Management

People with IBS should also be given advice about physical activity, lifestyle, diet and available medicines to help them live with their condition.

Physical activity

People with low levels of physical activity (determined by a General Practice Physical Activity Questionnaire) may be advised to increase their daily activity. View the General Practice Physical Activity Questionnaire.

Diet

Dietary advice includes: eating regular meals; taking time to eat without rushing; not skipping meals or leaving long gaps between eating; drinking at least eight cups of fluid (preferably water or non-caffeinated drinks) per day; avoiding drinking more than three cups of tea or coffee or three portions of fruit a day; and limiting intake of fizzy drinks, alcohol, high-fibre, processed or re-cooked food.  

People with diarrhoea should avoid aritificial sweetener sorbitol and some diabetic or slimming products. People with wind or bloating may find it helps to eat oats (such as oat-based breakfast cereal or porridge) and linseeds (up to one tablespoon a day). A probiotic product may help symptoms, and should be taken for at least four weeks in doses recommended by the manufacturer. A record should be kept to see if this makes a difference to symptoms.

Medicines

Prescription of medicines will depend on individual symptoms. An antispasmodic agent can reduce bowel spasm, loperamide prescribed for diarrhoea, and a laxative offered for constipation. People should be instructed as to how to adjust doses of loperamide and/or laxatives until they are producing soft, well-formed stools.  If these medicines do not help, a low dose of tricyclic antidepressant (TCA) may be offered to help with pain (this is separate from TCA's action in treating depression) or, if TCA is ineffective, a selective serotonin reuptake inhibitor (SSRI). 

Other treatments

Further treatments include psychological interventions, such as hypnotherapy, psychological therapy or cognitive behavioural therapy. Acupuncture or reflexology should not be recommended as treatments for IBS.