Irritable bowel syndrome (IBS)

Overview

Irritable bowel syndrome (IBS) is a common condition of the digestive system. It causes repeated tummy (abdominal) pain together with changes in how often you open your bowels or what your stools look like. Some people mainly have diarrhoea, some mainly have constipation, and some swing between the two. Symptoms tend to come in flare-ups and then settle, often over many years.

IBS is called a functional disorder. This means the gut looks normal on tests, but it does not work in the usual way. Experts think the problem lies in how the brain and the gut talk to each other. This can make the gut more sensitive, so normal amounts of gas or stool cause pain, and it can change how fast food moves through. Women get IBS up to twice as often as men, and it is more common in people under 50.

IBS can be painful and upsetting, but it does not harm the gut or lead to other diseases. There is no single test for it. A doctor makes the diagnosis from your symptoms and a few simple tests to rule out other conditions. Most people manage it with changes to eating habits, more physical activity, stress control and, when needed, medicines aimed at their main symptom.

Symptoms

• Tummy pain or cramps, often eased by opening your bowels
• Bloating or a swollen, tight feeling in the tummy
• Diarrhoea, constipation, or both at different times
• A sudden urge to open your bowels, or straining
• Feeling that your bowel has not fully emptied
• Mucus (clear or whitish slime) in your stools
• Passing a lot of wind
• Symptoms that get worse after eating
• Tiredness, nausea (feeling sick), backache or bladder problems
• In women, symptoms that are often worse during periods

Causes and risk factors

Causes

• The exact cause is not known; several factors probably add up
• Problems in how the brain and gut work together, making the gut oversensitive
• Food moving through the gut too fast or too slowly
• A previous bad gut infection (gastroenteritis)
• Stress, anxiety or difficult life events, including in childhood
• Genes and a family history of IBS

What makes it more likely

• Being female
• Being younger than 50
• Having a parent, brother or sister with IBS
• Having had a severe stomach or bowel infection
• Stressful or traumatic events in childhood
• Anxiety, depression or long-term stress
• Frequent use of antibiotics, which can trigger flare-ups

Complications

IBS does not damage the digestive tract or turn into other bowel diseases. Its main burden is on daily life. Symptoms often come and go over many years, and flare-ups of pain, urgency, diarrhoea or, sometimes, accidental leakage of stool can make work, travel and social life harder. People with IBS are also more likely to have other conditions at the same time, such as indigestion, acid reflux (GERD), long-term pain conditions like fibromyalgia or chronic fatigue syndrome, and anxiety or depression. Getting a clear diagnosis and a plan helps many people feel more in control.

Are you a PMDC-registered doctor who treats Irritable bowel syndrome (IBS)? List your profile free.

Diagnosis

There is no single test for IBS. A doctor asks about your symptoms, your health and your family history, and may examine your tummy. UK guidance suggests thinking of IBS when someone has had tummy pain or discomfort, bloating or a change in bowel habit for at least six months, the pain is linked to opening the bowels or to a change in stool, and there are other typical features such as straining, urgency, bloating, mucus or symptoms after eating. Doctors also look for warning signs that need a hospital referral.

Simple blood tests are used to rule out other conditions: a full blood count, tests for inflammation (ESR or CRP) and a blood test for coeliac disease. People with diarrhoea should be checked for coeliac disease and inflammatory bowel disease. Tests such as colonoscopy, ultrasound, thyroid tests or stool tests are not needed to confirm IBS. Colonoscopy is not routine in people under 45 without warning signs.

Treatment

1. Learn about IBS and start self-help: regular meals, enough fluids, regular physical activity and time to relax
2. Adjust your diet: cut down on caffeine, alcohol, fizzy drinks and high-fibre foods such as bran; keep a food and symptom diary to spot triggers
3. Use medicines for the main symptom when needed: an antispasmodic for pain and cramps, a laxative for constipation, or loperamide for diarrhoea; your doctor or pharmacist advises on the dose
4. If symptoms continue, see a dietitian, who may suggest a short trial of a low FODMAP diet (cutting out certain hard-to-digest carbohydrates, then adding them back one by one)
5. If first steps do not help, a doctor may try a low-dose tricyclic antidepressant to calm gut pain; an SSRI may be tried if that does not work
6. Gut-focused talking therapies, such as cognitive behavioural therapy (CBT) or hypnotherapy, can help, especially when symptoms are long-lasting
7. Agree regular follow-up with your doctor and report any new warning signs

Medicines in Pakistan

Medicines a doctor may use, by group. Read the role: some are only for special cases. Each link opens our page for that medicine, with every brand and its official DRAP price. Your doctor decides which medicine and dose are right for you.

Also used (not yet in our price list): Ispaghula husk (soluble fibre), Linaclotide (for long-lasting IBS with constipation when laxatives have not worked)

Self-care and prevention

Self-care

• Eat regular meals and do not skip or rush them
• Drink plenty of fluids, mostly water or drinks without caffeine
• Limit tea and coffee to no more than three cups a day, and cut down on alcohol and fizzy drinks
• Eat no more than three portions of fresh fruit a day
• If you have wind and bloating, try oats and eat fewer gassy foods such as beans, cabbage and onions
• If you have diarrhoea, avoid sorbitol (a sweetener in some sugar-free sweets and gum)
• Keep a food and symptom diary to find your own triggers
• Be active regularly and make time to relax; probiotics can be tried for at least four weeks to see if they help

Prevention

• IBS cannot always be prevented, but flare-ups can often be reduced
• Keep to regular meal times and avoid foods you know trigger your symptoms
• Find ways to manage stress, such as exercise, relaxation or talking therapy
• Stay physically active

Common questions

Is IBS dangerous or can it turn into cancer?

IBS can be painful and disrupt daily life, but it does not damage the gut or lead to other health problems. Some warning signs, such as weight loss, bleeding from the bottom or a lump in the tummy, are not caused by IBS and need a doctor's check quickly.

Can IBS be cured?

IBS is usually a long-term condition that comes and goes. There is no single cure, but most people can control their symptoms well with diet changes, more activity, stress management and medicines for their main symptom. It may take some trial and error to find what works for you.

What foods make IBS worse?

Common triggers include alcohol, caffeine, fizzy drinks, spicy or fatty foods and large amounts of fruit or high-fibre foods like bran. Triggers differ from person to person, so a food and symptom diary helps. A dietitian can guide a low FODMAP diet if simple changes are not enough.

Does stress cause IBS?

Stress and anxiety do not fully explain IBS, but they can trigger flare-ups and make symptoms worse because the brain and gut are closely linked. Relaxation, regular exercise and talking therapies such as CBT can ease symptoms for many people.

Do I need a colonoscopy to diagnose IBS?

Usually not. IBS is diagnosed from your symptoms plus a few blood tests to rule out other conditions. A colonoscopy or other hospital test is only needed if there are warning signs or the cause is unclear.

Sources

1. NICE. Irritable bowel syndrome in adults: diagnosis and management (CG61) (2017).
2. American College of Gastroenterology. ACG's First Clinical Guideline on Management of Irritable Bowel Syndrome (2021).
3. NHS. Irritable bowel syndrome (IBS) (2025).
4. NIDDK (US National Institutes of Health). Definition & Facts for Irritable Bowel Syndrome - NIDDK (2017).
5. NIDDK (US National Institutes of Health). Symptoms & Causes of Irritable Bowel Syndrome - NIDDK (2017).
6. Journal of the Pakistan Medical Association. Irritable bowel syndrome and health seeking behaviour in different communities of Pakistan (2007).

Prepared from the sources listed below by the MedInfoBase team. Last reviewed 16 October 2026. This page is general health information, not medical advice. It gives no doses and does not replace a doctor: talk to your doctor or pharmacist before starting, stopping or changing any medicine. How we write and check our pages.

Related conditions

ConstipationAcute gastroenteritis (diarrhoea and vomiting)Gastro-oesophageal reflux disease (GERD)Anxiety disorders

All health conditions