Irritable Bowel Syndrome (IBS)

28 Feb 2017.

Irritable bowel syndrome (IBS) is a common, long-term condition of the digestive system. It can cause bouts of stomach cramps, bloating, diarrhoea and/or constipation [1].

The symptoms vary between individuals and affect some people more severely than others. They tend to come and go in periods lasting a few days to a few months at a time, often during times of stress or after eating certain foods [1].

IBS is thought to affect up to one in five people at some point in their life, and it usually first develops when a person is between 20 and 30 years of age [1].

IBS disproportionately affects ‘women of reproductive age’ (i.e. people with a menstrual cycle) [1]. It can also worsen at certain times in the menstrual cycle [2], during or after pregnancy [3], and tends to improve after menopause (but not always) [4]. Sex hormones, especially oestrogen, are known to affect IBS symptoms [4], and people taking hormonal medication (especially those containing drospirenone) may also be more likely to develop IBS [5].

Main symptoms: Abdominal pain; backache; bladder urgency; bloating; constipation; diarrhoea; fatiguelow mood, or self-esteem; nausea/ vomiting; passing mucus in stool; and sensitivity to certain foods/ drinks.


Notes: IBS can be hormone-related, or a non-hormonal chronic ill-health condition. Track symptoms over time, and/ or change or stop hormonal medication (under medical supervision), to determine your situation.

If your symptoms are caused by your hormonal medication, we suggest that you discuss your options with a doctor. These steps may reduce symptom severity, but are unlikely to be able to stop them completely whilst you remain on the same medication.


The good news is that the symptoms of IBS can respond positively to the four steps outlined on our ‘all symptoms‘ page, whether they are hormone-related, or not.


Managing hormone-related IBS:

Try a hormone-balancing diet– As outlined in this blog, a vegetable-based ‘anti-inflammatory’ diet can significantly improve all hormone-related symptoms.

We highlight a few of the key steps that are especially relevant for those suffering from IBS, below;

According to the NHS, a healthy diet plays an important part in controlling  symptoms of IBS [1].  It may be helpful to keep a food diary and record whether certain foods make your symptoms better or worse. You can then avoid foods that trigger your symptoms.

IBS symptoms may also improve by:

  • having regular meals and taking your time when eating
  • not missing meals or leaving long gaps between eating
  • drinking at least eight cups of water per day
  • Reducing the amount of caffeine or alcohol consumed
  • Avoiding processed foods
  • If you have wind (flatulence) and bloating, it may help to eat oats (such as oat-based breakfast cereal or porridge) and linseeds (up to one tablespoon a day)

Many people find that exercise helps to relieve the symptoms of IBS [1]. Aim to do a minimum of 2.5 hours of moderate-intensity aerobic activity, such as cycling or fast walking, every week.

The exercise should be strenuous enough to increase your heart and breathing rates [1].

Read more about NHS health and fitness and physical activity guidelines for adults.


Improving self-esteem and reducing stress levels- we all know that our emotional state can affect our digestive system, and vice versa… So, it is important to ensure that your self-esteem is high enough to avoid falling into a negative cycle of health anxiety, that can re-trigger IBS symptoms. This is especially important during the menstrual cycle, or when taking hormonal medication, when hormone levels are changing.

NoteThe Oxford Cognitive Therapy Centre produces a highly effective (and cheap!) booklet on ‘Building self-esteem’

Reducing stress levels may also reduce the frequency and severity of IBS symptoms [1]. Some ways to help relieve stress include:

If you are particularly stressed, you may benefit from a talking therapy, such as stress counselling or cognitive behavioural therapy (CBT). Read more about how to manage stress.


If you have tried the suggested tips and tricks for at least 3 months, and your symptoms do not improve, please consult your doctor.

If you have any suggestions, or tips, for managing IBS- please let us know– we can share them with others!

Further information:


Page last reviewed and updated: June 2018


References:

1. NHS. (2014) Irritable Bowel Syndrome (IBS). [ONLINE] Available at: http://www.nhs.uk/Conditions/Irritable-bowel-syndrome/Pages/Introduction.aspx. [Accessed 25 July 2017].

2. Bharadwaj S, Barber MD, Graff LA, Shen B. (2015) Symptomatology of irritable bowel syndrome and inflammatory bowel disease during the menstrual cycle. Gastroenterol Rep (Oxf). Aug;3(3):185-93. doi:10.1093/gastro/gov010.

3. Johnson P, Mount K, Graziano S. (2014) Functional bowel disorders in pregnancy: effect on quality of life, evaluation and management. Acta Obstet Gynecol Scand. Sep;93(9):874-9. doi: 10.1111/aogs.12434.

4.  Mulak A, Taché Y, Larauche M. (2014) Sex hormones in the modulation of irritable bowel syndrome. World J Gastroenterol. Mar 14;20(10):2433-48. doi: 10.3748/wjg.v20.i10.2433.

5. Bird ST, Liu W, Brophy JM, Bressler B, Delaney JA, Etminan M. (2012) Irritable bowel syndrome and drospirenone-containing oral contraceptives; a comparative-safety study. Curr Drug Saf. Feb;7(1):8-15. PubMed PMID: 22663950.


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