Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome is a common, long-term condition affecting the digestive system. It is classified as a functional gastrointestinal disorder — meaning that the bowel looks structurally normal but does not work as it should. It affects roughly one in five people at some point in their life and is more commonly diagnosed in women than men, though it can affect anyone at any age.
Understanding IBS
The exact cause of IBS is not fully understood, but it is thought to involve a complex interplay between the gut and the brain — often referred to as the gut-brain axis. People with IBS appear to have a more sensitive gut, which reacts more strongly to stimuli such as food, stress, hormonal changes, and certain medications. Other contributing factors may include a previous gastrointestinal infection (post-infectious IBS), an imbalance in gut bacteria, abnormal gut motility, and heightened visceral sensitivity.
Symptoms
The hallmark symptoms of IBS are abdominal pain or cramping that is typically relieved by opening the bowels, bloating and excessive wind, and changes in bowel habit — which may manifest as diarrhoea, constipation, or an alternation between the two. Symptoms often flare up and subside, and many people find that stress, certain foods (particularly those high in fermentable carbohydrates, known as FODMAPs), and hormonal fluctuations around menstruation can act as triggers.
Diagnosis
There is no single definitive test for IBS. Diagnosis is based on the pattern of symptoms and the exclusion of other conditions with similar presentations, such as inflammatory bowel disease, coeliac disease, and colorectal cancer. Blood tests, stool tests, and sometimes a colonoscopy may be carried out to rule these out.
Treatment
Management is highly individualised. Dietary modifications — particularly a low-FODMAP diet, which reduces intake of certain fermentable carbohydrates — have strong evidence behind them and help a significant proportion of patients. Increasing soluble fibre, staying well hydrated, and establishing regular mealtimes are also helpful. Antispasmodic medications can relieve cramping, while laxatives or antidiarrhoeal agents address bowel habit changes. Gut-directed psychological therapies, including cognitive behavioural therapy and hypnotherapy, have good evidence for reducing symptom severity in those whose IBS is closely linked to stress and anxiety.
Choosing where to be treated
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