What is irritable bowel syndrome (IBS)?
IBS is a very common condition. It describes a wide range of symptoms that vary from one
person to another and can be worse for some people than others.
The most common symptoms are:
• wind and/or bloating
• diarrhoea or constipation, or both
• low abdominal pain, which may ease after opening the
bowels or be accompanied by a change in bowel habit
or stool appearance
• passing mucus
• feeling the need to open the bowels even after
having just been to the toilet
• a feeling of urgency
• feeling that your symptoms are worse after
eating.
• wind and/or bloating
• diarrhoea or constipation, or both
• low abdominal pain, which may ease after opening the
bowels or be accompanied by a change in bowel habit
or stool appearance
• passing mucus
• feeling the need to open the bowels even after
having just been to the toilet
• a feeling of urgency
• feeling that your symptoms are worse after
eating.
Helpful hints:
• keep a food and symptom diary to see if
diet affects your symptoms. Remember
symptoms may not be caused by the food
you have just eaten, but what you ate
earlier that day or the day before.
• give your bowels time to adjust to any
changes that you make.
• keep a food and symptom diary to see if
diet affects your symptoms. Remember
symptoms may not be caused by the food
you have just eaten, but what you ate
earlier that day or the day before.
• give your bowels time to adjust to any
changes that you make.
Ensure that you:
• eat regular meals
• do not skip meals or eat late at night
• take your time when eating meals
• sit down to eat and chew your food well
• take regular exercise – for example,
walking, cycling or swimming
• make time to relax.
• eat regular meals
• do not skip meals or eat late at night
• take your time when eating meals
• sit down to eat and chew your food well
• take regular exercise – for example,
walking, cycling or swimming
• make time to relax.
How much is 1 portion of fruit or vegetables?
Fresh fruit = 80 g
• 1 apple, banana, pear, orange or similar sized fruit,
• ½ grapefruit, 1 slice of large fruit (melon, pineapple)
• 2 plums
• a handful of grapes, cherries, berries
• 3 heaped tablespoons fruit salad (fresh, tinned, stewed)
Dried fruit = 25 g
• 1 heaped tablespoon raisins, figs, apricots
Vegetables = 80 g
• 3 heaped tablespoons raw, cooked, frozen or
tinned vegetables
• a dessert bowl of salad
• 1 apple, banana, pear, orange or similar sized fruit,
• ½ grapefruit, 1 slice of large fruit (melon, pineapple)
• 2 plums
• a handful of grapes, cherries, berries
• 3 heaped tablespoons fruit salad (fresh, tinned, stewed)
Dried fruit = 25 g
• 1 heaped tablespoon raisins, figs, apricots
Vegetables = 80 g
• 3 heaped tablespoons raw, cooked, frozen or
tinned vegetables
• a dessert bowl of salad
Resistant starches
• These are the starches in foods that are not completely digested by the body. They enter the
bowel where they ferment and produce gas. Try reducing your intake of the following foods:
• pulses, whole grains, sweetcorn, green bananas and muesli that contains bran
• undercooked or reheated potato or maize/corn – instead eat them freshly cooked and still hot
• oven chips, crisps, potato waffles, fried rice – choose baked potatoes or boiled rice
• part-baked and reheated breads, such as garlic bread, pizza base – choose fresh breads
• processed food such as potato or pasta salad, or manufactured biscuits and cakes
• ready meals containing pasta or potato, such as lasagne, shepherd’s pie, macaroni cheese
• dried pasta – use fresh pasta instead.
bowel where they ferment and produce gas. Try reducing your intake of the following foods:
• pulses, whole grains, sweetcorn, green bananas and muesli that contains bran
• undercooked or reheated potato or maize/corn – instead eat them freshly cooked and still hot
• oven chips, crisps, potato waffles, fried rice – choose baked potatoes or boiled rice
• part-baked and reheated breads, such as garlic bread, pizza base – choose fresh breads
• processed food such as potato or pasta salad, or manufactured biscuits and cakes
• ready meals containing pasta or potato, such as lasagne, shepherd’s pie, macaroni cheese
• dried pasta – use fresh pasta instead.
For symptoms of diarrhoea
• Replace lost fluids by drinking plenty – at least 8 cups a day. Choose water or noncaffeinated
drinks – for example, herbal teas or sugar-free squash.
• Limit fizzy drinks.
• Try not to have alcohol every day and then have no more than 2 units a day.
• Restrict intake of caffeinated drinks (for example, tea, coffee or cola) to 3 cups a day.
• Limit insoluble fibre intake from wholegrain breads, bran, cereals, nuts and seeds (except
golden linseeds).
• Avoid skin, pips and pith from fruit and vegetables.
• Limit fresh and dried fruit to 3 portions a day and fruit juice to 1 small glass a day.*
*Remember to make up the recommended ‘5 a day’ with vegetables.
• Limit intake of foods high in resistant starches (see box overleaf).
• Avoid sugar-free sweets (such as mints and gum) and food products containing sorbitol.
• Live ‘probiotic’ yoghurts, supplements or fermented milk drinks: if you choose to try them you will need to take them daily for at least one month at the dose recommended by the
manufacturer to see if they are likely to help. Monitor the effect on your symptoms. If a
product does not appear effective, you could consider another brand as the types of bacteria
used vary between products.
• Diarrhoea may also be caused by a high intake of fatty foods. Avoid foods high in fat,
such as chips, fast foods, burgers and sausages, crisps and cakes. Try low fat versions.
drinks – for example, herbal teas or sugar-free squash.
• Limit fizzy drinks.
• Try not to have alcohol every day and then have no more than 2 units a day.
• Restrict intake of caffeinated drinks (for example, tea, coffee or cola) to 3 cups a day.
• Limit insoluble fibre intake from wholegrain breads, bran, cereals, nuts and seeds (except
golden linseeds).
• Avoid skin, pips and pith from fruit and vegetables.
• Limit fresh and dried fruit to 3 portions a day and fruit juice to 1 small glass a day.*
*Remember to make up the recommended ‘5 a day’ with vegetables.
• Limit intake of foods high in resistant starches (see box overleaf).
• Avoid sugar-free sweets (such as mints and gum) and food products containing sorbitol.
• Live ‘probiotic’ yoghurts, supplements or fermented milk drinks: if you choose to try them you will need to take them daily for at least one month at the dose recommended by the
manufacturer to see if they are likely to help. Monitor the effect on your symptoms. If a
product does not appear effective, you could consider another brand as the types of bacteria
used vary between products.
• Diarrhoea may also be caused by a high intake of fatty foods. Avoid foods high in fat,
such as chips, fast foods, burgers and sausages, crisps and cakes. Try low fat versions.
• Dietary fibre may help with constipation but tends to generate gas, stimulate contractions
and make pain, bloating, flatulence and diarrhoea worse. NICE clinical guideline 61 advises
that fibre intake should be adjusted according to its effect and reduced if necessary. If you
do increase your fibre intake, do so gradually, because any sudden increase may make
symptoms worse.
• For symptoms of constipation only, you could try wholegrains, along with fruit and
vegetables, introducing no more than 1 extra portion over a 2 day period.
• Oats and golden linseeds are good sources of soluble fibre, which help to soften the stool
and make it easier to pass; they may also help with symptoms of wind and bloating.
• Ensure a good fluid intake – at least 8 cups of non-caffeinated fluid a day.
• If you wish to try ‘probiotics’ the notes under ‘symptoms of diarrhoea’ may be useful.
and make pain, bloating, flatulence and diarrhoea worse. NICE clinical guideline 61 advises
that fibre intake should be adjusted according to its effect and reduced if necessary. If you
do increase your fibre intake, do so gradually, because any sudden increase may make
symptoms worse.
• For symptoms of constipation only, you could try wholegrains, along with fruit and
vegetables, introducing no more than 1 extra portion over a 2 day period.
• Oats and golden linseeds are good sources of soluble fibre, which help to soften the stool
and make it easier to pass; they may also help with symptoms of wind and bloating.
• Ensure a good fluid intake – at least 8 cups of non-caffeinated fluid a day.
• If you wish to try ‘probiotics’ the notes under ‘symptoms of diarrhoea’ may be useful.