IBS that comes and goes

Overview

Irritable bowel syndrome (IBS) is a common condition that affects the digestive system. It causes symptoms like stomach cramps, bloating, diarrhea, and constipation. These symptoms often come and go, meaning you may have good weeks and bad weeks.

Yes, IBS is very common. About 1 in 5 people in the UK experience it at some point in their lives.

IBS can affect anyone, but it's more common in women and people under 50. It often starts in the teenage years or early adulthood.

Symptoms

Common symptoms

• Cramping or pain in the lower belly that often goes away after passing gas or having a bowel movement.
• Bloating and swelling of the belly.
• Diarrhea, constipation, or both (changing bowel habits).
• Feeling that you haven't fully emptied your bowels after going to the toilet.
• Passing mucus (clear or white fluid) with your stool.

Symptoms in children

• Children with IBS may have similar symptoms, including belly pain, bloating, and changes in bowel movements.
• They might complain of pain around the belly button or have a feeling of urgency to go to the toilet.
• Symptoms can affect their appetite and school attendance. If your child has these symptoms, see a doctor for advice.

Symptoms in older adults

• Older adults with IBS may have symptoms similar to younger adults, but they are more likely to have constipation rather than diarrhea.
• They might also have other health conditions or take medications that can affect the bowels, so it's important to discuss symptoms with a healthcare provider.

Causes

Main causes

• The exact cause is unknown, but it's thought to involve problems with how the gut moves food through the body (muscle contractions) and how the brain and gut communicate.
• Triggers can include certain foods (like fatty or spicy foods), stress, hormonal changes (like during menstruation), or infections.
• Some people may have food intolerances (like to lactose or gluten) that worsen symptoms.

Risk factors

• Family history of IBS.
• Mental health issues like anxiety or depression.
• Previous infection in the gut (such as food poisoning).
• Being a woman (hormonal factors may play a role).

When to see a doctor

See a doctor urgently if:

• If you have any emergency symptoms (see above), call your local emergency number immediately.
• If you have symptoms that are getting worse or are interfering with daily life, see a doctor within a few days.

Book a routine appointment if:

• If you have had changes in your bowel habits for more than a few weeks, make an appointment with your doctor.
• If you are over 50 and notice new symptoms like changes in bowel habits or belly pain, see a doctor to rule out other conditions.
• If you have rectal bleeding (even a small amount) or bleeding in your stool, you should see a doctor promptly.

Diagnosis

IBS is usually diagnosed based on your symptoms and medical history. There is no specific test for IBS, but your doctor may do tests to rule out other conditions.

Tests that may be done

• Blood tests to check for anaemia, inflammation, or other problems.
• Stool tests to look for infections or bleeding.
• A test to check for coeliac disease (an autoimmune reaction to gluten).
• In some cases, a colonoscopy (a camera tube to look at the bowel) might be recommended, especially if you are over 50 or have certain warning signs.

What to expect at your appointment

Your doctor will ask about your symptoms, diet, stress levels, and family history. You may be asked to keep a diary of your symptoms and what you eat. Based on the results, your doctor will explain if your symptoms fit a diagnosis of IBS and discuss next steps for management.

Treatment

Treatment for IBS focuses on managing symptoms and improving quality of life. There is no cure, but many people find relief with lifestyle changes, dietary adjustments, and sometimes medication.

Self-care at home

• Keep a food and symptom diary to identify triggers.
• Eat smaller, more frequent meals and avoid large fatty meals.
• Stay hydrated, but limit caffeine, alcohol, and fizzy drinks.
• Try stress-reducing activities like gentle exercise, meditation, or talking to a counsellor.
• Gradually increase soluble fibre (like oats, psyllium) but avoid too much insoluble fibre (like bran) if it worsens symptoms.

Medical treatments

Your doctor may recommend over-the-counter remedies for diarrhea or constipation, antispasmodics for cramps, or medications that affect gut movement or pain signals. Always follow your doctor's advice and never take medications not prescribed or recommended for you. Some people benefit from probiotics, but discuss with your doctor first.

When is surgery considered?

Surgery is not a treatment for IBS. Surgery may be considered only if there is another condition, like gallstones or bowel obstruction, that requires intervention.

Living with this condition

Living with IBS that comes and goes means learning to manage flare-ups when they happen and making adjustments to your routine. Many people plan ahead for travel or social events, and find ways to reduce stress.

Lifestyle tips

• Establish a regular sleep schedule to support your digestive system.
• Exercise moderately most days, such as walking, swimming, or yoga.
• Practice mindfulness or deep breathing to manage stress.
• Avoid smoking and limit alcohol.

Diet and exercise

A balanced diet with plenty of fruits, vegetables, and whole grains can help, but pay attention to how specific foods affect you. Some people benefit from a low-FODMAP diet under guidance from a dietitian. Regular exercise helps reduce stress and can improve bowel regularity.

Mental health and emotional wellbeing

IBS can cause anxiety and affect your mood, especially during flare-ups. It's normal to feel frustrated or worried. If you feel overwhelmed, talk to your doctor — counselling or support groups can help. Remember, you're not alone, and seeking help is a sign of strength.

Prevention

IBS cannot be prevented, but you can reduce the frequency and severity of flare-ups by identifying and avoiding your triggers. This includes managing stress, eating a healthy diet, and staying active.

Complications

If left untreated

• Persistent symptoms can harm your quality of life, interfering with work, sleep, and social activities.
• Stress and anxiety can worsen without proper management.
• Severe diarrhea or constipation can lead to dehydration or hemorrhoids.

Long-term outlook

IBS is a manageable condition. Most people with IBS lead full, active lives. With the right support and strategies, you can control symptoms and reduce their impact on your daily life.

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