Irritable bowel syndrome (IBS) | NHS inform

Irritable bowel syndrome (IBS) is a common, long-term condition of the digestive system. Symptoms can include stomach cramps, bloating, diarrhoea and/or ... Home Illnessesandconditions Symptomsandself-help Testsandtreatments Healthyliving Care,supportandrights Scotland'sServiceDirectory Home Illnessesandconditions Stomach,liverandgastrointestinaltract Irritablebowelsyndrome(IBS) Irritablebowelsyndrome(IBS) Seeallpartsofthisguide Hideguideparts 1. AboutIBS 2. ManagingIBS 3. IBSandyourmentalhealth AboutIBS Irritablebowelsyndrome(IBS)isacommon,long-termconditionofthedigestivesystem.Symptomscanincludestomachcramps,bloating,diarrhoeaand/orconstipation. Theconditionisoftenlifelong,althoughthesymptomsmaychangeovertime.Withtherightstrategies,IBScanbesuccessfullymanaged. IBSdoesnotposeaseriousthreattoyourphysicalhealthanddoesnotincreaseyourchancesofdevelopingcancerorotherbowel-relatedconditions. TheexactcauseofIBSisunknown.ManycauseshavebeensuggestedbutnonehavebeenproventoleadtoIBS. IBSsymptoms ThesymptomsofIBSvarybetweenindividualsandaffectsomepeoplemoreseverelythanothers.Symptomscanbecomeworse,oftenduringtimesofstressoraftereatingcertainfoods. YoumayfindsomeofthesymptomsofIBSeaseaftergoingtothetoiletandmovingyourbowels. Mainsymptoms ThemostcommonsymptomsofIBSare: abdominal(stomach)pain andcramping,whichmayberelievedbymovingyourbowels achangeinyourbowelhabits–suchas diarrhoea, constipation orsometimesboth bloatingandswellingofyourstomach excessivewind(flatulence) occasionallyexperiencinganurgentneedtomoveyourbowels Otherlesscommonsymptomsmayalsobeexperienced,suchas: lackofenergy(lethargy) feelingsick heartburn ThesymptomsofIBScanalsohaveasignificantimpactonaperson'sday-to-daylifeand,asaresult,somepeoplemayexperiencesymptomsoflowmoodandstress. Non-urgentadvice: SeeyourGPif: youthinkyouhaveIBStypesymptoms,sotheycantrytoidentifythecause you'refeelinganxiousorexperiencingachangeinyourmoodasthiscanworsenIBSsymptoms Urgentadvice: SeeyourGPurgentlyif: Youhaveothersymptoms,including: achangeinyourbowelhabitsthathaslastedformorethansixweeks,especiallyifyouareover50yearsofage unexplainedweightloss aswellingorlumpinyourstomachorbackpassage bleedingfromyourbackpassage Thesecansometimesbeasignofapotentiallymoreseriouscondition. YoushouldalsotellyourGPifyouhavethesesymptomsandafamilyhistoryof bowelcancer or ovariancancer. FurtherinformationaboutmanagingIBS DiagnosingIBS TherearenospecifictestsforIBS.ManycasescanbediagnosedbasedonyoursymptomhistoryandyourGPwillundertakesomeroutinebloodandstoolteststoruleoutotherconditions. AsthesymptomsofIBSaresimilartootherconditionssuchas coeliacdisease andinflammatoryboweldisease,itisimportanttoruletheseout. Itisimportantnottomakeanydietarychangesuntilthesetestshavebeendone.Thisisparticularlyimportantforthe bloodtestforcoeliacdisease astheresultcanbeaffectedbyyourdiet. Privateallergytesting(forexamplehairsampling)isnotareliablewaytotestforallergiesorintolerances.Ifyouareconcerned,pleasetalktoyourGP. ManagingIBS Thesymptomsofirritablebowelsyndrome(IBS)canoftenbemanagedbychangingyourdietandlifestyle,andunderstandingthenatureofthecondition. Youmayfindithelpfulto: followahealthy,balanceddiet stayhydrated exerciseregularly manageyourstresslevels MedicationissometimesprescribedforpeoplewithIBStotreattheindividualsymptomstheyexperience.Insomecases,psychologicaltreatmentsmayalsobehelpful. Adjustingyourdiet ThefirststepintryingtoreduceyoursymptomsofIBSistofollowahealthy,balanceddiet.Aimto: eatregularmealsincludingbreakfast,lunchandaneveningmeal(ifrequired,smallsnackscanbeincluded) avoidmissingmealsoreatinglateatnight taketimeoveryourmeals,makingtimetositdownandchewyourfoodwell Usethe EatwellGuide tohelpyouincludefoodsfromeachfoodgroupinyourdailyroutine. Fibre PeoplewithIBSareoftenadvisedtomodifytheamountoffibreintheirdietdependingontheirmainsymptoms.Forexample,alowerfibredietcanbe beneficialfordiarrhoeawhereasahigherfibreintakecanbe beneficial forconstipation. Moreaboutadjustingyourfibreintake Fluid Havingenoughfluidisimportantforoverallhealth.Itmayalsoeaseyoursymptoms,especiallyconstipation.Thisisalsoparticularlyimportantwhenincreasingthefibreinyourdietortoreplacefluidslostwhenexperiencingdiarrhoea. Trytohaveatleast8cupsorglasses(1.5-2litres)offluidperday(youmayneedmoreifyouhavediarrhoeaorareincreasingyourfibreintake).Goodchoicesincludewater,sugarfreedrinksanddrinkswithnocaffeine.Aimtoreducefizzydrinksorthosethatarehighincaffeine. Caffeine Caffeineismostcommonlyfoundintea,coffee,energydrinksandcola.Ifyouthinkcaffeinemayaffectyoursymptoms,trytoreduceitfurtheroreliminateitcompletely. Tipstoreduceyourcaffeineintakeinclude: Reduceyourintakeofteaandcoffeeandaimtoswitchtodecaffeinatedornaturallycaffeine-freevarietiessuchasherbalteas. Limitcolaandironbrew.Decaffeinatedvarietiesareavailable,butlimitingfizzydrinksgenerallyisbest. EnergydrinkssuchasRedBull,MonsterandRockStarareveryhighincaffeineandshouldbeavoided. Alcohol AlcoholcanmakeIBSsymptomsworse.Aimtofollowrecommendationsforsafealcoholintakeanddrinknomorethan14unitsperweek.Spreadtheseoutoverthreeormoredaysandhaveregularalcohol-freedays. Moreabout alcoholguidelines Fattyfoods Highfatfoodsshouldbelimitedaspartofahealthydiet.TheyhavealsobeenshowntoaggravatesomeIBSsymptoms,especiallydiarrhoea.Thesefoodsinclude: friedfoods fastfood pastries crisps cakes ToimprovehealthandpotentialIBSsymptomsonlyincludethesefoodsinsmallamountsandinfrequently.Manyreducedorlow-fatvarietiesareavailableforahealthieralternative. Sweeteners Somesweetenerscancausediarrhoea.Lookoutforsweetenernamesendingintheletters‘ol’asthesearemostlikelytocausesymptoms. Thesearefoundinsomesugar-freedrinks,sweets,chewinggumandmints.Itcanalsobefoundin‘diabetic’andslimmingproducts.Checkthelabelsandlimittheseproducts. Processedfoods Processedorreheatedfoodscontainresistantstarch,whichcanbedifficultforyourbodytodigest.Processedfoodsinclude: readymeals potatoandpastasalads ovenchips part-bakedbreads Thesestarchescanaggravatewind,bloatinganddiarrhoeasymptoms.Tolimitthese,makeyourownmealsusingfreshfoodswhereverpossible. Easingbloatingandcramping IBScancause bloatingorcrampsaftereating.Therearesomethingsyoucandowhichwilleaseanybloatingorcrampingyoumayhave.Theseinclude: eatingsmallbutregularmeals eatingoatsregularly avoidingfoodsthatarehardtodigestsuchascauliflowerandBrusselssprouts exercisingregularly LowFODMAPdiet Ifyoursymptomsdonotimproveaftermakingchangestoyourdiet,aspecialdietcalledthelowFODMAPdietmaybehelpful. AlowFODMAPdietshouldonlybefollowedwiththesupportofaSpecialistDietitiantrainedinthelowFODMAPprocess. AlowFODMAPdietisn'tsuitableforeveryoneandmustonlybeusedfollowingadieteticconsultation. Probiotics Probioticsare‘goodbacteria’foundinsomefoodsorsupplements.Itissuggestedthatthese‘goodbacteria’canrestorethenaturalbalanceofyourgutbacteriawhenithasbeendisrupted. ItisunclearexactlyhowmuchofabenefitprobioticsofferandwhichtypesaremosteffectiveandresearchisongoingtoprovidefurtherevidencefortheuseofprobioticsinIBS. Ifyouwanttotryaprobioticproduct,youshouldtakeitforatleastfourweekstoseeifyoursymptomsimprove.Youshouldfollowthemanufacturer'srecommendationsregardingdosage. Moreaboutprobiotics Exercise ManypeoplefindthatexercisehelpstorelievethesymptomsofIBS.YourGPcanadviseyouonthetypeofexercisethatissuitableforyou. Aimtodoaminimumof150minutesofmoderate-intensityaerobicactivity,suchascyclingorfastwalking,everyweek. Theexerciseshouldbestrenuousenoughtoincreaseyourheartandbreathingrates. Moreabout physicalactivityguidelinesforadults. Medication SometimesmedicationscanbeusedtohelptreatIBS,including: antispasmodics–whichhelpreduceabdominal(stomach)painandcramping laxatives–whichcanhelprelieveconstipation antimotilitymedicines–whichcanhelprelievediarrhoea Allmedicationshouldbetakenfollowingthepacketoradoctor'sadvice. IBSandyourmentalhealth DuetotheeffectsthatIBScanhaveonyourabilitytoperformdaytodayactivitiessuchasworkingandsocialising,somepeoplemayexperiencechangesintheirmood. ThereisevidencesuggestingpsychologicalfactorsplayanimportantroleinIBS,thisisduetothelinkthatexistsbetweenthebrainandgut,oftencalledthe“gut-brainconnection”.Insomepeople,thegut-brainconnectioncantriggerorworsensymptomssuchasdiarrhoea,constipationandnausea. Insteadoftryingtoremovestressaltogether,youcanfocusonmanaginghowmuchstressyouencounteronadailybasisandchangethewaythatyourespondtostress. Somewaystomanagestressinclude: identifyingyourstressorsandseeiftherearesomethingswithinyourcontroltomanageorchange relaxationtechniques–suchasbreathingexercises,ordoingactivitiesthatyoufindrelaxing takingtimeoutforfriends,familyandactivitiesyouenjoy regularexercise–suchasyoga,walking,runningorswimming YoucanalsolistentoNHSPublicHealthScotland'spodcast, StepsforStress. Accessingfurthersupport Thereareseveraldifferenttypesofpsychologicaltherapy.Theyallinvolveteachingyoutechniquestohelpyouunderstandandself-manageyourconditionmoreeffectively. TheavailabilityofpsychologicalinterventionsontheNHSmayvarybetweenNHShealthboards. SpeaktoyourGPifyouhaveongoingfeelingsoflowmood,stressoranxietythatareaffectingyourdailylifeorimpactingyourabilitytomanageyourIBS.YourGPwilladviseonthebestsupportoptionforyou. Supportgroups ThereisalargecommunityofpeoplewithIBSandcharitiessuchas GUTSUK and TheIBSNetwork, who canprovidefurtherinformationandadviceonhowtolivewellwithIBS. AddPagetoInfoForMe Share ClickheretosharethispageonFacebook(Thiswillopenanewwindow). Tweet ClickheretosharethispageonTwitter(Thiswillopenanewwindow). Print Clickheretoprintthispage(Thiswillopenyourprintoptionsinanewwindow). AlsoonNHSinform Irritablebowelsyndrome(IBS)(BSL) Flatulence Strugglingwithstress? Mentalwellbeing Otherhealthsites IBSNetwork:whatisIBS?