Irritable Bowel Syndrome (IBS): Symptoms, Triggers and Care

6 min read · Conditions · By the Asthra Health Care team

What IBS is

Irritable bowel syndrome, or IBS, is a common condition in which the gut is extra sensitive and its movements are out of rhythm. The bowel looks normal on tests and scans, but it does not work smoothly. This causes repeated belly pain along with diarrhoea, constipation, or both, often for months or years at a time.

IBS is a long-term condition that comes and goes, with good and bad weeks. It can be frustrating and embarrassing, but it does not cause cancer or permanent damage to the bowel. It is more common in young adults and in women. Understanding your own pattern is the first step to controlling it.

Causes and triggers

The exact cause is not fully known. Doctors believe it involves an oversensitive gut, changes in the signals between the brain and the bowel, and changes in the normal gut bacteria. Some people develop IBS after a bout of gastroenteritis or food poisoning. Triggers differ from person to person, but common ones include the following.

• Stress, anxiety and poor sleep
• Large or oily meals, and irregular meal times
• Some foods such as beans, onions, cabbage, milk products or wheat in sensitive people
• Tea, coffee, aerated drinks and alcohol
• Hormonal changes around periods

Symptoms of irritable bowel syndrome

The main symptom is cramping belly pain or discomfort that often eases after passing stools. It usually comes with bloating, gas, mucus in the stools, urgency to rush to the toilet and a feeling of not fully emptying the bowel.

Doctors describe IBS by the main stool pattern: IBS with diarrhoea, IBS with constipation, or mixed, where both happen at different times. Symptoms often flare after meals or during stressful periods such as exams or work pressure, and may settle for weeks in between. Tiredness, backache and bladder symptoms are also common.

How irritable bowel syndrome is diagnosed

There is no single test for IBS. A doctor makes the diagnosis from your pattern of symptoms over several months, and by ruling out other conditions that can look similar, such as gut infections, worm infestation, coeliac disease, inflammatory bowel disease, thyroid problems, lactose intolerance and, in older people, bowel cancer.

Common tests include a complete blood count, stool tests for infection and inflammation, thyroid function and a coeliac antibody test. A colonoscopy is advised only when there are warning signs, a family history of bowel cancer, or new symptoms after age 50. Normal results are reassuring and support the diagnosis.

Treatment approach

Treatment is aimed at your main symptoms. Doctors may suggest antispasmodic medicines for cramps, fibre supplements or gentle laxatives for constipation, and anti-diarrhoeal medicines for loose stools. For persistent pain, a doctor may prescribe a low dose of certain antidepressants that calm gut nerves, only on a doctor's prescription.

Talking therapies such as cognitive behavioural therapy, gut-directed relaxation and simple breathing techniques help many people, because the brain and gut are closely linked. Treatment plans often need adjusting over time as symptoms change. Pregnant and breastfeeding women should check with a doctor before using any IBS medicine.

Diet and lifestyle tips

Keep a simple food and symptom diary for two to four weeks to spot your personal triggers. A doctor or dietitian may suggest a structured diet that limits certain fermentable foods for a short time, then slowly reintroduces them to find which ones you can tolerate. Avoid cutting out many foods on your own.

• Eat regular, moderate-sized meals and do not skip meals
• Cut down on fried food, tea, coffee and aerated drinks
• If constipated, increase soluble fibre such as oats and ispaghula slowly
• Drink enough water every day
• Exercise regularly; even a daily walk helps
• Practise stress relief such as breathing exercises, yoga or good sleep habits

When to see a doctor for irritable bowel syndrome

See a doctor if you have belly pain with a change in bowel habit that lasts more than a few weeks, so other causes can be ruled out. Children, pregnant women and older adults with new bowel symptoms should always be checked. A doctor or pharmacist can help you choose safe symptom relief and review your plan when symptoms change.

This article is general health information, not medical advice. Do not start, stop or combine medicines on your own — always follow your doctor's prescription and ask your pharmacist if unsure.