Irritable Bowel Syndrome (IBS)

What is Irritable Bowel Syndrome?

Irritable Bowel Syndrome (IBS) is a condition that affects the digestive system and is classified as a disorder of gut-brain interaction. Although the gut appears normal, its communication with the brain is disrupted, leading to functional problems. This complex relationship between the gut and brain, often influenced by the body’s natural stress responses (such as fight, flight, or freeze) can make IBS difficult to diagnose and manage.

IBS is not the same as inflammatory bowel diseases (such as Crohn’s disease or ulcerative colitis), coeliac disease, or bowel cancer, though they may share similar symptoms.

Living with IBS can be challenging, but while there is no cure, managing diet, lifestyle, and mental health, particularly stress, can significantly help reduce symptoms and improve quality of life. Addressing both physical and emotional wellbeing, including how the body reacts to stress, is crucial for effective IBS management.

Symptoms, diagnosis and treatment

What are the symptoms?

The main symptoms of IBS include:

abdominal pain or discomfort
bloating or distention
wind or farting
change in bowel habit (diarrhoea and/or constipation)

How does it get diagnosed?

A diagnosis of IBS can be considered if abdominal pain or discomfort is relieved by pooing or is linked to a change in bowel habit.

This should be accompanied by at least two of the following four symptoms:

Issues when going for a poo such as straining, urgency, and not being able to fully empty bowels
Abdominal bloating, distension, tension or hardness
Symptoms made worse by eating
Passage of mucus

Before your IBS can be diagnosed, it is essential that you speak to your GP. This ensures that the condition is diagnosed correctly and that your symptoms are not due to other conditions affecting the gut.

The GP may arrange:

A blood test to check for problems like coeliac disease
A sample of poo to be tested for infections and inflammatory bowel disease (Crohn’s disease and ulcerative colitis)

How common is IBS?

IBS is common and affects 1 in 5 people, and it can develop at any age. However, women are twice as likely as men to suffer from IBS.

How is IBS managed?

If you have a diagnosis of IBS, your GP will refer you to your local IBS service, where they will provide the resources and support to help relieve symptoms.

It is important that you seek support from your local IBS service, and they will provide you with resources and support to help you manage your IBS symptoms. This is because there are many approaches to managing IBS, and it is very individual as to what might work for you. Using the advice on this page many people can manage their symptoms and often it’s a mixture of lifestyle changes and dietary changes. Some of the simplest changes can have the largest impact and some of these changes might not even be dietary changes. On this page is some advice that may help relieve symptoms and manage symptoms of IBS.

Here are some general tips that you can try to help relieve your IBS symptoms.

Do

Cook homemade meals and use fresh ingredients if possible
Note down what you eat and the symptoms you get
Try to relax
Exercise frequently, aiming for 30-minutes per day
6-8 glasses of fluid per day (water or non-caffeinated drinks) spread evenly throughout the day

Don't

Delay or skip meals
Eat quickly
Eat very fatty, spicy or processed foods
Eat more than 3 portions of fresh fruit per day (80g is a portion)
Drink more than 3 cups (2 mugs) of caffeinated coffee or tea per day
Drink too much alcohol or fizzy drinks

Nutrition and diet quality

There is no single diet or treatment that works for everyone with IBS, but it’s important that you ensure that you follow a healthy balanced diet. A healthy balanced diet could help reduce symptoms but is also crucial to maintain good health and help you feel at your best.

A healthy diet means eating a wide range of food in the right portions and consuming the right amount of food and drink to maintain a healthy body weight.

Some individuals with IBS may find that changes to diet help to relieve symptoms.

Ease bloating, cramps and farting

Eat oats regularly.
Eat up to 1 tablespoon of ground linseeds per day – this can be an excellent addition to porridge.
Avoid foods that are hard to digest, such as cabbage, broccoli, cauliflower, Brussel sprouts, beans, onions and dried fruit.
Reduce or stop consumption of artificial sweeteners, in particular sorbitol.

Reduce diarrhoea

Reduce foods very high in fibre (such as brown bread and brown rice), nuts and seeds.
Reduce or stop consumption of artificial sweeteners, in particular sorbitol.
Important: if you have diarrhoea, ensure that you are drinking plenty of water to avoid dehydration.

Relieve constipation

Drink plenty of water to help make your poo soft.
Increase the amounts of foods that contain certain fibres from foods such as oats, pulses, carrots, peeled potatoes and linseeds (ground or whole).

Physical activity

All adults should participate in physical activity as it contributes to physical and mental well-being. Physical activity can also benefit those with IBS by minimising stress, reducing bloating and improving overall bowel function.

The physical activity guidelines recommend that we take part in 150 minutes of moderate activity per week for adults. This can be split up into 30 minutes of activity on at least 5 days of the week.

You can also reach your weekly activity target by undertaking 75 minutes of vigorous activity. This will provide the same health benefits of 150 minutes of moderate activity per week.

Examples of moderate aerobic activities

Dancing
Riding a bike
Walking
Gardening
Water aerobics
Hiking

Examples of vigorous activities

Running
Swimming at a fast pace
Riding a bike fast or at an incline
Team sports such as football, rugby or netball

Examples of strengthening activities

Sit to stands
Squats
Bicep curls
Press-ups or wall press-ups
Calf raises
Squats

It is important to work all the major muscles by doing strength activities at least two days per week.

Yoga

Yoga also counts as a strengthening exercise and has been shown to improve mood and reduce stress, which both have an essential role in IBS.

Physical activity plan

To help you include some physical activity into your daily routine and stay on track with your goals, you can use this physical activity plan.
Remember to increase your physical activity slowly, as doing too much too soon can lead to a loss of motivation and injuries.

You might find it helpful to think about the following before filling in your physical activity plan.

Are there local activities available that fit into my routine?
Do I actually enjoy this type of activity?
Are my friends available at this time to do the activity with me?
Choose affordable activities, such as a walk in the park or along the canal.

Sleep hygiene

Poor sleep is common for those who suffer from IBS due to abdominal pain, heartburn, and acid reflux. Poor sleep often results in us feeling grumpy and lethargic and can also increase IBS symptom severity.

What are the recommendations for sleep in adults?

Most adults need 7 – 9 hours of sleep a night to maintain good physical and mental health. Still, everyone is individual, and some need more sleep than others. However, as a general rule, if you feel fatigued and need to nap often, you are likely not getting enough sleep.

Improve your sleep quality

Go to bed and get up around the same time every day
Make sure your bedroom is cool, dark and quiet
Make sure your bed is comfortable with a mattress that isn’t too soft or too hard
Be physically active but try to avoid vigorous activity too close to bedtime
Reduce the amount of caffeine and cut off caffeine consumption in the evening
Do not eat too much food or drink alcohol, especially close to bedtime
Do not smoke as nicotine is a stimulant and take it longer for you to get to sleep and cause frequent awakenings
Have a warm bath, stretch and listen to some relaxing music

If you find your sleep is being disturbed by acid reflux, these additional tips may also be helpful

Avoid eating late at night: leaving two to three hours before going to bed will allow your stomach plenty of time to digest and reduce the chances of reflux.
Sleep on your life side: avoid sleeping on your back and try sleeping on your left side as this can help minimise acid reflux.
Raise the head of the bed: raising the head of the bed by 10 – 15cm by placing blocks under the bed or using a special wedge pillow can help reduce symptoms of acid reflux

Mental health support

Looking after our mental health is important for everybody but for those with IBS it can be vital. There is a link between between feelings like stress, anxiety and worry with IBS symptoms. Here are some useful resources to help support with this.

Bradford District and Craven Talking Therapies offers guidance on things such as low mood, anxiety, sleep problems and stress.
Self help leaflets on topics ranging from abuse, bereavement, anger, panic and social anxiety.

Diaphragmatic breathing

Diaphragmatic breathing, or belly breathing, helps manage the body’s fight, flight, or freeze response in IBS. By activating the parasympathetic nervous system (which promotes relaxation), it calms the gut-brain axis, reduces stress, and eases IBS symptoms. This simple technique improves digestion by relaxing the body and reducing tension.

Other support

You can buy a key from The IBS Network shop or Disability Rights UK shop to help you access public toilets if you get symptoms while away from home.

Useful links with videos and resources to support individuals with IBS

Useful diet sheets (PDF)

Useful books

Take control of your IBS: The step-by-step guide that actually works

Understand your IBS, reduce symptoms and flare-ups

Amazon

Why You Can’t Go: …and what you can do to find life-changing relief from constipation

Simple science-backed tips to relieve constipation and bloating and improve gut health

Amazon

Mindfulness: A Practical Guide to Finding Peace in a Frantic World

Break the cycle of anxiety, stress, unhappiness and exhaustion

Amazon / Waterstones

Useful apps

Couch to 5k

It’s an easy to follow programme known the world over and perfect for those new to running and need some extra support and motivation along the way.
Get it on Google Play or App Store

Headspace

Get happy. Stress less. Sleep soundly. Headspace is your guide to mindfulness for your everyday life.
Get it on Google Play or App Store

Calm

Choose from hundreds of guided meditations on everything like managing stress and anxiety to sleep, focus and mind-body health.
Get it on Google Play or App Store

Smiling mind

Free mindfulness meditation app developed by psychologists and educators to help bring balance to your life.
Get it on Google Play or App Store