Irritable bowel syndrome (IBS) is a common digestive disorder that makes life difficult for many people. Symptoms such as abdominal pain, bloating, diarrhoea or constipation can significantly impair quality of life. Many people are apprehensive about undergoing tests and are unsure where to turn with their symptoms. In this article, we provide a detailed overview of the symptoms and causes of IBS, the diagnostic process and the most effective treatment options, so that you too can regain control over your health.
IBS is not a serious disease involving organic changes, but rather a functional disorder, which means that the digestive system does not function as it normally should. Although the exact causes are not fully understood, stress, diet and an imbalance in the gut flora may all play a role in its development. The good news is that with the right lifestyle, diet and, where necessary, targeted treatment, the symptoms can be effectively alleviated. Read our expert guide and take the first step towards a symptom-free everyday life!
Symptoms of irritable bowel syndrome (IBS)
The diagnosis of IBS is based on characteristic symptoms. It is important to note that symptoms may vary from person to person and may change over time. According to the Rome IV criteria, a diagnosis of IBS can be made if the patient experiences recurrent abdominal pain occurring on average at least once a week over the past three months, and this is accompanied by at least two of the following:
- Pain associated with bowel movements: Abdominal discomfort or pain may ease or, conversely, worsen after a bowel movement.
- Changes in bowel movement frequency: The patient passes stools more frequently than usual (diarrhoea) or less frequently than usual (constipation).
- Changes in stool consistency: The consistency of the stools changes; they may be hard and lumpy, or loose and watery.
In addition to these main symptoms, other complaints are also common, such as:
- Bloating and flatulence: Many patients complain of an uncomfortable, tight feeling in their stomach.
- Feeling of fullness: A feeling of fullness that sets in quickly after meals.
- Not a complete sense of emptiness: Even after passing stools, the patient still feels as though their bowels have not been completely emptied.
- Mucous stools: The presence of mucus in the stools may also be a sign of IBS.
It is important to emphasise that if, in addition to the symptoms, any „warning signs” appear – such as unintentional weight loss, nocturnal diarrhoea, blood in the stools or new symptoms appearing in people over the age of 50, you must consult a doctor immediately so that the specialist can rule out other, more serious conditions. The Endomedix Gastroenterology Centre Our specialists are on hand to help you reach an accurate diagnosis.
Types of IBS
IBS can be divided into several subgroups based on the predominant stool characteristics, which helps in selecting the most appropriate treatment:
- IBS with diarrhoea-predominant symptoms (IBS-D): More than 25% of bowel movements are loose or watery, whilst fewer than 25% are hard.
- IBS with a predominant constipation pattern (IBS-C): More than 25% of bowel movements are hard and lumpy, whilst fewer than 25% are loose.
- Mixed-type IBS (IBS-M): Both hard and loose stools are common (both exceed 25%).
- Cannot be classified as IBS (IBS-U): The patient’s symptoms meet the criteria for IBS, but based on the nature of their stools, they cannot be clearly classified into any of the above categories.
What causes IBS? Possible triggers
Although the exact cause of IBS remains unclear to this day, research has identified a number of factors that may contribute to the development of the condition. It is the complex interaction between these factors that leads to the characteristic set of symptoms.
- Genetic predisposition: The fact that IBS runs in families suggests that genetic factors may also play a role in its development.
- Gut-brain axis dysfunction: Disruption of communication between the digestive system and the brain plays a central role in IBS. Stress and psychological factors can influence bowel movements and the perception of pain.
- Intestinal motility disorders: Abnormal bowel movements – whether too fast or too slow – can lead to diarrhoea or constipation.
- Visceral hypersensitivity: The digestive systems of patients with IBS react more sensitively to normal stimuli (e.g. the build-up of intestinal gas), which they experience as pain.
- Post-infectious IBS: In some cases, symptoms develop following a previous bout of gastroenteritis. The infection can alter the gut flora and cause inflammation.
- An imbalance in the gut flora (microbiome): A change in the composition of the beneficial bacteria living in the gut may contribute to bloating, gas and bowel movement disorders.
- Psychosocial factors: Chronic stress, anxiety, depression and past traumatic life events are closely linked to the onset and worsening of IBS symptoms.
Treatment for IBS: diet, medication and lifestyle changes
The management of IBS is complex and is always tailored to the individual, taking into account the predominant symptoms and triggering factors. The aim of treatment is to alleviate symptoms and improve quality of life.
Dietary advice
Diet is key to the management of IBS. It is generally recommended that all patients with IBS receive advice from a dietitian.
- Grate coating: Water-soluble fibres (e.g. psyllium husk, oats) can effectively relieve general symptoms and abdominal pain. It is important to start with a low dose (3–4 grams a day) and gradually increase the amount to avoid bloating. Insoluble fibre (e.g. wheat bran) should be avoided, as it can make symptoms worse.
- Low-FODMAP diet: It is recommended as a second-line treatment, particularly if initial dietary changes have not been successful. FODMAPs (fermentable oligo-, di- and monosaccharides and polyols) are short-chain carbohydrates that are poorly absorbed in the small intestine; their fermentation can lead to gas formation, bloating and abdominal pain. The essence of the diet is the temporary exclusion of these foods (e.g. onions, garlic, wheat, dairy products, certain fruits), followed by their systematic reintroduction under the supervision of a dietitian.
- Gluten-free diet: There is no clear evidence of its effectiveness in IBS, so it is not generally recommended.
- Other foods to avoid: It is best to avoid fatty, spicy foods, caffeine and alcohol, as these can irritate the digestive system.
Medication
Drug therapy is used to alleviate symptoms and is generally used alongside, and as a complement to, a diet.
- First-line treatments:
- Antispasmodics (spasmolytics): They are effective at relieving abdominal pain and cramps. Peppermint oil may also be effective.
- Medicines for diarrhoea: Loperamide is effective in treating the symptoms of diarrhoea, but abdominal pain or constipation may occur as side effects.
- Drivers: For constipation-predominant IBS, preparations containing polyethylene glycol (PEG) are recommended.
- Probiotics: Certain probiotic strains may help to relieve general symptoms and bloating. It is worth trying them for 4–12 weeks, and if there is no improvement, stop taking them.
- Second-line agents: If first-line treatment is unsuccessful, the doctor may prescribe neuromodulators (e.g. low-dose tricyclic antidepressants) or specific medicines that act on bowel function (e.g. rifaximin, linaclotide, eluxadoline), depending on the predominant symptoms.
Lifestyle changes and stress management
Lifestyle plays a key role in managing symptoms.
- Regular physical activity: Moderate-intensity exercise, such as walking or yoga, has been shown to alleviate symptoms, particularly in cases of constipation.
- Stress management: As stress can significantly exacerbate the symptoms of IBS, it is essential to learn effective stress management techniques. These may include:
- Cognitive behavioural therapy (CBT): It helps you to identify and change negative thought patterns.
- Hypnotherapy: Hypnotherapy targeting the gut has proved effective in alleviating symptoms.
- Relaxation techniques: Mindfulness, meditation and biofeedback can all help to reduce stress.
When should you see a doctor?
Although IBS is a benign condition, its symptoms can significantly impair quality of life, and distinguishing it from other, more serious conditions (e.g. inflammatory bowel disease, coeliac disease, cancer) is a task for a specialist. The Endomedix Gastroenterology Centre Our experienced specialists help to establish an accurate diagnosis and develop the most effective, personalised treatment plan.
Don’t suffer from these unpleasant symptoms any longer! With the right diagnosis and treatment, the symptoms of IBS can be managed, and you can live a full life again.
Find the solution at Endomedix Centres
The diagnosis and treatment of IBS require patience and expertise. A relationship of trust between doctor and patient is important, one in which the patient feels comfortable discussing their symptoms. The Endomedix Gastroenterology Centre We welcome you to a modern, friendly environment, where we’ll help you on your path to recovery using state-of-the-art diagnostic procedures and a personalised treatment plan. With the support of our expert dietitians and psychologists, we offer a comprehensive solution to help you achieve a symptom-free life. Book an appointment today and take a step towards better health!
