Irritable Bowel Syndrome
What is IBS?
Irritable bowel syndrome (IBS) is a common condition that affects the digestive system. It causes symptoms like stomach cramps, bloating, diarrhoea and constipation. These tend to come and go over time, and can last for days, weeks or months at a time. It's usually a lifelong problem. It can be very frustrating to live with and can have a big impact on your everyday life. There's no cure, but diet changes and medicines can often help control the symptoms. The exact cause is unknown – it's been linked to things like food passing through your gut too quickly or too slowly, oversensitive nerves in your gut, stress and a family history of IBS.
The following are common symptoms of IBS;
- Stomach pain or cramps – usually worse after eating and better after doing a poo
- Bloating – your tummy may feel uncomfortably full and swollen
- Diarrhoea – you may have watery poo and sometimes need to poo suddenly
- Constipation – you may strain when pooing and feel like you cannot empty your bowels fully
There may be days when your symptoms are better and days when they're worse (flare-ups). They may be triggered by food or drink.
More information can be obtained from the NHS website which can be accessed by clicking the link below.
Treatment for IBS is a done through a variety of routes, including diet, lifestyle as well as pharmacological treatments. The pharmacological treatments are then split into different tiers, which you will be prescribed based of your individual case and need. The different categories are explained below in more detail. Please be aware that when ordering treatments for IBS we may need to contact you to ask additional questions.
Diet and nutrition is an important way of managing IBS and there are several steps you can take that can help you to manage the condition. The points below list key steps that you should try and implement in your diet.
- Have regular meals and take time to eat
- Avoid missing meals or leaving long gaps between eating
- Drink at least 8 cups of fluid per day, especially water or other non-caffeinated drinks such as herbal teas
- Restrict tea and coffee to 3 cups per day
- Reduce intake of alcohol and fizzy drinks
- Reduce intake of 'resistant starch' (starch that resists digestion in the small intestine and reaches the colon intact), often found in processed or re-cooked foods
- Limit fresh fruit to 3 portions (of 80 g each) per day
- For diarrhoea, avoid sorbitol, an artificial sweetener found in sugar-free sweets (including chewing gum) and drinks, and in some diabetic and slimming products
- For wind and bloating consider increasing intake of oats (for example, oat-based breakfast cereal or porridge) and linseeds (up to 1 tablespoon per day)
It is also important to monitor your fibre intake
- Avoid the intake of insoluble fibre (for example, bran)
- Consider limiting intake of high-fibre food (for example, wholemeal or high-fibre flour and breads, cereals high in bran, and whole grains such as brown rice)
- If more fibre is needed, recommend soluble fibre such as ispaghula powder, or foods high in soluble fibre (for example, oats)
If these initial steps have little to no impact there are additional steps that can be taken regarding diet and nutrition. Speak to your GP and they will be able to help or refer you to a nutrition expert who can help.
It is important to maintain a healthy lifestyle to help manage IBS
People should make the most of their leisure time and to create relaxation time.
Individuals should also ensure they get an adequate amount of exercise. Those with a low level of exercise should try and increase it.
There is information, advice and fitness plans available on the NHS website - linked below.NHS Exercise Advice
Pharmaceutical treatments are available and/or prescribed based on differing levels of treatment. Patients start with diet and lifestyle alterations, however pharmaceutical options can be used simultaneously. First-line treatments are available first, only if these do not work would the patient be prescribed treatments from the Second or Third lines.
There is a wide variety of medication that is available to help manage the different symptoms of IBS. There are 3 main categories. Anti-spasmodics help to to treat pain and muscle cramps, but it can also help with diarrhoea. These treatments can be taken as required by the patient. There are also anti-motility medications, these are to help treat diarrhoea. Loperamide is the recommended first line treatment for diarrhoea; it is available from our Online Consultation Service as well as normally. The final type is laxatives, these help individuals who are suffering from constipation.
Click the link below to take you to our wide range of medications to help treat your symptoms.
An alternative laxative is available as a second-line treatment. The medication - Linaclotide - is only available if the following criteria are met, they are;
- optimal or maximum tolerated doses of previous laxatives from different classes have not helped and
- they have had constipation for at least 12 months
There are additional treatments available to patients, such as Tricyclic antidepressants (TCAs) or Selective Serotonin Reuptake Inhibitors (SSRIs). For these you will need to speak to your GP who will assess your condition and your previous treatments.
The final line of treatment is Eluxadoline. For this you will need to speak to your GP who will assess your condition and your previous treatments.