Irritable Bowel Syndrome is what’s known as a functional disorder, so an X-ray of the gut would show no obvious problem and there is no single cause.
It’s thought that in people with IBS, the gut is simply more sensitive, but experts still don’t know why.
It’s been suggested it could be triggered by an infection, such as gastroenteritis, or overuse of antibiotics or other drugs, typically anti-inflammatories.
Symptoms may come and go at different times in your life so it’s a question of learning to manage the condition.
What's in our guide:
- Know your fibre
- ....switch to white
- Choose sourdough bread
- Be choosy about your fruit
- ...and vegetables
- Peel fruit and veg first
- Don't go raw
- Exercise regularly - but not strenuously
- Sort out Stress
- See your GP
- Take laxatives if necessary
- Be careful about any medication
- Chew your food well
- What what you drink
- Up your bactaria
- Consider having hypnotherapy
- Try Yoga
1. Know your fibre
Although fibre is an important part of a healthy diet and can protect against bowel cancer, there’s a big difference between soluble and insoluble fibre.
“Soluble fibre (e.g. in oat-based products) dissolves in water and forms a gel-like substance which slows digestion and the rate at which we empty our stomach, whereas insoluble fibre (e.g. in wheat-based products) has a laxative effect,” explains Dr Megan Arroll, co-author of Irritable Bowel Syndrome: Navigating Your Way to Recovery (Hammersmith books, £14.99).
While soluble fibre can help with IBS symptoms, such as constipation, it can also make symptoms worse. If that’s the case…
2....switch to white
Although it goes against conventional nutritional advice, try avoiding anything with wholemeal flour (brown bread, crispbreads, and digestive biscuits etc) and opt for processed versions – white bread and pasta, anything made from white flour and cream crackers.
And because cereal fibre can be the worst offender for aggravating certain IBS symptoms, eat Rice Krispies for breakfast, suggests Dr Nick Read, gastroenterologist, nutritionist and psychotherapist, chair of trustees and medical adviser to The IBS Network ( theibsnetwork.org ).
“They’re easy to digest because they’re low in fibre and just contain rice,” he says.
Research suggests this simple dietary tweak eases symptoms by 30-40% in about two-thirds of people with IBS.
3. Choose sourdough bread
Studies at Reading University suggest that sourdough bread may be best for those with IBS because it has a positive effect on the composition of gut microbionta.
4. Be choosy about your fruit
Dr Read explains: “Many fruits and vegetables contain poorly absorbed complex sugars (fructo-oligosaccharides and galacto-oligosaccharides) that retain fluid in the gut and are fermented in the colon, generating gas and producing bloating.
“Stone fruits (plums, prunes, cherries) and apples may cause symptoms, whereas citrus fruits, kiwi fruits, most berries, rhubarb, bananas, passion fruit are fine.”
5...and vegetables
Avoid corn, brassicas (cabbage family) and nightshade vegetables (tomatoes, potatoes, aubergine and peppers), suggests Dr Arroll.
6. Peel fruit and veg first
This removes the insoluble fibre found in the skins, suggests Dr Arroll.
“Chopping, cooking and pureeing can also help – and fruits can be blended into smoothies.”
7. Don't go raw
Although we’re told raw is healthy, it can be hard to digest. Try cooked or canned fruit and veg instead.
Most Read
8. Exercise regularly - but not strenuously
“Intense exercise has been linked to a number of gastrointestinal symptoms, such as diarrhoea,” says Dr Arroll.
However, regular exercise does help with constipation, and is vital to maintaining physical and psychological health.
Try a daily walk, bike ride or swim rather than endurance work.
9. Sort out Stress
Stress can directly contribute to IBS symptoms so it’s important to take steps to combat this.
“Pace yourself and take regular breaks,” advises Dr Read.
“Find time to read, write, draw, cook or walk. All are conducive to mindfulness; help distance you from the pressures of the day and give you space to get things into perspective.
“And if there is something worrying you, talk to somebody about it.”
10. See your GP
“If you have ongoing symptoms for more than say three months, it’s important to see your GP in case you have a treatable or potentially life-threatening condition (colitis, cancer, coeliac disease),” warns Dr Read.
If the diagnosis is IBS, there is a variety of medication available – from drugs that stimulate or inhibit intestinal motility to antispasmodics. Bear in mind that
treatment is not “one size fits all”.
Ask about antidepressants
These can be helpful for severe IBS because they work on the nerves in the gut, which are similar to those in the brain.
11. Take laxatives if necessary
Some people simply have a naturally sluggish gut – and it’s a myth that laxatives make the bowel lazy.
Try a small dose of a laxative, such as macrogel (from your pharmacist), on a regular basis for a while to see if it helps.
12. Be careful about any medication
Common painkillers, such as codeine, are notorious for causing constipation, while ibuprofen can irritate the gut.
Blood pressure tablets and iron supplements can also trigger symptoms. If you do have aches and pains, choose paracetamol, which doesn’t affect the gut.
…and antibiotics
In fact, don’t take antibiotics unless you absolutely have to because of the adverse effect they have on gut bacteria.
13. Chew your food well
Chewing at least 30 times means that the gut processes food more quickly and, as a result, reduces the risk that it will ferment, producing gas and triggering pain, bloating and wind.
Put down your fork between bites so you get into the habit of eating more slowly.
14. Watch what you drink
Around 50% of people with IBS report feeling worse after a drink or two.
Beer and red wine seem to be particularly troublesome.
Don’t miss
15. Up your bactaria
The beneficial bacteria in the gut (Lactobacilli and Bifidobacteria) have
anti-inflammatory effects, and it’s now thought that some people with IBS have low-grade gut inflammation, says Dr Arroll.
Taking prebiotics (supplements or substances in certain foods which nourish the beneficial bacteria already in the gut) and probiotics (live bacteria ingested in foods like yoghurt and sauerkraut, and in supplements) can help.
Different people respond to different products, but try supplements which survive the acid medium of the stomach and also contain multiple strains of bacteria.
You need to take a product for a month to know if it’s making a difference. If it doesn’t, it might be worth trying a different one.
Symprove – £79 for four litre bottles from symprove.com has shown impressive results in independent trials.
16. Consider having hypnotherapy
“This is one of the most researched types of treatment for managing the symptoms of IBS,” says Dr Aroll.
The two main methods are the Manchester Approach and the North
Carolina Protocol.
“Your GP may be able to refer you because the National Institute for Health and Care Excellence (NICE) recommends this as a treatment for IBS,” she explains.
However, if the services aren’t offered by the NHS in your area, check out the Hypnotherapy Directory website – hypnotherapy-directory.org.uk/adv-search.html and select “Member of a Professional Body” for therapists vetted by a professional organisation.
17. Try Yoga
“Yoga postures are great for calming and encouraging deep breathing, which can help with IBS,” says celebrity trainer Christianne Wolff.
And if you have constipation, some poses like downward dog encourage movement in the lower abdomen.
Bonus Tips
Going out
Be prepared: Anxious about going out or travelling? Dr Arroll suggests taking an “emergency pack” (e.g. medications such as Buscopan for stomach cramping, diarrhoea relief tablets, flushable wet wipes and a change of underwear) with you.
Avoid 'diet' food
Forget low-fat foods: Avoid foods labelled “diet” or “light” which contain artificial sweeteners that can have a laxative effect.
And always choose table sugar over honey (in moderation). As it isn’t fermentable, it shouldn’t cause digestive problems.
Peppermint Oil
Peppermint oil is more effective for reducing IBS cramps than prescription muscle relaxants, according to a study in the British Medical Journal.
New Underwear
Ditch the control pants: Shape underwear puts pressure on the abdomen, resulting in trapped wind.
What is IBS?
Dr Nick Read, chairman of charity the IBS Network, says it’s an umbrella term for unexplained symptoms that can disturb the large intestine or colon...
“IBS affects around a third of the population at some point in their lives, with one in 10 people seeking help from their GP.
“Symptoms can include abdominal pain and spasms, diarrhoea, constipation or erratic bowel habits, bloating, wind and an urgent need to go to the toilet.
“It’s more common in women, and younger people, and can be triggered by life changes or stress. It is important to get a proper diagnosis – doctors will carry out tests to exclude other abnormalities such as colitis, coeliac disease or Crohn’s disease before diagnosing IBS.
“Because it is a ‘functional disorder’, there is no known cause or cure. But managing IBS is about understanding it. Self-management, and learning how lifestyle and diet can affect your symptoms is key.
There is no magic cure but you can learn to control it and live a normal life.”
Experiences
A natural gel eased my IBS misery
Mum-of three Helen Moore, 44, an artist and sculptor ( equorum.co.uk ), from Dorchester says:
My bowels have always been unpredictable – and I was eventually diagnosed with IBS in my late 20s after the birth of my second child.
I suffered daily with either diarrhoea or constipation, but by far the worst symptom was the overwhelming lethargy – some days it was like having the flu without the temperature.
It destroyed my confidence and I didn’t want to go anywhere for fear of not being able to find a toilet.
My anxiety soared and recently I started getting crippling, vice-like pain around the diaphragm area. During one particularly bad attack, when I couldn’t move or eat, a GP came out on a home visit and diagnosed gastritis (inflammation of the stomach lining).
I was prescribed omeprazole, a proton pump inhibitor to stop acid production. However, I hated the thought of popping pills and decided to look for a natural alternative.
I came across various herbal remedies and supplements, but the only one free from side effects was a product called silicolgel. It’s a liquid combination of silicic acid, silicon and oxygen in a colloidal hydrated gel which lines the digestive tract (one tablespoon covers an area of three square metres).
Apparently, this protective lining doesn’t affect good bacteria but acts as a magnet for bad bacteria – physically binding with toxins, irritants and pathogens – reducing their ability to cause inflammation before being passed out of the body.
After 24 hours, the pain had eased. Three days later, I could get back to work. For the first time since I can remember, I went to the toilet normally – not constipated or loose.
I took silicolgel as recommended for four weeks, then planned a week off. But after one day I was so anxious I would relapse that I simply reduced the dose to two tablespoons a day, and now take one spoonful a day.
If I know a period of anxiety is approaching, then I will increase the dose again. It’s not an exaggeration to say this natural remedy has given me my life back.
- Silicolgel is priced £8.29 (200ml) and £18.49 (500ml) from Boots, Holland & Barrett, and independent pharmacies and health food stores.
I suffered for 13 years before a diagnosis
Matthew Chaddock, 31, an office manager from Leeds, was finally diagnosed with IBS after suffering 13 years with a whole range of debilitating symptoms
From the age of about 12 something wasn’t right – I was going to the loo up to half a dozen times a day, then other days not all.
My mum took me to the GP who simple said I should ‘eat better’, ‘try different foods’ and ‘cut back on fibre’, but that didn’t have much effect. Back then, my IBS was quite easy to hide and wasn’t really impinging on my life, so I just struggled on.
Around six years ago, my symptoms suddenly got much worse, going to the toilet much more frequently, with bloating, lower back pain and generally feeling pretty rubbish.
I’d recently tried eating more wholemeal bread, which I now know can be a trigger for IBS. I went to my GP who prescribed various medications to slow down my bowel movements, which worked to some extent. But he also told me to increase my fibre, fruit and vegetable intake.
I then got referred to a consultant who simply said: ‘Don’t worry, it’s just IBS, there’s not much you can do’.
I realised then, with that formal diagnosis, that I had to take matters into my own hands.
I researched online and through the IBS Network. I then cut back on insoluble fibre, cutting out wholemeal bread and reducing my fruit and veg intake, which helped a little. I also tried probiotics, which didn’t help me, and hypnotherapy, which had a positive, but short-term effect.
Three years ago I set up a support group in Leeds for people with IBS to share information. IBS is a constant in my life but at least I know what I’m dealing with.
- For more information on IBS and support, go to theibsnetwork.org
To mark IBS Awareness Month in the UK, Asda Pharmacy are holding digestive health events instore from 1-24 April. The campaign is also backed by the IBS Network.