Irritable Bowel Syndrome
Also known as IBS, Spastic colon
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is irritable bowel syndrome?
Irritable bowel syndrome is a disorder of gut brain interaction causing recurrent abdominal pain with changes in stool frequency or form. There is no structural damage, which is why tests come back normal, but the symptoms and their impact are real. It is diagnosed positively using symptom criteria after excluding a small number of specific conditions.
Causes
- Visceral hypersensitivity to normal gut signals
- Altered gut motility
- Disturbance of the gut brain axis
- Post infectious changes after gastroenteritis
- Changes in gut microbiota
- Stress and psychological factors as modulators
Symptoms
- Recurrent abdominal pain related to defecation
- Bloating and abdominal distension
- Diarrhoea, constipation or alternating patterns
- Urgency or a feeling of incomplete emptying
- Mucus in the stool
- Symptoms worsened by stress or certain foods
Risk factors
- Female sex
- Age under 50 at onset
- Previous episode of gastroenteritis
- Anxiety or depression
- Family history
- Early life adverse events
Diagnosis
- Rome criteria based on symptom pattern and duration
- Full blood count and inflammatory markers
- Coeliac serology
- Faecal calprotectin to distinguish from inflammatory bowel disease
- Colonoscopy only where alarm features are present
Treatment
- Dietary review, including a supervised low FODMAP trial
- Soluble fibre for constipation predominant symptoms
- Antispasmodics such as mebeverine or peppermint oil
- Laxatives or antidiarrhoeals matched to the predominant pattern
- Low dose tricyclic antidepressants for pain modulation
- Cognitive behavioural therapy or gut directed hypnotherapy
- Regular exercise and stress management
Self care
- Eat regular meals and do not skip or rush them
- Limit caffeine, alcohol and fizzy drinks
- Try reducing high FODMAP foods with dietitian guidance
- Adjust fibre type to your pattern, favouring soluble fibre
- Stay physically active
- Use relaxation techniques, since stress is a strong modulator
- Keep a symptom and food diary
When to see a doctor
Book an appointment if:
- Symptoms interfering with work or daily life
- Symptoms changing from your usual pattern
- No improvement despite dietary and lifestyle changes
- New symptoms after age 50
- Considering a low FODMAP diet, so it is done properly
- Low mood or anxiety alongside gut symptoms
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- IBS cannot be prevented, but flares can be reduced
- Maintain regular eating patterns
- Manage stress proactively
- Stay active
- Avoid unnecessary antibiotics where possible
- Treat gastroenteritis with good hydration to reduce post infectious IBS
Outlook
IBS is a long term condition that fluctuates but does not damage the bowel or increase cancer risk. Most people achieve good control through dietary adjustment, stress management and targeted medication. Symptoms often improve over years, and a positive diagnosis rather than repeated testing tends to improve outcomes.
Common questions
Which symptoms are not typical of IBS?
Weight loss, rectal bleeding, waking at night with symptoms, fever, anaemia, onset after age 50 or a family history of bowel cancer are alarm features. They point away from IBS and need investigation.
Does IBS increase cancer risk?
No. IBS does not damage the bowel and does not raise the risk of bowel cancer or inflammatory bowel disease, though it can coexist with them.
Should I try a low FODMAP diet?
It helps many people but is restrictive and should be done with a dietitian. It is a short elimination phase followed by structured reintroduction, not a permanent way of eating.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.