Irritable Bowel Syndrome (IBS): Symptoms, Triggers and Treatment

Cramping, bloating, gas, and a bowel that cannot decide between diarrhoea and constipation. Many people with irritable bowel syndrome (IBS) are told it is “just gas” or “just stress”, and spend years trying one medicine after another. IBS is very common, it is real, and it is not dangerous. It does not damage the bowel or turn into cancer, but it can make life miserable, and the right approach brings real relief.

What is IBS?

IBS is a long-term disorder of how the gut works. The bowel is overly sensitive and its movements are disturbed, even though the bowel looks normal on tests. It is usually divided into types:

• IBS with diarrhoea (IBS-D)
• IBS with constipation (IBS-C)
• Mixed (IBS-M), with both

IBS symptoms

• Abdominal pain or cramps that eases after passing stool
• Bloating and a swollen tummy, and a lot of gas
• Diarrhoea, constipation, or a swing between the two
• Mucus in the stool
• A feeling of incomplete emptying and urgency

Symptoms come and go, often worse after meals, during stress and around the menstrual period. They usually start in young adulthood, and are more common in women.

What triggers IBS?

• Stress, anxiety and poor sleep, because the gut and the brain are closely connected
• Certain foods: fried and fatty dishes, very spicy food, strong tea and coffee, fizzy drinks, alcohol and artificial sweeteners
• Foods that ferment in the gut in some people: onion, garlic, beans, chana, rajma, wheat in large amounts, some fruits and milk (lactose)
• A previous stomach infection
• Irregular meals, eating too fast and skipping breakfast
• Hormone changes around periods

Is it really IBS? Warning signs

IBS is diagnosed by symptoms, after other conditions have been excluded. You should see a doctor first, and not assume IBS, if you have:

• Blood in the stool or black stools
• Unexplained weight loss
• Anaemia, or constant tiredness
• Symptoms that wake you at night, or fever
• New symptoms after the age of 50
• A family history of bowel cancer, inflammatory bowel disease or coeliac disease

Your doctor may order blood tests, stool tests and, sometimes, a scope, to rule out infections such as giardia, coeliac disease, inflammatory bowel disease and thyroid problems.

How to manage IBS

• Keep a food and symptom diary for two weeks to spot your own triggers, instead of cutting out everything.
• Eat regular meals, chew slowly, and do not skip meals or overeat.
• Reduce, rather than eliminate, fatty, fried and very spicy food, caffeine and fizzy drinks.
• Fibre: soluble fibre, such as isabgol (psyllium), oats and fruit, helps constipation and mixed IBS. Raw bran and very coarse fibre can worsen bloating.
• Low-FODMAP diet: a short, guided trial of avoiding fermentable carbohydrates, followed by careful re-introduction, helps many people. It is best done with a dietitian and not as a lifelong diet.
• Peppermint oil capsules can ease cramps and bloating in some people.
• Walk and exercise regularly. It improves gut movement and mood.
• Manage stress: relaxation, breathing exercises, prayer, adequate sleep and, when needed, talking therapy such as CBT or gut-directed hypnotherapy.

Medicines your doctor may suggest

• Antispasmodics such as mebeverine, trimebutine and hyoscine butylbromide for cramping pain, taken before meals or when needed
• Simethicone for gas, though evidence is modest
• Loperamide for occasional diarrhoea, used sparingly
• Laxatives such as lactulose, when constipation is the main problem, and sometimes newer medicines
• Rifaximin, an antibiotic used by specialists for some people with diarrhoea-type IBS
• Low doses of certain antidepressants, which calm the gut’s nerves and help pain, even without depression. These are used under a doctor’s supervision.
• Probiotics, which may help some, but results vary, so try one for four weeks and stop if it does not help.

Please do not take antibiotics, steroids or multiple “stomach medicines” without a doctor’s advice. They rarely help IBS and can make things worse.

When to see a doctor

• Any warning sign listed above
• Symptoms that are new, or have changed, after the age of 50
• Severe pain, persistent vomiting, or a swollen, hard tummy
• Symptoms that interfere with work, travel or social life despite self-care

Key takeaways

• IBS is a common, real, non-dangerous gut disorder with pain, bloating and altered bowel habits.
• Blood in the stool, weight loss, anaemia or night symptoms need tests before calling it IBS.
• Regular meals, a symptom diary, soluble fibre, exercise and stress control help most.
• Antispasmodics and other medicines are chosen according to the main symptom.

Related medicines on Medimart

These are commonly used for IBS symptoms:

• Mebeverine: relieves bowel cramps
• Trimebutine: regulates bowel movement and eases pain
• Hyoscine butylbromide: relieves spasm and cramps
• Peppermint oil: a supplement for cramps and bloating
• Simethicone: eases gas and bloating
• Lactulose: a gentle laxative for constipation
• Loperamide: for occasional diarrhoea
• Rifaximin: prescribed by specialists for some IBS with diarrhoea

Prescription medicines are supplied only against a valid prescription. Please take them only as advised by your doctor.

Browse indigestion and bloating relief on Medimart with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace advice from a doctor. Please see a doctor before assuming that bowel symptoms are IBS.