Irritable bowel syndrome
The symptoms of irritable bowel syndrome (IBS) canoften bemanaged by changing your diet and lifestyle, and understanding thenature of the condition.
In some cases,medicationor psychological treatments mayalso behelpful.
Changing your diet will playan important part incontrolling your symptoms of IBS . However, there is no "one size fits all" diet for people with the condition. The diet that works best for you will depend onyour symptoms and how you react to different foods.
It may be helpful to keep a food diary and record whether certain foods make your symptoms better or worse.You can then avoid foods that trigger your symptoms.However, it's important toremember that these foods will not necessarily need to be avoided for life.
People with IBS are often advised to modify the amount of fibre in their diet. There are two main types of fibre: soluble fibre (which dissolves in water) and insoluble fibre(which doesn't dissolve in water).
Foods that contain soluble fibre include:
Foods that contain insoluble fibre include:
If you have Traveller's diarrhoea , you may find it helps to cut down on the insoluble fibre you eat. It may also help to avoid the skin, pith and pips from fruit and vegetables.
If you have constipation , increasing the amount of soluble fibre in your diet and the amount of water you drink can help.
Your GP may be able toadvise on whatyour recommended fibre intake should be.
If you experience persistent or frequent bloating, a special diet called the low FODMAP diet can be effective.
FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. These are types of carbohydrates that arent easily broken down and absorbed by the gut. This means they start to ferment in the gut relatively quickly, and the gases released during this process can lead to bloating.
A low FODMAP diet essentially involves restricting your intake of various foods that are high in FODMAPs, such as some fruits and vegetables, animal milk, wheat products and beans.
If you want to try the low FODMAP diet, its best to do so under the guidance of a professional dietitian, who can ensure your diet is still healthy and balanced. You can ask your GP or specialist to refer you.
You can read more about the low FODMAP diet on the Kings College London website.
Your IBS symptoms may also improve by:
Many people find that exercise helps to relieve the symptoms of IBS. Your GP can advise you on the type of exercise that is suitable for you.
Aim to do a minimum of 150 minutes of moderate-intensity aerobic activity, such as cycling or fast walking, every week.
The exercise should be strenuous enough to increase your heart and breathing rates.
Some ways to help relieve stress include:
If you are particularlystressed, you may benefit from a talking therapy, such as stress counselling or cognitive behavioural therapy (CBT) .
They contain so-called "friendly bacteria" that can supposedlyrestore the natural balance of your gut bacteria when it has been disrupted.
Some people find taking probiotics regularly helps to relieve the symptoms of IBS. However, there isa little evidence to support this, and it is unclear exactly how much of a benefit probiotics offer and which types are most effective.
If you want to try a probiotic product, you shouldtake it for at least four weeks to see if your symptoms improve, and you should follow the manufacturer's recommendations regarding dosage.
Anumber of different medicationscan beused to help treat IBS, including:
These medications are discussed in more detail below.
Antispasmodics work by helping to relax the muscles in your digestive system. Examples of antispasmodic medicines include mebeverine and therapeutic peppermint oil.
Side effects associated with antispasmodics are rare. However, people taking peppermint oil may have occasional heartburn and irritation on the skin around their bottom.
Bulk-forming laxatives are usually recommended for people withIBS-related constipation. They make your stools softer, which means they areeasier to pass.
It's important to drink plenty of fluids while using a bulk-forming laxative. This will help prevent the laxative from causing an obstruction in your digestive system.
Start on a low dose and then, if necessary, increase it every few days until one or two soft stools are produced every one or two days. Do nottake a bulk-forming laxative just before you go to bed.
Side effects associated withtaking laxatives can include bloating and wind. However, if you increase your dose gradually, you should have few, if any, side effects.
The antimotility medicineloperamide is usually recommended for IBS-related diarrhoea.
Loperamide works by slowingcontractions of muscles in the bowel, which slows down the speed at which food passes through your digestive system. This allows more time for your stools to harden and solidify.
Side effects of loperamide can include stomach cramps and bloating, dizziness , drowsiness and rashes.
Two types of antidepressants are used to treat IBS tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) .
TCAs, such as amitriptyline, are usually recommended when antispasmodic medicines have not been able to control the symptoms of pain and cramping. They work by preventing signals being sent to and from the nerves in your digestive system.
However, TCAswill only start to provide relief after three to four weeks, as your body gets used to the medication.
Side effects of TCAs can include a dry mouth, constipation, blurred vision and drowsiness. These side effects should improvewithin a few days of starting the medication. Tell your GP if the side effects become a problem they may prescribe anothertype of antidepressant.
SSRIs are an alternative type ofantidepressant. Examples of SSRIs that are used to treat IBS include citalopram, fluoxetineand paroxetine.
Common side effects of SSRIs include blurred vision, dizziness and diarrhoea or constipation.
If yourIBS symptoms are still causing problems after 12 months of treatment, your GPmay refer youfor a type of therapy known as a psychological intervention.
There are several different types of psychological therapy. Theyall involve teaching you techniques to help you control your condition better, and there is good evidence to suggest theymay help some people with IBS.
Psychological treatments that may be offered to people with IBS include:
The availability of psychological interventions on the NHS may vary from region to region.
Some peopleclaim therapies such as acupuncture and reflexology can help people with IBS. However, there isno medical evidence to suggest their effectiveness, and they are not recommended.
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.
The symptoms of IBS are usually worse after eating and tend to come and go in bouts.
The exact cause of irritable bowel syndrome (IBS) is unknown, but most experts think that it's related to problems with digestion and increased sensitivity of the gut.
There are no specific tests for IBS, as it does not cause any obvious detectable abnormalities in your digestive system.
The symptoms of irritable bowel syndrome (IBS) can often be managed by changing your diet and lifestyle, and understanding the nature of the condition.
After having irritable bowel syndrome (IBS) for more than 20 years, Ansar Ahmed Ullah is learning to live with the condition.
Geoff Lyon has had severe IBS since early childhood. He tells us his story.