A Patient’s Story
Tim, 29, began avoiding social plans because he never knew how his gut would behave. Some days it was urgent diarrhoea, other days painful bloating and constipation.Â
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Tests kept coming back normal, yet the symptoms were real. Eventually, after specialist assessment, Tim was diagnosed with irritable bowel syndrome.
What Is Irritable Bowel Syndrome?
Irritable bowel syndrome (IBS) is a common functional digestive disorder affecting the large intestine. It is estimated to affect 10 to 15 percent of people, often starting before the age of 50.
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IBS does not cause structural damage to the bowel, but it can cause significant, long-term symptoms that interfere with daily life.
Common Symptoms of IBS
Symptoms vary between individuals and may fluctuate over time.
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Typical IBS symptoms include
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Abdominal pain or cramping
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Bloating and excess wind
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Diarrhoea, constipation, or both
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Urgency or incomplete bowel movements
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Fatigue
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Symptoms worse after meals
Many women notice symptom worsening around menstruation.
Types of IBS
IBS is classified based on bowel habit:
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IBS-D: diarrhoea-predominant
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IBS-C: constipation-predominant
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IBS-M: mixed bowel habits
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IBS-U: unclassified
Identifying the subtype helps guide treatment.
What Causes IBS?
The exact cause is not fully understood, but IBS is linked to gut–brain interaction disorders.
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Contributing factors include:
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Visceral hypersensitivity (an over-sensitive gut)
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Abnormal gut motility (food moving too fast or too slow)
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Stress and anxiety
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Dietary triggers
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Post-infectious IBS after gastroenteritis
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Changes in gut bacteria
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Altered serotonin signalling in the bowel
IBS can run in families, suggesting a genetic component.
How Is IBS Diagnosed?
There is no single test for IBS. Diagnosis is based on symptoms and exclusion of other conditions.
Assessment may include:
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Blood tests
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Stool tests
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Screening for coeliac disease or inflammation
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Sometimes endoscopy or imaging
Once other causes are ruled out, IBS can be diagnosed confidently.
Managing IBS Effectively
While IBS has no cure, symptoms can be well controlled with the right approach.
Management may include:
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Dietary modification, such as a Low FODMAP approach
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Stress and gut–brain therapies
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Targeted medications
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Treating overlapping conditions, such as SIBO or reflux
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Personalised lifestyle advice
Seeing an IBS specialist gastroenterologist is key to long-term improvement.
When to Seek Specialist Advice
You should seek medical review if you have:
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Ongoing symptoms affecting quality of life
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Unintentional weight loss
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Rectal bleeding
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Anaemia
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Symptoms waking you at night
These are not typical IBS features and require investigation.