It is estimated that 5-20% of the population live with Irritable Bowel Syndrome (IBS), it is more prevalent in women and in those aged 20-39 years (NICE, 2025) That said increasing in clinic I am seeing men and women who are experiencing issues for the first time from their 50’s through to their late 70’s.
IBS can cause pain, bloating, diarrhoea (IBS-D), constipation (IBS-C) and sometimes you can experience both constipation and diarrhoea which is known as mixed (IBS-M). IBS is no longer diagnosed only by ruling everything else out; the Rome Foundation Criteria IV now guide diagnosis, meaning fewer invasive tests are usually required.
It is very natural to draw the conclusion that diet alone is the only factor that impacts IBS, however a number of lifestyle factors such as stress, activity and sleep also play an important role. In trying to work out what’s causing symptoms, many people begin restricting foods, which can increase food fear and make the gut more sensitive over time.
This guide will help you understand the different ways IBS can be managed, and point you to the most useful next step for your symptoms.
What IBS is (and what it isn’t)
IBS was re-classified in May 2016 as ‘functional disorder of the gut-brain axis’, although it is still commonly referred to as IBS.
Although there is no inflammation or structural damage in IBS, symptoms are very real, as people with IBS experience heightened sensitivity to normal movement of food and gas through the bowel.
Why IBS advice often feels confusing
Often clients that come to be looking for help feel unheard by the doctors, that they just get offered one medicine after another or told to go and google a ‘low FODMAP diet’. It is no wonder that they turn to google, often searching frantically late in to the night to try and find some sort of relief.
There is a huge amount of conflicting dietary advice online, alongside countless supplements marketed for IBS, bloating, constipation and diarrhoea. Add in well-meaning friends and family, all with their own opinions about food and it’s easy to feel overwhelmed.
It is important to remember that everyone’s situation is different and what works for one may not work for another.
The main ways IBS symptoms can be managed
Management of IBS usually focuses on 2 key areas – diet and lifestyle.
How food and diet can affect IBS
- Food can trigger symptoms, but rarely just one food that is the problem. FODMAPs are a group of carbohydrates that can worsen IBS symptoms for some people.
- Is not just WHAT you eat but the timing, portion size and combinations all matter (that’s where is gets complicated!)
- Whilst the Low FODMAP is often advised to help manage IBS, it is not applicable for everyone, it should not be used as a first line treatment. Most importantly it is a tool, to determine what foods may trigger your problems it is NOT a forever diet.
If you are interested in finding out more about the role of diet in IBS then why not check out The Best Diet for IBS: What Works and What to Avoid
Lifestyle factors that influence IBS
Lifestyle, mainly stress, nervous system regulation, sleep and activity all have a role to play in manging IBS. Stress does not directly ‘cause’ IBS, however being under stress, especially continuing stress everyday can strongly influences symptoms. This is due to the gut-brain axis, the bi-directional communication between the brain and the gut via the Vagus nerve with chemical messages, nerve impulses travelling backwards and forwards constantly.
Without considering lifestyle dietary management will not be as effective.
If you would like to find out more about lifestyle then head to my blog article, How to Relieve IBS Symptoms Fast Without Restrictive Diets
What to do first if you have IBS
Whether you have been recently diagnosed with IBS or have had it for some time then you are here to looking for what to do next. Firstly, if your symptoms have changed or getting worse, if you are losing weight or notice any blood in your poo then the first place you need to go is to see your GP.
If you have never considered the role of lifestyle in your gut issues then I would recommend that you start with the lifestyle article first. Often the simple changes discussed here can make a difference without having to cut out any foods in your diet.
If you are struggling with food and have food fear then head to the dietary management article.
When diet alone isn’t enough for IBS
Often, people reach me after years of restricting foods, trying countless supplements, and beginning to avoid social situations.
Making you diet smaller and smaller can actually make your gut more sensitive and the problem worse.
When guesswork and restriction aren’t helping, personalised support can make a real difference.
If you’d like to explore this further, you can read more about my Gut R.E.S.E.T. programme.
