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Irritable Bowel Syndrome (IBS)

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What is Irritable Bowel Syndrome?

Irritable Bowel Syndrome or ‘IBS’ is a condition that affects the digestive system. IBS is a functional disorder where the gut looks normal, but its function is disrupted. This can make IBS difficult to diagnose.

IBS is not an inflammatory bowel disease (such as Crohn’s disease and ulcerative colitis), coeliac disease or bowel cancer. However, these conditions can share similar symptoms.

Living with IBS can be challenging. Although there is no cure, changes to diet and lifestyle can help provide significant symptom relief.

Symptoms, diagnosis and treatment

What are the symptoms?

The main symptoms of IBS include:

  • Abdominal pain or discomfort
  • Bloating or distention
  • Wind or farting
  • Change in bowel habit (Diarrhoea and/or constipation)

How does it get diagnosed?

A diagnosis of IBS can be considered if abdominal pain or discomfort is relieved by pooing or is linked to a change in bowel habit.

This should be accompanied by at least two of the following four symptoms:

  • Issues when going for a poo such as straining, urgency, and not being able to fully empty bowels.
  • Abdominal bloating, distension, tension or hardness
  • Symptoms made worse by eating
  • Passage of mucus

Before your IBS can be diagnosed, it is essential that you speak to your GP. This ensures that the condition is diagnosed correctly and that your symptoms are not due to other conditions affecting the gut.

The GP may arrange:

  • A blood test to check for problems like coeliac disease
  • A sample of poo to be tested for infections and inflammatory bowel disease (Crohn’s disease and ulcerative colitis)

How common is IBS?

IBS is common and affects 1 in 5 people, and it can develop at any age. However, women are twice as likely as men to suffer from IBS.

How is IBS managed?

If you have a diagnosis of IBS, your GP will refer you to your local IBS service, where they will provide the resources and support to help relieve symptoms.

It is important that you seek support from your local IBS service, and they will provide you with resources and support to help you manage your IBS symptoms. This is because there are many approaches to managing IBS, and it is very individual as to what might work for you. Using the advice on this page many people can manage their symptoms and often it’s a mixture of lifestyle changes and dietary changes. Some of the simplest changes can have the largest impact and some of these changes might not even be dietary changes. On this page is some advice that may help relieve symptoms and manage symptoms of IBS.

Here are some general tips that you can try to help relieve your IBS symptoms.

Do

  • Cook homemade meals and use fresh ingredients if possible
  • Note down what you eat and the symptoms you get
  • Try to relax
  • Exercise frequently, aiming for 30-minutes per day
  • 6-8 glasses of fluid per day (Water or non-caffeinated drinks) spread evenly throughout the day

Don't

  • Delay or skip meals
  • Eat quickly
  • Eat very fatty, spicy or processed foods
  • Eat more than 3 portions of fresh fruit per day (80g is a portion)
  • Drink more than 3 cups (2 mugs) of caffeinated coffee or tea per day
  • Drink too much alcohol or fizzy drinks

Nutrition and diet quality

There is no single diet or treatment that works for everyone with IBS, but it’s important that you ensure that you follow a healthy balanced diet. A healthy balanced diet could help reduce symptoms but is also crucial to maintain good health and help you feel at your best.

A healthy diet means eating a wide range of food in the right portions and consuming the right amount of food and drink to maintain a healthy body weight.
Some individuals with IBS may find that changes to diet help to relieve symptoms.

Ease bloating, cramps and farting

  • Eat oats regularly.
  • Eat up to 1 tablespoon of ground linseeds per day – this can be an excellent addition to porridge.
  • Avoid foods that are hard to digest, such as cabbage, broccoli, cauliflower, Brussel sprouts, beans, onions and dried fruit.
  • Reduce or stop consumption of artificial sweeteners, in particular sorbitol.

Reduce diarrhoea

  • Reduce foods very high in fibre (such as brown bread and brown rice), nuts and seeds.
  • Reduce or stop consumption of artificial sweeteners, in particular sorbitol.
  • Important: if you have diarrhoea, ensure that you are drinking plenty of water to avoid dehydration.

Relieve constipation

  • Drink plenty of water to help make your poo soft.
  • Increase the amounts of foods that contain certain fibres from foods such as oats, pulses, carrots, peeled potatoes and linseeds (ground or whole).

Physical activity

All adults should participate in physical activity as it contributes to physical and mental well-being. Physical activity can also benefit those with IBS by minimising stress, reducing bloating and improving overall bowel function.

The physical activity guidelines recommend that we take part in 150 minutes of moderate activity per week for adults. This can be split up into 30 minutes of activity on at least 5 days of the week.

You can also reach your weekly activity target by undertaking 75 minutes of vigorous activity. This will provide the same health benefits of 150 minutes of moderate activity per week.

Examples of moderate aerobic activities

  • Dancing
  • Riding a bike
  • Walking
  • Gardening
  • Water aerobics
  • Hiking

Examples of vigorous activities

  • Running
  • Swimming at a fast pace
  • Riding a bike fast or at an incline
  • Team sports such as football, rugby or netball

Examples of strengthening activities

  • Sit to stands
  • Squats
  • Bicep curls
  • Press-ups or wall press-ups
  • Calf raises
  • Squats

It is important to work all the major muscles by doing strength activities at least two days per week.

Yoga

Yoga also counts as a strengthening exercise and has been shown to improve mood and reduce stress, which both have an essential role in IBS.

You can find more information on yoga on the NHS website (A guide to yoga).

Physical activity plan

To help you include some physical activity into your daily routine and stay on track with your goals, you can use this physical activity plan.
Remember to increase your physical activity slowly, as doing too much too soon can lead to a loss of motivation and injuries.

You might find it helpful to think about the following before filling in your physical activity plan.

  • Are there local activities available that fit into my routine?
  • Do I actually enjoy this type of activity?
  • Are my friends available at this time to do the activity with me?
  • Choose affordable activities, such as a walk in the park or along the canal.

Sleep hygiene

Poor sleep is common for those who suffer from IBS due to abdominal pain, heartburn, and acid reflux.
Poor sleep often results in us feeling grumpy and lethargic and can also increase IBS symptom severity.

What are the recommendations for sleep in adults?

Most adults need 7 – 9 hours of sleep a night to maintain good physical and mental health. Still, everyone is individual, and some need more sleep than others. However, as a general rule, if you feel fatigued and need to nap often, you are likely not getting enough sleep.

Improve your sleep quality

  • Go to bed and get up around the same time every day
  • Make sure your bedroom is cool, dark and quiet
  • Make sure your bed is comfortable with a mattress that isn’t too soft or too hard
  • Be physically active but try to avoid vigorous activity too close to bedtime
  • Reduce the amount of caffeine and cut off caffeine consumption in the evening
  • Do not eat too much food or drink alcohol, especially close to bedtime
  • Do not smoke as nicotine is a stimulant and take it longer for you to get to sleep and cause frequent awakenings
  • Have a warm bath, stretch and listen to some relaxing music

If you find your sleep is being disturbed by acid reflux, these additional tips may also be helpful

  • Avoid eating late at night: leaving two to three hours before going to bed will allow your stomach plenty of time to digest and reduce the chances of reflux.
  • Sleep on your life side: avoid sleeping on your back and try sleeping on your left side as this can help minimise acid reflux.
  • Raise the head of the bed: raising the head of the bed by 10 – 15cm by placing blocks under the bed or using a special wedge pillow can help reduce symptoms of acid reflux

Mental health support

Looking after our mental health is important for everybody but for those with IBS it can be vital. There is a link between between feelings like stress, anxiety and worry with IBS symptoms. Here are some useful resources to help support with this.

  • My Wellbeing College offers guidance on things such as low mood, anxiety, sleep problems and stress.
  • Self help leaflets on topics ranging from abuse, bereavement, anger, panic and social anxiety.

Other support

You can buy a key from The IBS Network shop or Disability Rights UK shop to help you access public toilets if you get symptoms while away from home.

Useful links with videos and resources to support individuals with IBS

Useful diet sheets (PDF)

Useful books

IBS: Dietary Advice To Calm Your GutIBS: Dietary Advice To Calm Your Gut

This book presents the latest findings on IBS along with practical advice.

Purchase this book from Amazon or Waterstones.

Eat Yourself Healthy: An easy-to-digest guide to health and happiness from the inside outEat Yourself Healthy: An easy-to-digest guide to health and happiness from the inside out

This book includes expert advice on dealing with common complaints such as IBS and bloating, diagnosing food intolerances, and managing good gut health with sleep and exercise routines.

Purchase this book from Amazon or Waterstones.

Mindfulness: A Practical Guide to Finding Peace in a Frantic WorldMindfulness: A Practical Guide to Finding Peace in a Frantic World

Reveals a set of simple yet powerful practices that you can incorporate into daily life to break the cycle of anxiety, stress, unhappiness and exhaustion. It promotes the kind of happiness that gets into your bones and allows you to meet the worst that life throws at you with new courage

Purchase this book from Amazon or Waterstones.

Useful applications

Couch to 5K appOne You Couch to 5k

It’s an easy to follow programme known the world over and perfect for those new to running and need some extra support and motivation along the way.

Get it on Google Play or App Store

Headspace appHeadspace

Get happy. Stress less. Sleep soundly. Headspace is your guide to mindfulness for your everyday life.

Get it on Google Play or App Store

Calm appCalm

Choose from hundreds of guided meditations on everything like managing stress and anxiety to sleep, focus and mind-body health.

Get it on Google Play or App Store

Smiling Mind appSmiling mind

Free mindfulness meditation app developed by psychologists and educators to help bring balance to your life.

Get it on Google Play or App Store

Zemedy appZemedy: IBS, Bowel and Gut care

Zemedy offers personalised digestion care that helps you change how you address IBS by tracking your mood, pain, poop, food intolerances, stress, and identifying patterns within your mind and body.

Get it on Google Play or App Store

Food maestro appFood maestro

If you suffer from a food allergy, or food intolerance or have a specific food diet lifestyle, this award-winning app is here to help you find products that are suitable for you quickly and easily.

Get it on Google Play or App Store

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