Clinical update

Irritable bowel syndrome

Irritable bowel syndrome (IBS) is a common, relapsing and often lifelong disorder that causes bouts of stomach cramps, bloating, diarrhoea and constipation.

Essential facts

Irritable bowel syndrome (IBS) is a common, relapsing and often lifelong disorder that causes bouts of stomach cramps, bloating, diarrhoea and constipation. It is thought to affect up to one in five people at some point in their life, and around twice as many women as men. While IBS can affect people of all ages, including children, it usually develops between age 20-30.

The National Institute for Health and Care Excellence (NICE) has published new quality standards on IBS in adults. These are expected to contribute to improvements in quality of life and limit unnecessary hospital attendances.

Picture credit: SPL

Common symptoms include abdominal pain and discomfort, a change in bowel habits, such as diarrhoea, constipation or both, stomach bloating, excessive flatulence, and passing mucus. Other problems include lethargy, nausea, back pain, dyspareunia and incontinence.

Symptoms vary between individuals, but are usually

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Essential facts

Irritable bowel syndrome (IBS) is a common, relapsing and often lifelong disorder that causes bouts of stomach cramps, bloating, diarrhoea and constipation. It is thought to affect up to one in five people at some point in their life, and around twice as many women as men. While IBS can affect people of all ages, including children, it usually develops between age 20-30.

The National Institute for Health and Care Excellence (NICE) has published new quality standards on IBS in adults. These are expected to contribute to improvements in quality of life and limit unnecessary hospital attendances.

Picture credit: SPL

Common symptoms include abdominal pain and discomfort, a change in bowel habits, such as diarrhoea, constipation or both, stomach bloating, excessive flatulence, and passing mucus. Other problems include lethargy, nausea, back pain, dyspareunia and incontinence.

Symptoms vary between individuals, but are usually worse after eating and tend to last a few days. Although they usually improve, symptoms may not disappear completely, and can overlap with other gastrointestinal disorders such as non-ulcer dyspepsia or coeliac disease.

While the exact causes of IBS are unknown, possibilities include gut hypersensitivity, disturbed colonic motility, bowel dysfunction following an infection and dysbiosis.

Symptoms can be triggered by diet, including alcohol, fizzy drinks, caffeine, processed snacks, dairy products and fatty or fried foods. Stress and anxiety are common aggravating factors, and some people also experience lack of sleep and depression, which can lead to absence from work and avoidance of social situations.

There is no single, specific treatment for IBS. Patients need an individual plan based on their symptoms and the effect on their quality of life.

Information on the importance of self-help, including general lifestyle, diet and physical activity, should be given. This could include having regular meals, restricting intake of tea, coffee, alcohol and fizzy drinks, and keeping a nutritional diary to help determine trigger foods.

Practitioners should also be aware of ‘red flag’ indicators to rule out bowel or ovarian cancer.


Expert comment

Jackie Holley, nurse manager on the IBS Network helpline

Patients often hope there is a magic cure for IBS, but unfortunately that is not the case. IBS is an individual condition, so self-awareness and self-care are key to managing it.

‘On the helpline, we encourage patients to take information from healthcare professionals and combine it with their own knowledge of the condition.

‘Some myths about IBS still need to be dispelled, including that it is a psychological condition or not important, but these are gradually disappearing.

‘The NICE guidelines are concise and patient centred, with a clear rationale, processes and outcomes that provide a good model of care. I hope there will be guidelines for IBS in children in the future.’


Find out more

IBS in adults: quality standard (2016)

IBS in adults: diagnosis and management (2015)

The IBS Network

The Bladder and Bowel Foundation

Living with IBS

The Association for Continence Advice (ACA)

Prevention and management of constipation in adults (2015) tinyurl.com/NS-constipation

Study of irritable bowel syndrome and co-existing psychological illness (2014)

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