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Understanding Irritable Bowel Syndrome

April 28, 20243 min read

Diagnosis, Symptoms, and Management


Irritable Bowel Syndrome (IBS) is a common yet complex functional bowel disorder that affects millions worldwide. Characterised by symptoms such as abdominal pain, bloating, and altered bowel habits, IBS can significantly impact the quality of life. In this comprehensive guide, we delve into the intricacies of IBS, exploring its diagnosis, symptoms, and effective management strategies.

"IBS is very much a diagnosis of exclusion" - Dr. Ferghal Armstrong

What is Irritable Bowel Syndrome?

Irritable Bowel Syndrome (IBS) is primarily a functional disorder, meaning symptoms arise despite the absence of visible disease or abnormalities detectable through standard tests such as CT scans, MRIs, or ultrasounds. Dr. Ferghal Armstrong and dietitian Charmmy Cheng highlight that IBS is diagnosed based on specific symptom criteria, focusing on recurrent abdominal pain and changes in bowel habits that persist for at least three months.

Diagnosing IBS

The diagnosis of IBS relies heavily on symptom recognition. As discussed in the "Lifestyle Matters" episode, the key symptoms include abdominal pain linked to bowel movements, changes in the frequency or consistency of stool, and symptom onset at least six months before diagnosis. Dr. Armstrong emphasises that IBS is essentially a "diagnosis of exclusion," which necessitates ruling out other conditions that could cause similar symptoms..

Recognising Red Flag Symptoms

It’s crucial to distinguish IBS from conditions with similar symptoms, such as celiac disease, inflammatory bowel disease (IBD), and even colorectal cancer, particularly in patients over 50 years. Charmmy Cheng stresses the importance of screening for these diseases, as overlooking them could lead to worsening health outcomes. Red flag symptoms that may point to more serious conditions include significant weight loss, blood in the stool, and persistent changes in bowel habits.

Managing IBS Symptoms

Managing IBS often involves a multidisciplinary approach, including dietary changes and medication. A low FODMAP diet, which limits certain types of carbohydrates that are poorly absorbed by the small intestine, has been shown to be particularly effective. Dr. Armstrong also mentions the use of antispasmodics and fiber supplements as part of the treatment plan. However, the approach should always be tailored to the individual’s symptoms and lifestyle, ensuring a patient-centered treatment.

The Role of Dietitians in IBS Management

Dietitians play a crucial role in the management of IBS by providing specialised dietary advice tailored to alleviate symptoms. Charmmy Cheng discusses the use of the Bristol Stool Chart to help patients identify abnormal stool patterns, which is crucial in managing conditions like IBS. Dietitians also take comprehensive diet histories to identify triggers and recommend dietary adjustments that might alleviate symptoms.


While IBS remains a challenging condition to manage due to its idiopathic nature, understanding its symptoms, getting a proper diagnosis, and employing effective management strategies can significantly alleviate symptoms and improve life quality. If you suspect you have IBS, it is essential to consult healthcare professionals like gastroenterologists or dietitians who specialise in digestive disorders. With the right approach, IBS can be managed effectively, allowing individuals to lead a comfortable and fulfilling life.

Remember, IBS is a manageable condition, and with the insights from experts like Dr. Ferghal Armstrong and Charmmy Cheng, patients can find strategies that work best for their unique set of symptoms.

You can watch the episode below.

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