Irritable bowel syndrome (IBS)

Irritable bowel syndrome (IBS) is a fairly common bowel disorder characterized by abdominal pain and changes in bowel habits. 

Lower abdominal pain and bloating associated with alteration of bowel habits, and abdominal discomfort which is relieved by passing motions are the most frequent symptoms. IBS can present as diarrhoea-predominant, constipation-predominant or IBS with alternating stool pattern.

Other symptoms include rapid digestion of food, frequent motions, bloating, headaches and anxiety. Individuals with IBS may also burp frequently and suffer from bad breath, fatigue and nausea.

Diet
There are a number of dietary changes a person with IBS can make to lessen pain, discomfort, and bowel dysfunction. Having soluble fibre foods and supplements, substituting milk products with soya or rice products, being careful with fresh fruits and vegetables that are high in insoluble fibre, and eating frequent meals of small amounts of food, can all help to lessen the symptoms of IBS. Foods and drinks to be avoided or minimized include red meat, oily or fatty and fried products, milk products , solid chocolate, coffee, alcohol, fizzy drinks, especially those containing sorbitol or other artificial sweeteners.

Fibre
In patients who do not have diarrhoea-predominant irritable bowel, soluble fibre at doses of 20 grams per day can reduce overall symptoms but will not reduce pain. Fybogel Hi-Fibre sachets

Initial treatments
Medications may consist of stool softeners (Dioctyl capsules, Dulcoease capsules) and laxatives (see below) in constipation-predominant IBS, and antidiarrhoeals (e.g. loperamide capsules or Imodium capsules), in diarrhoea-predominant IBS.

Laxatives
For patients with constipation who do not adequately respond to dietary fibre, osmotic agents such as lactulose solution can help avoid 'cathartic colon' which has been associated with stimulant laxatives such as senokot and dulcolax.


Antispasmodics
The use of antispasmodic drugs may help patients, especially those with cramps or diarrhoea.  For adults and children over 10 years, Mebeverine tablets act directly at the smooth muscle of the gastrointestinal tract, relieving spasm, abdominal cramps and wind without affecting normal gut motility. Fybogel Mebeverine sachets is a combination of the antispasmodic with fibre for adults and children over 12 years.


Enteric coated peppermint oil capsules (Colpermin) are available for relief of painful spasms and bloating for adults over 15 years.

If your symptoms still persist after 2 weeks with the over the counter treatment, particularly if you have never been diagnosed as having IBS then consult your doctor.

Diagnosed IBS does not lead to more serious conditions in most patients.

For much more information click IBS or go to NHSDirect at www.nhs.u

This page was last updated: Monday 25 September, 2017