Irritable Bowel Syndrome (IBS)

• Pain in the guts

• Diarrhoea

• Constipation

• Alternative diarrhoea and constipation

• Bloating

• Trapped wind

• Indigestion

• Needing to burp frequently

• Excessive or smelly flatulence

• Urgent need to poo or having to strain to poo

• Leaking poo when passing wind

• Tiredness, insomnia, fatigue

• Muscle and joint pain

• Headaches

• Bladder problems

• Stress, anxiety or depression

The latter may occur alongside the condition, and sometimes it is difficult to tell if emotional or mental health problems are an irritable bowel syndrome trigger, or a symptom of IBS.

Symptoms of IBS may get worse at certain times, for example:

• If you are stressed, anxious or depressed

• If you are experiencing emotional upset or trauma

• If you are ill with other health conditions

• If you are taking medications for other health conditions

IBS is not ‘all in the mind’ but many people report that there is a link between how they are feeling and their IBS symptoms, and vice versa. Experts also now understand that there is a clear link between the gut and the brain, called the gut-brain axis.

If you think you may have symptoms of IBS, you should visit your GP to discuss these. It may feel embarrassing to talk about bowel movements but it is important to tell your GP in detail about the symptoms you are experiencing. Your GP may diagnose you based on your symptoms, as there is no specific test for irritable bowel syndrome. However, your GP may want to run some blood tests and stool (poo) sample tests to rule out some other conditions such as coeliac disease or inflammatory bowel disease. If you are given a full blood screening, your GP will also be looking for evidence of other issues such as anaemia, thyroid problems and issues with your liver and kidneys. They may also examine you to feel for any swollen areas in your gut.

Your GP may also ask about, or be listening for warning signs of, other more severe health conditions such as bowel cancer or ovarian cancer, and these include:

• Bleeding from the bottom

• Weight loss that cannot be attributed to diet or exercise

• Fever

• Fatigue

• Significant changes in bowel habit (i.e. your normal bowel habits are fine with no symptoms)

• Significant bloating that lasts for long periods or does not go away

If you are given a diagnosis of IBS and develop any of the symptoms listed above, you should revisit your GP. Read more about the symptoms of IBS and diagnosis of IBS

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Some people choose to live with their IBS and put up with the symptoms they experience, perhaps because IBS treatments they have tried have not worked, or because they prefer not to take medication. Everyone is affected differently by their IBS. Here, we discuss the treatments for irritable bowel syndrome in more detail.

Medication for irritable bowel syndrome

There are lots of over the counter medications that are designed to help reduce irritable bowel syndrome symptoms:

• Laxatives – to reduce constipation or make it easier to poo. There are different types which may either make your poo bulkier so that your bowels can push it out, make it softer or more watery or make bowel movement faster. Read more about laxatives

• Diarrhoea treatments – to help firm up your poo e.g. loperamide is very commonly used. However, some people find that using this as a treatment for IBS means they then get constipated. Read more about loperamide

• Wind relief medicines – e.g. Deflatine, Wind Settlers, Windeze, etc. These help to relieve bloating and the pain of trapped wind

• Indigestion relief – e.g. Rennies are a popular brand and these contain calcium carbonate which helps to neutralise excess stomach acid

Some people living with IBS may find that their symptoms decrease whilst taking antidepressant tablets. It is unlikely that GPs will prescribe antidepressants to someone who does not experience mood issues alongside their IBS, but for those that do, they may find their mood issues improve as well as their gut symptoms. This is thought to be because antidepressants can positively affect pain receptors, making a person feel less pain, or reducing their anxiety and low mood, which may make their gut issues worse. Read more about antidepressants.

Natural supplements for irritable bowel syndrome

Some people choose to take natural supplements for IBS, such as peppermint oil, which is proven to help some people with IBS symptoms.

Irritable bowel syndrome supplements may suit some people but not others, and some may find that taking certain vitamins and minerals make their gut issues worse.

Other people find that taking minerals such as magnesium helps relieve their IBS symptoms. Many people also take probiotics, which come in various forms and can be bought in yoghurt drinks from the supermarket. These contain good forms of bacteria which may help some people who have an imbalance of bacteria in their gut. However, probiotics do not work for everyone and can actually make some IBS symptoms worse.

It is advisable for a person with IBS to discuss taking natural IBS supplements with their GP before doing so, as some vitamins, minerals and herbal substances can interfere with other medication or health conditions.

Holistic and complementary therapies for irritable bowel syndrome

There are lots of complementary therapy treatments for IBS such as:

• Acupuncture – the insertion of needles into key points around the body, which may help relieve pain, encourage the gut to have better movement of food waste, and reduce stress. Read more about acupuncture and IBS

• Colonic hydrotherapy – involves inserting water into the bowel via a tube, in order to cleanse the colon, which some people with IBS may find temporarily relieving

• Hypnotherapy – uses relaxation techniques to deeply relax the body and relieve stress, which may all contribute to IBS symptom relief. Read more about hypnotherapy and IBS

• Reflexology – involves massaging certain parts of the feet in order to relieve stress and help balance the body, helping internal organs to function better and improve digestion

Read more about complementary therapy irritable bowel syndrome treatments

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Psychological treatments for irritable bowel syndrome

Some people with IBS also experience anxiety, stress and depression. Research now understands that there is a link between the gut and the brain, and that serotonin is made within the gut, so this connection is not surprising. It may be difficult to ascertain if mood issues occurred before IBS symptoms or vice versa, and really it does not matter which came first. This link suggests that finding ways to reduce stress/anxiety/depression may have a positive effect on a person’s experience of IBS. Therefore, some people benefit from cognitive behavioural therapy (CBT) as an irritable bowel syndrome treatment. Read more about CBT.

Diet and irritable bowel syndrome

Dietary changes may improve IBS symptoms, and we talk about this in more detail in the next section.

Read more about treatments for irritable bowel syndrome

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Living with an IBS diagnosis will affect each person differently.

IBS may impact a person’s life in the following ways (this is not an exhaustive list):

• Traveling/holidays – these may present more symptoms, as well as concern about having toileting issues whilst travelling and being unable to get to a toilet, or being in pain whilst away from home. Read more about travelling with IBS

• Embarrassment – some people may find their IBS causes them embarrassment e.g. depending on the type of IBS they have, they may experience flatulence, bloating, urgent diarrhoea, etc and feel embarrassed about having these symptoms around other people. Some people may be embarrassed about showing their distended stomach (e.g. in a swimsuit), having to use public toilets and so on. Others find they have bowel or urinary incontinence due to IBS, which can also create anxiety and embarrassment

• Diet for IBS – if a person is following a special diet, or avoiding certain foods that are an IBS trigger for them, they may find it difficult to eat out at restaurants and cafes, or eat at other people’s houses. Some people may feel anxious about this, or about eating something that will cause their symptoms to come on. Read more about diet and IBS

• Work life – some people find their IBS affects their ability to carry out their job, or causes them distress due to feeling embarrassed about their gut problems

• Impact of pain – some people experience significant pain as a symptom of their IBS, and living with pain may affect a person’s concentration, relationships, personality, enjoyment and ability to do everyday activities

• Fear and anxiety – many people with IBS have fears that their condition may turn into, or has been misdiagnosed as, a more severe, underlying health condition (e.g. bowel cancer). This is rarely the case, and discussing these fears with a friend, GP, or charity helpline may provide some reassurance

• Frustration with healthcare – some people with IBS feel that they are not taken seriously by GPs and feel frustrated that there are not more options for their IBS treatment, or that they feel they have tried every option for treatment and are still not able to reduce the impact of their symptoms

• Emotional and mental health effects – IBS is linked to anxiety, stress and depression and some people find that their IBS causes mental health problems, or their mental health problems exacerbate their IBS symptoms

• Sex life and libido – some people report that their irritable bowel syndrome symptoms affect their desire to have sex or that sex is uncomfortable for them

• Relationships – living with pain, discomfort, stress and anxiety can cause difficulties in relationships, and living with IBS may cause a person distress, irritability and low moods, which may in turn affect their close relationships. Find support for relationship problems

NRS Healthcare are experts in daily living aids, which are products designed to make everyday tasks easier for people who have mobility difficulties or other health conditions.

If you have difficulties with mobility, using the toilet can become difficult. If you also have irritable bowel syndrome, this may cause you an even greater challenge, and increase anxiety. If this is the case for you, we may have a daily living aid solution to suit your needs such as:

o Raised Toilet Seat – if bending to sit down is difficult for you, then a higher toilet seat may help take some pressure off your joints

o Toilet frame and seat – if you need support to get on and off the toilet, this frame provides a raised seat with handles and is placed over your existing toilet

o Commode – if your mobility difficulties make it hard for you to reach the toilet or bathroom in time, you may find a commode more convenient

o Folding/travel commode – if your mobility difficulties make it difficult for you to use or access the toilet whilst you’re away from home, a compact commode may help

Some people with irritable bowel syndrome also experience bowel or urinary incontinence, and there are a range of products for IBS incontinence available to make your daily routine easier and more hygienic.

This is not an exhaustive list and if you are looking for products that can help you with mobility, using the toilet or any other aspects of daily living, we have a team of Occupational Therapists at NRS Healthcare who can advise. Contact them by email [email protected] or telephone 0345 121 8111.

Irritable bowel syndrome and employment

Many people with a diagnosis of irritable bowel syndrome are able to work but being in employment may present challenges. These can include anxiety about using the toilet, colleagues being aware of a person’s IBS symptoms, having to use the toilet regularly at work, feeling uncomfortable due to symptoms such as pain, bloating or constipation, and missing work due to symptom flare-ups. Some people find IBS affects their morning routine due to symptoms, or that eating at work affects their gut during the day. It may be advisable to discuss with your employer if your IBS is affecting your work life. Read more about IBS and employment.

IBS Support Group UK – Facebook group for people living with IBS to share stories, advice and experiences

IBS Network Forum – online forum for people with IBS to discuss their symptoms, treatments, and share advice

About IBS – a site run by the US charity International Foundation for Gastrointestinal Disorders, which features lots of information about all aspects of living with IBS including IBS treatments, IBS diet, IBS support, and much more

Bladder & Bowel Community – a charity providing advice and information on bladder and bowel conditions, including IBS, and offering a free ‘Just can’t wait card’ for urgent toilet access

Bladder and Bowel UK – a charity providing online resources and information about bowel and bladder issues, including content on constipation, incontinence, fluid intake, and other practical matters

Guts UK – a UK charity for people with gut-related conditions such as IBS, with details about what causes IBS and treatments for IBS

NHS – provides official medical information on irritable bowel syndrome and related conditions

The British Dietetic Association – advice and information on IBS and diet, including self-care, lifestyle advice and information on foods and drinks to eat or reduce intake of

The IBS Network – a charity that provides advice and information on living with irritable bowel syndrome, with online information and support groups

Coeliac disease

– an auto-immune disease affecting the digestive system, where the body reacts to gluten found in wheat, barley and rye, and damages the small intestine’s lining

Digestive system

– the gastrointestinal tract, which includes all the organs required for moving food through the body, using its nutrients and excreting it as waste

Gastroenteritis

– a common stomach bug that may be viral or bacterial and causes diarrhoea

Gut-brain axis

– the link between the gut and the brain, which is thought to involve chemicals and neurotransmitters that travel backwards and forwards along pathways between the brain and the gut (bowel)

Inflammatory bowel disease

– a group of conditions such as Crohn’s disease and colitis, caused by inflammation in the gut or digestive system