Irritable Bowel Syndrome (IBS)
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Irritable Bowel Syndrome (IBS) key facts
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Irritable Bowel Syndrome (IBS) is a disorder that affects the intestine, causing abdominal pain, cramping, and changes in bowel movements. Here, we will take a closer look at the causes, symptoms, and treatment options available.
What is Irritable bowel syndrome?
IBS is a chronic disorder of the digestive system. Symptoms, include bloating, cramping, stomach pain, and changes in bowel movements. Symptoms may appear as diarrhoea, constipation, or both.
The exact cause of IBS is not known but is thought to be due to hypersensitivity of the nerves in the gut, abnormal contractions of muscle in the intestines, and an imbalance in gut bacteria.
IBS does increase your risk of developing Crohn’s disease, colitis, ulcerative colitis or colon cancer. You are however recommended to be tested for coeliac disease.
Types of IBS
Each subtype of IBS has specific patterns of bowel movement:
- IBS-D (Irritable Bowel Syndrome with diarrhoea): With frequent, loose, watery stools
- IBS-C (Irritable Bowel Syndrome with constipation): With infrequent bowel movements and difficulty passing stools
- IBS-M (Mixed Irritable Bowel Syndrome): With a combination of both diarrhoea and constipation
- IBS-U (Unclassified Irritable Bowel Syndrome): When symptoms do not fit any particular category
Symptoms of IBS
Common symptoms of irritable bowel syndrome include:
- Abdominal pain and cramping
- Changes in bowel movements
- Diarrhoea, constipation, or both
- Bloating
- Flatulence
- Urgency to have a bowel movement
- Mucus in the stool
IBS symptoms can impact a person’s quality of life greatly, causing tiredness, anxiety, and depression. Speak to a healthcare professional if you experience persistent changes in bowel habits or have any other concerning symptoms.
Causes and triggers of IBS
Potential triggers include:
- Muscles in the intestines contracting more forcefully and for longer than usual
- A lack of coordination between the brain and intestines resulting in an overreaction to digestive processes
- Severe gastrointestinal infection, such as gastroenteritis
- Early life stress, including physical, sexual, or emotional abuse
- Changes in gut microbes
- Certain foods such as those containing gluten, wheat, dairy products, beans and carbonated drinks
- Increased stress can contribute to flare-ups of IBS
Identifying and avoiding triggers is an essential part of managing IBS.
Medical history and physical examination
Diagnosis will require a family history of the nature, frequency, and duration of symptoms to be taken. Potential triggers or factors that make symptoms worse will also need to be identified. An examination may be carried out to rule out other potential conditions such as a gluten or lactose intolerance.
Diagnostic criteria for IBS
The Rome IV criteria is often used for the diagnosis of IBS. Patients must show signs of recurring abdominal pain or discomfort, lasting for at least 6 months. Symptoms must last for at least 3 days each month in the past 3 months.
Symptoms must include those linked to a change in bowel movements and the absence of bleeding, weight loss, or anemia. Blood tests, stool tests, X-rays, CT scans, colonoscopy, or endoscopy may be required to rule out other conditions.
Exclusion of other conditions
Other conditions that may present with similar symptoms, such as inflammatory bowel disease (IBD), celiac disease, and colon cancer, must be ruled out before a diagnosis of IBS can be established. This may involve additional tests such as blood tests, stool tests, and imaging studies.
It is essential to consult with a healthcare professional for an accurate diagnosis, as self-diagnosis can lead to unnecessary anxiety and delays in appropriate treatment.
Treatments for IBS
Lifestyle changes
- Stress reduction techniques such as relaxation exercises, hypnotherapy, and meditation
- Regular physical activity, such as walking, yoga, or swimming
- Establishing a sleep schedule and practicing good sleep hygiene
Dietary changes
- Increasing fiber supplements can help regulate bowel movements
- Low FODMAP diet to restrict foods high in fermentable carbohydrates (FODMAPs) and reintroducing them gradually to identify triggers
- Keeping a food diary to track symptoms and identify potential triggers
- Drinking water and staying hydrated
Medications
- Antispasmodics such as Colofac to relax muscles in the gastrointestinal tract, to reduce abdominal pain and cramping
- Over the counter anti-diarrheal medications such as loperamide
- Laxatives to relieve constipation
- Probiotics to restore a balance of gut bacteria and alleviate symptoms
- Tricyclic antidepressants to block the action of neurons that control the intestines
Psychological Interventions
- Cognitive behavioral therapy (CBT) to identify and modify behaviors that contribute to IBS symptoms
- Relaxation techniques such as deep breathing exercises, progressive muscle relaxation, and guided imagery
- Mindfulness-based stress reduction (MBSR) combines mindfulness, body awareness, and yoga to reduce stress
Frequently asked questions
What is IBS?
IBS is a disorder of the digestive tract. Symptoms, include cramping, bloating abdominal pain, and changes in bowel movements. Symptoms appear as diarrhoea, constipation, or both.
What are the main symptoms of IBS?
The main symptoms of IBS vary from person to person, but include abdominal pain, changes in bowel habits, diarrhoea, constipation, bloating, flatulence and difficulty passing stools.
Are there different types of IBS?
There are 4 types of IBS, irritable bowel syndrome with diarrhoea (IBS-D), irritable bowel syndrome with constipation (IBS-C), mixed irritable bowel syndrome (IBS-M), and unclassified irritable bowel syndrome (IBS-U).
Is IBS curable?
Currently, there is no cure for IBS, but various medications and lifestyle changes can help manage and improve symptoms. These include changes to your diet, stress management, exercise and probiotics.
What changes should I make to my diet if I have IBS?
One approach is the low FODMAP diet. Following this diet plan involves the management of foods high in carbohydrates, and gradually reintroducing them into your diet to identify triggers.
What changes can I make to my lifestyle if I have IBS?
Regular exercise, adequate sleep, stress management, deep breathing exercises, meditation, hydration, and regular meal times can all help support your gut health.
Conclusion
Irritable Bowel Syndrome is a disorder that affects the gastrointestinal tract. Symptoms include cramping, bloating, and changes in bowel movements. What causes IBS is not known, but abnormal muscle contractions, changes to the nervous system, and changes in the balance of gut bacteria are all thought to play a part. Treatment for IBS includes lifestyle, dietary, medication, CBT, and meditation.
Sources
- NHS IBS
- Mountsinai – Irritable bowel syndrome
- Hopkinsmedicine – Irritable bowel syndrome
- NIH – Irritable bowel syndrome
- My.clevelandclinic – Irritable bowel syndrome
- Mayoclinic – Irritable bowel syndrome symptoms and causes
- Nhsinform – Irritable bowel syndrome
- AboutIBS – Irritable bowel syndrome guide
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The Get Treated Privately service is a private prescribing service which is designed for adults aged 18 years and over, who are experiencing health issues and who would like to receive a fast-track assessment and if applicable, a treatment plan from a qualified prescribing clinician. Treatments are dispensed and delivered to your home or workplace from our regulated online pharmacy.
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Yes. Our formulary of medications prescribed and conditions treated are controlled, governed, and continuously risk-assessed by our Medical Director, Dr. Aseel Hamoud. Unlike other prescribing services which operate using faceless questionnaires, our service is conducted through remote video consultations, also known as synchronous consultations. This builds patient safety and prescribing appropriateness into our service, ensuring our prescribing clinicians can be satisfied with who and what they are treating. There is no guarantee of supply of medications, and any prescriptions supplied are at the sole discretion of our clinician prescriber. There is no charge for the consultation.
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How do I book a consultation?
Once you have logged into your account, you will need to navigate to the Get Treated Privately service card which is located as a service item on the dashboard.
Using the action button on the service card, you can select one of the following – ‘Search Treatments’ or ‘Search Conditions’.
Depending on the search type and the product/condition that you would like to get treated, you will be taken to a consultation booking screen. Follow the simple steps to complete your booking. During the booking confirmation, you will be able to select a date and time that is convenient for you, along with the preferred language and gender of the prescribing clinician you wish to choose. You will then see a list of all available expert clinicians who are trained to assess the medication or condition chosen. Once you have confirmed your booking, you will see a summary of the appointment including preliminary information about the consultation. At this point, you will also be able to add a reminder to your calendar. Always ensure your account health profile is up to date before any consultation. This ensures that our clinicians have the most up-to-date information about your current health status and anything that may influence their prescribing decisions. You will receive a push notification, SMS notification and email reminding you of your consultation, 30 minutes before the virtual consultation is due to start.
Depending on certain medications which require our clinicians to have your up-to-date blood pressure readings, you may be required to submit a virtual blood pressure check, using your smartphone or device. We will provide you with full instructions, when this is required.
What happens during the remote video consultation?
During the consultation, the clinician will ask you a series of questions that will allow the clinician to assess your condition and potential treatment options. At the end of the consultation, the clinician will decide if a treatment is a safe and suitable option for you. If it is, the clinician will discuss the various treatment options that may be available, so that you can jointly agree on the option that is most suited to you. Once you have jointly agreed on a treatment plan, the clinician will issue a prescription order which will be available in your Cart at the end of the consultation.
Also, with your consent, the clinician may wish to inform your doctor of the treatment that was prescribed. We recommend that you agree to this since your doctor is responsible for your overall care and they should have a record of this consultation and medication prescribed. In addition, our clinician may take the opportunity to advise you on your overall health including advice on healthy living or stop smoking.
What happens at the end of the consultation?
At the end of the consultation, you will receive a notification which will summarise the outcome. It will also advise you if any referrals were made to your doctor, along with any other advice that was given to you by the clinician.
If a referral letter was issued to your doctor, you will be able to view a copy of this in the ‘Documents’ section of the dashboard. If you were prescribed a treatment, it will now be available in your Cart.
When you go to your Cart, you will be able to select the treatment, checkout and make payment. Once the checkout is complete, your prescription order will be sent to our regulated online pharmacy for processing.
What if the prescriber does not prescribe what I want?
We operate a safe prescribing service. This means that our prescribing clinicians always exercise their clinical judgment when prescribing. Unfortunately, we do not operate a self select service where you can choose a medication and simply buy. If the clinician that sees you does not prescribe anything, then you will not be charged.
Will I get status updates for my order?
Yes. When your treatment is approved, and after you have checked out and paid for your order, we will keep you fully updated with the status of your order. Every time the status of your order changes, you will be notified immediately. These notifications will appear in the ‘Notification Feed’ section on the dashboard.
How will my order be delivered?
All orders are shipped in discreet and unmarked packaging. This means it is suitable for delivery wherever you require (home, work, or a neighbour).
For thermo-sensitive orders (e.g. Insulin or weight loss injections) we use cold chain-validated packaging. Your parcel will normally receive an estimated delivery window from the courier on the day of delivery.
For your protection and safety, your first order can only be delivered to the address that is registered with NowPatient. Future orders can be delivered to any other address, for example, your workplace.
Do you ship cold-chain or temperature sensitive products?
Yes. We use a specialist courier service for all thermo-sensitive deliveries. This is to ensure that cold chain integrity is always maintained and thus the product quality, safety and efficacy.
Learn more about how we handle the delivery of temperature sensitive products.
Where do you deliver?
We currently deliver to all postcodes/zipcodes worldwide. Some postcodes in rural areas may have a slightly longer delivery time.
When will my order arrive?
We aim to ship all orders placed Monday – Friday before 3pm on the same day. Orders placed outside these times will be shipped the next working day. All deliveries are shipped by Royal Mail, which delivers Monday through Saturday in the UK. For deliveries outside of the UK, please check with your national postal service for accurate delivery days.
Our delivery options have the following delivery times:
- UK – Royal Mail Tracked 24 & Signed for Delivery – Next day delivery
- Europe – Royal Mail Tracked – Typical delivery of 3-5 working days
- Worldwide – Royal Mail – Typical delivery of 5-7 working days. If a tracked option is available for your country via Royal Mail, this service will be applied.
What should I do if my order has not arrived?
Delivery is normally made promptly after your dispatch notification is received. You can check the tracking details of your order in the ‘Notification Feed’ section of the dashboard, at any point after dispatch.
Unfortunately, packages can sometimes get lost in the delivery system. If after 10 days you have not received your delivery, please contact us and we will do all we can to resolve the problem.
Can you prescribe GLP-1 weight loss injections?
Yes. However, with GLP-1 weight loss medications, the license requires that there are support resources put in place as part of the plan including coaching for a healthy lifestyle, exercise, and diet. Our clinicians will discuss this with you, if you are prescribed this type of treatment.
You can learn more on our Weight Loss Programs feature page.
What’s included with my order?
If you are ordering prescription medication, your order will contain your medication only.
If you are ordering weight loss injections, your order will contain:
- Your prescription of pre-filled weight loss injection pens
- Needles
- Sharps bin for safe disposal of needles (if ordered as part of the bundle)
Can I reorder my medication, if I have already been prescribed a course?
Yes. However, as a responsible prescribing service, we do not issue more than one monthly cycle of medication at a time. This means that, if you would like to reorder, you will need to rebook a consultation.
This is important, because it allows our clinicians to keep track on the progress of your treatment plan and ensure that the medication remains safe and effective for you.
What is the earliest I can reorder my medication or treatment?
14 days after you have received your first monthly supply, we will send you a notification to advise you that you are eligible to reorder your medication. To ensure that we are able to safely prescribe the next supply, you will need to rebook a consultation.
This ensures that our clinician can check in on your treatment plan and ensure it is working as intended and continues to be safe, suitable and appropriate for you.
How do I reorder my medication?
When you are eligible to reorder your next medication, we will send you a notification reminder. This notification reminder will request that you book a consultation with a NowPatient Clinician.
You should book a suitable time and date for the consultation.
At the end of the consultation, the clinician may advise you to either
- Stop the treatment
- Stay on the current dose
- Increase the dose
If our clinician deems it safe for you to continue taking the medication, the medication will be added to your cart, from where you can checkout.
Delivery will be made in line with our delivery timescales.
As a responsible prescribing service, we will always monitor your treatment plan to ensure that it remains safe, effective and suitable for you.
How do I reorder weight loss medication?
Our weight loss programs are built to closely monitor treatment progress and safety. Please refer to the Weight Loss Programs Service Guide that explains how you can reorder or step edit your dose.
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