Living with this distressing digestive complaint can be difficult. Find out what causes IBS, common symptoms and how to manage it

Ever experience stomach pain and bloating? If so, you may be wondering if your symptoms are actually irritable bowel syndrome (IBS).

IBS is a common gut condition, affecting up to one in five people in the UK at some point. So, could you be one of them?

There's no known cure for irritable bowel syndrome (IBS). But through careful diet choices, it’s often possible to control your symptoms.

W have included a few dos and don’ts when it comes to what to eat with IBS.¹

About two in 10 people in the UK have IBS. It’s common.

But what is IBS? Put simply, it’s a long-term condition that leads to frequent abdominal discomfort and bowel symptoms.

It has no specific cause. And symptoms vary from individual to individual. This inconsistency means IBS is usually only diagnosed at the point when all other possibilities are ruled out.²

Once you have the diagnosis, a common reaction is to change what you eat. But if you’re looking for a single diet that tells you what to eat with IBS, unfortunately, this simple solution doesn’t exist.

However, there are lots of foods that you can eat (or avoid eating) to help manage your symptoms. We pick up some of the key themes in these dos and don’ts.

In this article, you’ll find out

• What IBS is
• Types of IBS
• IBS symptoms
• IBS causes
• IBS triggers
• Warning signs of IBS
• How to prevent IBS
• IBS do’s and don’ts
• FAQs

What is irritable bowel syndrome?

IBS is a long-term condition that affects the large intestine. IBS causes spells of stomach pain, bloating, diarrhoea and constipation.

These spells come and go and can last anywhere from a few days to a few months each time.

IBS is a lifelong condition that usually first affects people between the ages of 20 and 30. Women are two times more likely to be affected than men, with some people experiencing more severe symptoms than others.

What are the 3 types of IBS?

You may be interested to know that there are actually three different types of IBS. These include:

• IBS-C – mainly experience constipation and hard or lumpy stools
• IBS-D – mainly experience diarrhoea and loose or watery stools
• IBS-M/IBS-A – you experience equal amounts of symptoms above³

What are the symptoms of IBS?

Symptoms can vary in severity but for some people, they can be very painful and distressing. Common IBS symptoms include:

• Stomach cramps
• Bloating
• Excess gas
• Constipation, diarrhoea or both⁴

What causes IBS?

It's not clear why IBS affects some people, and its exact cause is unknown.⁵

However, it has been linked to the following:

• Gastroenteritis – IBS develops in up to 10% of previously healthy individuals after a bout of the stomach bug ⁶
• Changes in gut microflora – the type and number of friendly bacteria in the gut may be different in someone with IBS⁷
• Increased gut sensitivity – people with IBS may have issues with their nervous system that make them ultra-sensitive to everyday abdominal changes⁸
• A faulty gut-brain connection – the muscles in your intestines squeeze food through the digestive system but if the messages between your gut and brain become disrupted, food may pass through too quickly (diarrhoea) or too slowly (constipation)⁹

What can trigger IBS symptoms?

The exact cause of IBS remains unknown but it is thought that stress, a gut that’s sensitive to pain, and digestive problems may be linked to the condition.

During times of stress, many people with IBS experience flare-ups. Certain foods may also trigger IBS.

These are different for each person but fizzy drinks, fatty food, alcohol, chocolate and caffeine are the most common.

Diet: skipping meals or leaving long gaps between mealtimes can be a trigger. Certain foods can also set off an episode of IBS, such as caffeinated and fizzy drinks, alcohol, chocolate, spicy or fatty foods.¹⁰

Stress: according to a 2014 study in World Journal of Gastroenterology, anxiety or stress can upset the gut-brain connection. This may then lead to overactivity in your gut and trigger an IBS flare-up.¹¹

What are the warning signs of IBS?

Read on to find out about the warning signs of IBS...

1. Changes in bowel habits

Switching between constipation and diarrhoea, your bowels may also feel like they haven’t been completely emptied after going to the toilet.

2. Stomach pain or discomfort

Ranging from a dull ache to sharp pains or cramps, it’s usually worse after eating and feels better after going to the toilet.

3. Stomach bloating

You often feel bloated and your stomach looks swollen, especially in the evening.

4. Excessive flatulence

Caused by retention of gas resulting in bloating and passing more wind than usual.

5. A sudden, urgent need to go to the toilet

People with IBS may sometimes quickly need to find a toilet to relieve themselves.

6. Passing mucus

On occasion, mucus may be mixed with your stools. At other times, you might pass mucus alone when going to the toilet.

7. Problems with your bladder

Those with IBS may need to urinate more often than usual. Sometimes they may wake up at night to urinate and may often find it difficult to fully empty their bladder.

8. Feeling low on energy

IBS often causes a lack of energy with those affected feeling tired and run down.

How to fix IBS

So what can you do to ‘fix’ IBS? While there isn’t an exact cure, there are a few key do’s and don’ts of IBS, which may be able to help you with managing your symptoms.

DO know your IBS type

Bloating and constipation, or diarrhoea and stomach cramps? The symptoms you suffer will depend of your type of IBS.

There are three varieties: IBS -C (constipation dominant), IBS-D (diarrhoea dominant) and IBS-M (mixed constipation and diarrhoea.) Your type is an important influence on what food to eat with IBS.

DO know your triggers

Most of us can’t remember exactly what we eat on a day-to-day basis. This is why it can be helpful to write it down.

To start a food diary, write down everything you eat daily, including the time you ate it, and the severity and time of your IBS symptoms on the same day.

This allows you to recognise patterns between your diet and any bowel discomfort.

With this knowledge, you could then reduce or eliminate (with professional consultation) your trigger foods for IBS for a short period and see if your symptoms reduce.

After a few weeks, gradually reintroduce the food and monitor the impact.

DO eat probiotics

The large intestine contains trillions of bacteria that break down food and regulate bowel function.

There’s evidence to suggest IBS symptoms may be linked to some kind of imbalance between friendly bacteria and the other not-so-friendly species.¹⁹

Probiotics could help by topping up the level of good bacteria in the gut. This crowds out the more hostile varieties.

Probiotics can be found naturally in a number of foods – e.g. live, cultured dairy products and fermented foods. They also come in supplements.

DON’T eat too much fibre

Wondering what are the best foods for IBS? Fibre is probably at the top of your list. And fibre is great.

It’s a rich source of prebiotic goodness, which feeds those helpful, friendly bacteria in your gut. It also helps maintain regular bowel movement. But it’s not a case of more must be best for IBS.

Most people benefit from a moderate increase in fibre intake.

But, in some people with IBS, it can also exacerbate symptoms by increasing abdominal pain and bloating. So, finding the right level for you is key.

And remember, water is also needed to help fibre to pass through the digestive tract. Increasing fibre and not increasing water can actually worsen constipation.²⁰

DON’T try a low FODMAP diet without professional advice

FODMAPs are a well-known group of foods that trigger IBS.

You may hear claims that IBS can be treated by going on a temporary, restricted diet called the low FODMAP diet. The guiding theory is to replace high FODMAP foods that are poorly digested, with low FODMAP foods that easily breakdown in the stomach.

This can reduce bloating, constipation and other IBS symptoms. Sounds good, but don’t rush in without professional advice.

A low FODMAP diet is very restricted, and if it isn’t implemented carefully, you risk missing out on vital nutrients.

A dietitian can help identify which high FODMAP foods you’re most sensitive to and make sure you get the right nourishment from what you eat.

DON’T follow a friend’s experience of what to eat with IBS

Feeling inspired after a friend of a friend’s IBS symptoms disappeared when they started eating a diet rich in fermented foods? It may work for you too. Or you might get better results from another food source.

IBS sufferers aren’t all sensitive to the same foods. Whilst for one person increasing fermented foods works, other people might find that these foods cause an increase in digestive upsets.

It’s essential to find out what works for you.

So, in summary…

Foods to eat with IBS

1. Fibre (in moderation). Stick to more soluble fibre sources and increase water intake too.
2. Try them to see if they help relieve symptoms.
3. Low FODMAP foods. But only eliminate high FODMAP foods with the guidance of a dietitian.

Foods to avoid with IBS

• Too much fibre. In particular insoluble fibre, which is harder to digest and can trigger IBS symptoms.
• High FODMAP foods. But seek advice before cutting them out.
• Your personal triggers. Whether it’s gluten or lactose, spicy foods or alcohol, the best IBS diet is the one where you cut out the foods that make the biggest difference to your symptoms.

It’s not all about what to eat with IBS

Many other things (as well as food) can exacerbate IBS symptoms.

For example, eating habits – skipping meals or eating too quickly. Or it could be more to do with your lifestyle – stress, depression and anxiety can also contribute.

It’s important to remember the food you eat isn’t the sole cause of IBS and to take a more holistic approach to managing your condition.

Managing your symptoms

It’s important to see your GP if you’re not sure what’s causing your digestive symptoms – other, more serious, health conditions can also cause stomach pain and diarrhoea, including Crohn’s disease and colitis.^21,22

How is IBS treated?

IBS can’t be cured, but making diet and lifestyle changes may help relieve symptoms. Identifying your triggers and learning to avoid them is key to preventing flare-ups.

Lowering stress levels, regular exercise, eating regular meals and including probiotics in your diet may also help ease symptoms.

There are also several over-the-counter medicines available as well as prescribed medicines available to help treat the condition.

Most IBS symptoms are long-lasting with occasional flare-ups that are more severe. If you notice the above symptoms, contact your GP to talk through them and discuss treatment.

Your GP can also prescribe any medication if needed, such as laxatives.

Is there a test for IBS?

There isn’t a test that tells you if you have IBS or not. But you may be required to do some tests to make sure your symptoms aren’t caused by coeliac disease or an infection.²³

Can men and women get IBS?

Yes, both men and women can get IBS. Although studies have shown that IBS is more common in women than it is in men.²⁴

The final say

There are multiple different types of IBS, but thankfully there are various ways you can manage the condition in order to keep your symptoms at bay.

The advice in this article is for information only and should not replace medical care. Please check with your GP or healthcare professional before trying any supplements, treatments or remedies. Food supplements must not be used as a substitute for a varied and balanced diet and a healthy lifestyle.