollen
- diarrhoea – you may have watery poo and sometimes need to poo suddenly
- constipation – you may strain when pooing and feel like you cannot empty your bowels fully
There may be days when your symptoms are better and days when they're worse (flare-ups). They may be triggered by food or drink.
What can trigger IBS symptoms
IBS flare-ups can happen for no obvious reason.
Sometimes they have a trigger like:
- certain foods, such as spicy or fatty food
- stress and anxiety
IBS can also cause:
- farting (flatulence)
- passing mucus from your bottom
- tiredness and a lack of energy
- feeling sick (nausea)
- problems peeing – like needing to pee often, sudden urges to pee, and feeling like you cannot fully empty your bladder
- not always being able to control when you poo (incontinence)
See a GP if you think you might have IBS
They can check for IBS and do some tests to rule out other problems.
Ask for an urgent appointment if you have:
- lost a lot of weight for no reason
- bleeding from your bottom or bloody diarrhoea
- a hard lump or swelling in your tummy
- shortness of breath, noticeable heartbeats (palpitations) and pale skin
These could be signs of something more serious.
Learn more about irritable bowel syndrome: getting diagnosed
What happens at your GP appointment
The GP will ask about your symptoms, such as:
- what symptoms you have
- if they come and go
- how often you get them
- when you get them (for example, after eating certain foods)
- how long you've had them
Before your appointment, it might help to write down details of your symptoms to help you remember them.
The GP may also feel your tummy to check for lumps or swelling.
Tests for IBS
There's no test for IBS, but you might need some tests to rule out other possible causes of your symptoms.
The GP may arrange:
- a blood test to check for problems like coeliac disease
- tests on a sample of your poo to check for infections and inflammatory bowel disease (IBD)
You will not usually need further tests in hospital unless the GP is not sure what the problem is.
What happens if you're diagnosed with IBS
If the GP thinks you have IBS, they'll talk to you about what it is and what the treatment options are.
It might be difficult to take in everything they tell you.
If you're unsure about something afterwards, write down any questions you have and make another appointment to go over them.
The IBS Network also has online information you might find useful.
Learn more about irritable bowel syndrome: diet, lifestyle and medicines
There's no single diet or medicine that works for everyone with IBS. But there are lots of things that can help if you have been diagnosed with it.
cook homemade meals using fresh ingredients when you can
keep a diary of what you eat and any symptoms you get – try to avoid things that trigger your IBS
try to find ways to relax
get plenty of exercise
try probiotics for a month to see if they help
do not delay or skip meals
do not eat too quickly
do not eat lots of fatty, spicy or processed foods
do not eat more than 3 portions of fresh fruit a day (a portion is 80g)
do not drink more than 3 cups of tea or coffee a day
do not drink lots of alcohol or fizzy drinks
- eat oats (such as porridge) regularly
- eat up to 1 tablespoon of linseeds a day
- avoid foods that are hard to digest (like cabbage, broccoli, cauliflower, brussels sprouts, beans, onions and dried fruit)
- avoid products containing a sweetener called sorbitol
- ask a pharmacist about medicines that can help, like Buscopan or peppermint oil
- cut down on high-fibre foods like wholegrain foods (such as brown bread and brown rice), nuts and seeds
- avoid products containing a sweetener called sorbitol
- ask a pharmacist about medicines that can help, like Imodium (loperamide)
If you keep getting diarrhoea, make sure you drink plenty of water to avoid dehydration.
- drink plenty of water to help make your poo softer
- increase how much soluble fibre you eat – good foods include oats, pulses, carrots, peeled potatoes and linseeds
- ask a pharmacist about medicines that can help (laxatives), like Fybogel or Celevac
See a GP if:
- diet changes and pharmacy medicines are not helping
- you need to avoid lots of different foods to control your symptoms
They may refer you to a dietitian or specialist for advice, and can also suggest other treatments to try.
Learn more about irritable bowel syndrome: further help and support
A GP may refer you to an NHS dietitian if general diet tips for IBS, such as avoiding foods that trigger your symptoms, are not helping.
They can suggest other changes you can make to your diet to ease your symptoms.
Low FODMAP diet
A dietitian may recommend a diet called a low FODMAP diet.
This involves avoiding foods that are not easily broken down by the gut, such as some types of:
- fruit and vegetables
- wheat products
Watch a video guide from NHS dietitians
Our 35-minute video guide can help you learn more about managing your symptoms.
It's similar to the advice you'd get if you saw a dietitian.
The guide covers things like:
- general diet tips for IBS
- advice on certain types of food, like dairy and gluten
- basics of the low FODMAP diet
- allergy testing
If you want to see a dietitian privately, make sure they're registered with the British Dietetic Association (BDA).
IBS medicines from a GP
If pharmacy medicines are not helping, a GP may prescribe a stronger medicine, such as:
These are antidepressants, but they can also help ease IBS symptoms.
They may take a few weeks to start working and can cause side effects.
A GP may refer you to a specialist if you have severe symptoms and other medicines have not helped.
Psychological therapies for IBS
If you have had IBS for a long time and other treatments are not helping, a GP may refer you for a talking therapy, such as cognitive behavioural therapy (CBT).
This can help if stress or anxiety is triggering your symptoms. It can also help you cope with your condition better.
You can also refer yourself directly to an NHS psychological therapies service (IAPT) without a referral from a GP.
These offer psychological therapies like CBT for common mental health problems like stress, anxiety and depression.