IBS
WHAT IS IBS
Irritable bowel syndrome (IBS) is a common long-term condition that affects the digestive system. It can cause a wide range of symptoms including diarrhoea and constipation, bloating and stomach cramps which can vary in frequency and severity and from person-to-person. These symptoms occur without any visible signs of damage or disease inside the digestive system, meaning the exact cause of IBS is still unknown.
IBS must be confirmed by a GP. It’s usually a lifelong condition and symptoms can change over time. Whilst it doesn’t cause inflammation, any risks to your physical health or increase your chances of developing cancer or other bowel-related conditions, IBS can sometimes be difficult to live with and may negatively impact your day-to-day life.
HOW TO HELP MANAGE GUT HEALTH
Although there’s no cure for IBS, there are a range of lifestyle changes and products that can help manage and relieve symptoms to lessen their impact on daily life. Read on to find out more about symptoms and ways of managing IBS, along with information about similar conditions.
IBS symptoms can vary from person to person and can change throughout an individual’s lifetime. If you have IBS, your symptoms could be mild and not happen often, or you could experience flare-ups where your symptoms are worse and more frequent.
Some of the most common symptoms you may experience include:
• stomach cramps or pain in your stomach – often worse after eating and sometimes better after moving your bowels by doing a poo
• diarrhoea (loose, watery poo)
• constipation (harder, lumpier poo that may be unusually large or small and happens less often than usual)
• experiencing an urgent need to move your bowels by doing a poo
• bloating and having a tummy that feels swollen and uncomfortably full
• excessive wind and farting (flatulence)
Other symptoms may include:
• having a lack of energy and feeling tired
• feeling sick (nausea)
• passing mucus (a clear liquid or gel-like substance) from your bottom
• backache
• having a sudden urge to pee, needing to pee more often and feeling like you can’t empty your bladder fully
• experiencing bowel incontinence (not being able to control when you poo)
• heartburn (a burning feeling in the chest caused by stomach acid travelling up towards the throat)
• Low mood and stress symptoms result from the impact IBS has on quality of life.
For more information on mental health, visit our Mental Health Hub.
Some symptoms of IBS can be similar to symptoms of colon cancer and IBD (inflammatory bowel disease). You should see a GP if you have symptoms that include:
• unintentional weight loss
• bleeding from your bottom
• blood in your poo
IBS must be confirmed by a GP, rather than trying to self-diagnose, and it’s important for your GP to rule out any other causes for your symptoms. Some treatment options for helping to manage symptoms may only be suitable for those with medically confirmed IBS.
There’s no known cause of IBS, but it has been linked to having a family history of IBS, having oversensitive nerves in your gut and food passing too slowly or quickly through your gut.
Certain things can trigger a flare-up of IBS symptoms including:
• drinking alcohol
• drinking caffeine
• eating spicy or fatty foods
• experiencing stress or anxiety (or both).
For more information on mental health, visit our Mental Health Hub.
There are some conditions that share similar symptoms with IBS. Here are some of the most common:
Bloating
Bloating is when your stomach feels full and uncomfortable and can include stomach pain, a rumbly tummy and passing wind more than usual.
It’s often caused by having lots of gas in your gut which can happen after drinking fizzy drinks, eating certain vegetables, by swallowing excess air when you eat or by chewing gum. Bloating can also be caused by things including:
• food intolerances
• IBS
Some people feel bloated around the time of a menstrual period. For more information on periods visit the Boots Period Health Hub.
Bloating is usually nothing to worry about, but you should see a GP, if bloating doesn’t go away or if you experience any of the following:
• you’ve been feeling bloated for three weeks or more
• you feel bloated regularly such as more than 12 times a month
• you keep feeling bloated even after changing your diet
• you have swelling or a lump in your stomach
• you have bloating whilst feeling sick, having diarrhoea, constipation, unexplained weight loss or blood in your poo
• bloating makes it difficult to move or carry out daily activities
If you experience regular bloating or bloating that doesn’t happen as often and an underlying cause has been ruled out, you can help ease it by:
• exercising regularly
• drinking plenty of water
• eating high-fibre foods, if constipated
• eating smaller more frequent meals instead of larger meals
• chewing with your mouth closed to help avoid swallowing excess air
• massaging your stomach from right to left which may help release trapped wind
You can also find products at your local Boots pharmacy which may help relieve certain symptoms. These include Boots Wind Relief Tablets (contain dried aluminium hydroxide gel, always read the label) which help relieve pain and discomfort of trapped wind.
Speak to a member of the pharmacy team for advice about your symptoms and to help find products that may be suitable for you.
Haemorrhoids
Haemorrhoids (also known as piles) are lumps containing enlarged blood vessels that can develop inside or around your bottom (anus).
In many cases, haemorrhoids go unnoticed and disappear by themselves in a few days. But you may experience symptoms including:
• soreness, redness, lumps or itchiness around your anus
• bright red blood on the toilet paper after pooing
• mucus (a clear liquid) on the toilet paper or in your underwear after pooing
• feeling like you still need to poo after going to the toilet
If your GP has confirmed haemorrhoids and they are causing you discomfort, there are a number of products that you can buy from your local Boots pharmacy to help relieve symptoms. These include cooling cleansing wipes and soothing ointments to treat external piles such as Boots Haemorrhoid Relief Ointment (contains lidocaine and zinc oxide, always read the label).
There are also suppositories, such as Boots Haemorrhoid Relief Suppositories (always read the label) which are inserted into the anus to help relieve pain and itching of internal piles.
A member of the pharmacy team will be able to advise on the most suitable product for you.
You should see your GP if you experience any of the following:
• your pile symptoms get worse or there's no improvement after seven days of at-home treatment
• you keep getting piles
• you notice any abnormal changes around your anus
Coeliac disease
Coeliac disease is an autoimmune condition where the body’s immune system mistakenly attacks your own tissue when you eat gluten. This causes damage to your gut and means it doesn’t take in nutrients from food as well as it should.
Milder cases sometimes go undiagnosed or misdiagnosed or get mistaken for other conditions like IBS and gluten intolerance. You can read more about the differences between coeliac disease and gluten intolerance here.
Some common symptoms of coeliac disease include:
• stomach pain
• diarrhoea (loose, watery poo) which may smell particularly unpleasant
• bloating
• passing wind
• indigestion (you may feel full, bloated, sick or experience a painful burning feeling in the chest)
• constipation (harder, lumpier poo that happens less often than usual)
• fatigue, extreme tiredness
• headache
• mouth ulcers
• iron deficiency or anaemia
• weight loss
• tooth enamel defects (white, yellow, or brown spots on the teeth)
The only known treatment for coeliac disease is to follow a lifelong gluten-free diet which should help control symptoms and prevent long-term complications. This means avoiding food and drink containing barley, rye or wheat and, in some cases, oats which can be contaminated with other gluten-containing cereals and trigger symptoms in some people.
We have a range of gluten-free snacks to choose from, as well a section of gluten-free meal deals for when you’re on the go.
If you think you might have coeliac disease, speak to your GP.
Inflammatory bowel disease
Inflammatory bowel disease (IBD) is mainly used to describe two long-term conditions: ulcerative colitis and Crohn's disease. Both of these conditions involve inflammation of the gut, but ulcerative colitis only affects the large intestine (colon) whereas Crohn’s disease may affect any part of the digestive system (running from the mouth to the anus).
The most common symptoms of IBD include:
• stomach pain, cramps or swelling in the tummy
• recurrent diarrhoea (loose, watery poo) that can contain blood
• feeling extremely tired
• experiencing weight loss
There’s no known cure for IBD and symptoms can range from mild to severe but lifestyle changes, following specific diets, medicines and surgery are some of the ways that these conditions can be managed.
If you think you might have IBD, speak to your GP.
There are general diet and lifestyle changes that may help manage the symptoms of IBS, including:
• following a healthy, balanced diet with three regular meals a day (smaller meal sizes may help ease symptoms)
• drinking plenty of water and staying hydrated throughout the day
• exercising regularly (the NHS recommend 150 minutes of moderate-intensity exercise per week for adults aged 19-64; if you haven’t exercised for some time or if you have a medical condition or any concerns, speak to a GP to determine what types of exercise are suitable for you)
• finding ways to relax and manage day-to-day stress levels. If you would like some more information on mental health visit the Boots Mental Health Hub.
• keeping a diary of what you eat and any symptoms you get afterwards to help identify any potential triggers
It can also be helpful to avoid certain things including:
• skipping or delaying meals
• eating too quickly
• eating lots of processed, fatty or spicy foods
• eating more than three portions of fresh fruit a day. In order to get your five fruit and vegetable a day, try to increase your vegetable intake. You could snack on carrots and cucumber
• drinking more than three cups of caffeinated tea or coffee a day
• drinking lots of alcohol, fizzy drinks or energy drinks
• use sugar-free products and sweeteners containing sorbitol, mannitol and xylitol
There are also products available, such as Colpermin IBS Relief Capsules (contains peppermint oil, always read the label) which is for medically confirmed IBS and may help relieve symptoms including painful spasms, bloating, trapped wind, diarrhoea and constipation.
Speak to a member of the pharmacy team for advice and suitable product recommendations.
Here are some more ways to help ease specific symptoms:
Easing bloating, cramps & trapped wind
To help ease bloating, cramps and trapped wind, it may be useful to make some simple diet changes including:
• eating small but regular meals instead of fewer larger meals
• regularly eating oats (which are rich in fibre) such as having porridge or overnight oats for breakfast
• eating up to one tablespoon of linseeds (whole or ground) per day
• avoiding hard-to-digest foods which can include onions, cauliflower, cabbage, beans, Brussels sprouts, broccoli and dried fruits
• avoiding sugar-free mints and chewing gum
There are also products available from your local Boots pharmacy that may help. These include Boots Wind Relief Tablets (contain dried aluminium hydroxide gel, always read the label) which help relieve pain and discomfort of trapped wind and indigestion. Alternatively, Buscopan IBS Relief Tablets (contains hyoscine butyl bromide, always read the label) which are suitable for medically confirmed IBS and may help relieve abdominal cramps, pain and discomfort.
Speak to a pharmacy team member for advice about which products may be suitable for you.
Reducing diarrhoea
If you’re regularly experiencing diarrhoea (loose, watery poo), it may be helpful to cut down the amount of fibre in your diet by eating less wholegrain foods (like brown bread and brown rice), nuts and seeds. Avoid products containing a sweetener called sorbitol.
There are also products available from your local Boots pharmacy that can help relieve symptoms of diarrhoea. These include Boots Diarrhoea Relief 2mg Capsules (contains loperamide hydrochloride, always read the label) which may help relieve symptoms of IBS-related diarrhoea in medically confirmed IBS.
It’s also important to replace lost fluids after diarrhoea with non-caffeinated drinks such as water.
Relieving constipation
If you’re regularly experiencing constipation, it may help to increase the amount of soluble fibre in your diet by eating foods including oats, pulses, carrots, peeled potatoes and linseeds (whole or ground). It can also help to drink plenty of water to help make your poo softer.
There is a range of products available from your local Boots pharmacy, which may help relieve constipation when it happens, including drinks containing fibre.
Managing IBS when you’re out & about
When you’re out of the house, it can be helpful to make sure you know where your nearest toilets are in case you have a sudden onset of IBS symptoms, such as diarrhoea. In some cases, public toilets are locked. However, you can buy a radar key from the IBS Network or Disability Rights UK shop which gives you independent access to locked public toilets that are under the National Key Scheme.
Stress and anxiety can trigger IBS symptoms, but living with IBS can in turn trigger daily stress and anxious feelings because of the effect it may have on daily life. It’s important to speak to your GP if you’re experiencing stress and anxiety as this should be treated separately and, in turn, is likely help to reduce the risk of triggering IBS.
If you’re concerned about your symptoms, they are not improving or last longer than two weeks you should speak to a GP. They may refer you for talking therapy, such as cognitive behavioural therapy (CBT) on the NHS. Or you can self-refer for talking therapies and counselling via the NHS.
It’s important to see your GP to have a diagnosis of IBS confirmed as they can help rule out other conditions, such as coeliac disease and IBD (inflammatory bowel disease), that may have similar symptoms.
A GP will ask about your symptoms and may arrange for tests to rule out other possible causes. If your GP suspects you have IBS they will provide advice and explain what your treatment options are. They may refer you to a specialist or dietitian for further advice.
You should make an urgent appointment with your GP if you experience any of the following, which could be signs of something more serious:
• unexplained weight loss
• bleeding from your bottom
• bloody diarrhoea (loose, watery poo with visible blood)
• a hard lump or swelling in your stomach
• shortness of breath, palpitations (noticeable heartbeats) and pale skin
• a change in your bowel habits that has lasted for more than six weeks, especially if you’re over the age of 50
LEARN MORE ABOUT INDIGESTION
FREQUENTLY ASKED QUESTIONS
The only way to know for certain if you have IBS is to get a diagnosis from a GP. If you’re experiencing symptoms of IBS, keeping a diary of your symptoms in the run-up to a GP appointment can be helpful.
At your appointment, a GP may ask you more about your symptoms such as how often they occur, how long you’ve had them, if your symptoms come and go and if you get them after eating certain foods.
There’s no way of testing for IBS, but a GP may arrange for tests to rule out other conditions such as coeliac disease, infection or IBD (inflammatory bowel disease) with similar symptoms.
There’s a known link between stress and IBS and a flare-up of symptoms can be triggered by both stress and anxiety. There’s also growing research around communication that exists between the gut and the brain, also known as the ‘gut-brain axis’, linking gut microbiota to mood and mental health.
You should speak to your GP if you’re experiencing stress or anxiety (or both) which should be treated separately from IBS and doing so may help to reduce the risk of triggering IBS. They may refer you for talking therapies such as CBT (cognitive behavioural therapy) which you may be able to access on the NHS. Or you may be able to self-refer to talking therapies and counselling on the NHS.
Some studies have shown a potential link between the menstrual cycle and worsening IBS symptoms, though more studies need to be done to confirm this link.
Bloating and tummy pain or discomfort are associated with various menstrual cycle stages and symptoms of IBS. It may feel like the symptoms of IBS are worse during your period. For more information on periods visit the Boots Period Health Hub.
The health of our gut has a huge impact on our overall health and wellbeing, affecting everything from how well our immune system is working to our mood and even skin health.
Our body is home to trillions of live microbes, another word for bacteria, fungi and viruses. These are collectively known as the microbiome and mainly live in the large intestine and other areas of the gastrointestinal tract such as the mouth and stomach. These gut microbes play an essential role in helping to break down food and produce vitamins and chemicals to help our bodies function.
You may have heard of live-friendly bacteria. These are sometimes called probiotics. Live-friendly bacteria can be found in some food products such as live yoghurt. They are also thought to support the balance of bacteria in the gut, although more research is needed to prove any health claims and evidence of their benefits.
There are a number of products available at your local Boots pharmacy which contain live-friendly bacteria including biotic culture capsules and advanced multi-strain bacteria capsules.
There’s no way to tell whether you have a healthy gut, but symptoms such as constipation, stomach cramps and diarrhoea could indicate a problem with your gut health or a gut-related condition such as IBS.
Our gut microbiome is heavily influenced by our diet, but things like sleep, stress levels and how much exercise you do can also play a role. From drinking plenty of fluids, to eating plenty of fibre and avoiding potential food triggers, we’ve got plenty of tips to help keep your gut healthy.
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