What is irritable bowel syndrome (IBS)?

by | Feb 15, 2026 | Functional digestive disorder, irritable bowel syndrome

hypnotherapy for IBS

IBS is a functional digestive disorder characterised by:

  • Abdominal pain.
  • Abdominal bloating.

Frequently, a high degree of volatility in patterns of bowel movements will be present. This ranges from diarrhoea to constipation, and sufferers may vary between both. This range in IBS presentations has resulted in four distinct subtypes

  • Predominance of diarrhoea (IBS-D).
  • Predominance of constipation (IBS-C).
  • mix of these two bowel movement types (IBS-M),
  • ‘unclassifiable’ (IBS-U).

Symptoms of IBS

IBS is not a direct threat to life but has substantial negative impacts of quality of life, which is mostly the result of the abdominal pain. However, other factors are likely to contribute, most commonly:

  • The sense of urgency around bowel movements which may result in them fearing they are at risk of soiling themselves.
  • Experience of soiling themselves.

Both of which cause significant fear of embarrassment.  The fear of embarrassment can result in limiting coping behaviours. Two notable limiting coping behaviours are:

  • Toilet mapping – This is where a person with IBS will only go to places where they know the locations of all publicly available toilets.
  • House bound – Where the person with IBS feels the risk of soiling themselves is so high that they cannot leave home. Sometimes this is related to public toilet phobia.

Other common negative impacts of IBS are:

  • Limited sex life – This may occur for several reasons, such as: The discomfort of IBS dulls sex drive and can upset comfort with the feel and look of the body. In some cases, people worry about a loss of bowel control occurring during sex due to stimulation or distinction.
  • Limited social life – People with IBS may avoid social situations because of the socially awkward nature of using other people toilets or that dietary limitation due to IBS may prevent them from relaxing into shared meals.

 

Causes of IBS

The potential causes of IBS are many and various and poorly understood, current thinking includes:

  • Unhealthy Microbiota (Gut bacteria) – For one reason or another the composition of a person’s gut bacteria is unhealthy. This could be an overgrowth of bacteria or an unhealthy mix of bacteria. However, introducing health gut bacteria has yet to show reliable improvements for people with IBS.
  • Dysregulation of the gut brain connection – The brain and gut fail to communicate effectively. This maybe the result of unhealth microbiota (see above).
  • Diet – Lots of people report food-based triggers for IBS. Lactose and gluten intolerance are common.  Eating processed foods like tinned meat, fruit compotes, confectionary, whole cereals and legumes have all been linked to IBS. Again, it is theorised that these may result in alterations to the microbiome.
  • High histamine foods – Histamine, one of the bodies organic chemicals produced as an immune response, appears in some foods. When this is present it can alter the digestion of carbohydrates potentially causes IBS.
  • Stress – Post-traumatic stress disorder (PTSD) and early life stressors have both been linked with IBS. This suggests that stress may be in-part a cause of IBS. However, stress is believed to keep IBS going once it has started, so its role may be that it keeps it going once started by something else.
  • Other risk factors – there are many factors which have been linked to IBS without much understanding of how they may cause it, these include: low birth weight, sleep problems, air pollution,

 

How common is IBS?

A large scale study published in 2021 found that globally about 4.1% of adults had IBS, of whom;

  • 2% are female.
  • 2% had IBS-D
  • 3% had IBS-C
  • 3% had IBS-M

 

Treatment of IBS

The of treatment has been the reduction of symptoms. Initially, the first treatments are:

  • Increase in dietary fibre.
  • Stool bulking agents.

These work well for some but have only moderate benefit overall.

  • Soluble fibre, fibre which dissolves in water to make a gel like substance in the digestion, appears to be the most reliable.

Should these fail to produce sufficient benefit people tend to move on to:

  • Antispasmodics – These relax digestive movement, reducing cramps.
  • Tricyclic antidepressants – A small dose of these appears to re-regulate the brain-gut connection.

However, for lots of people these conventional medical interventions do not work sufficiently well and many turn to more natural and psychological treatments.

Natural and psychological treatments for IBS

A vast range of these exist covering everything from exercise to shamanism. Broadly these can be grouped into categories:

  • Biologically based therapies – Using herbs and food to improve digestion. These are the most used. This is probably because as it makes the most sense to people to use a biology-based approach for what is seen as a biological problem. Of these the FODMAP diet programme is the most well researched. Unfortunate, the unfortunately the FODMAP diet is difficult to follow. Another effective treatment is peppermint oil.
  • Mind-body interventions – These look to increase the mind’s ability to influence the body, as with hypnotherapy, biofeedback and CBT.
  • Energy therapies – these use various types of energy to create change, a common example of which is reiki.
  • Manipulative and body-based therapies – using movement to create change as with exercise and massage.

 

For a more detailed and academic version of this go feel free to read chapter 1 of my thesis

The author

Dr Matt Krouwel PhD is a hypnotherapist with a doctorate in hypnotherapy for IBS. He is based in Birmingham (UK) and works with IBS both in-person and online.

hypnotherapy for IBS