IBS

Warning
Warning:

This site gives you information NOT medical advice. You should consult your medical practitioner if you have any unexplained symptoms of illness or concerns about treatment. Do not stop a prescribed conventional treatment without consulting a doctor. Tell all the practitioners you're working with, conventional or complementary, about any medicines, remedies, herbs or supplements you are taking or considering using.

What do we mean by IBS?

Irritable bowel syndrome (IBS) is a disorder that interferes with the way the colon (large intestine) works. It causes abdominal pain, cramps, spasms, bloating, constipation and diarrhoea. The symptoms vary and they tend to come and go, without warning. They can be quite mild, but some people feel severe pain in parts of their abdomen. People who get IBS often get 'reflux indigestion' symptoms (heartburn, or acid reflux with burning feelings in middle of the chest) too.

How can we be sure that IBS is the problem?

IBS is usually diagnosed by its symptoms, after your doctor has ruled out other causes. It's normal to experience indigestion, bloating or wind, and constipation or diarrhoea occasionally. These problems could be the result of a change of diet, hurried meals or a shift in routine. But if symptoms like this continue or worsen, or if you develop any gut symptoms you have not had before, you should check with your doctor in case the problem is due to a different digestive disorder that needs treatment.

Is it curable?

Most people can control and live with the symptoms of IBS by using various prescription and over-the-counter medicines: laxatives, anti-diarrhoea medicines, antispasmodics, or tricyclic drugs. The gut is very sensitive to stress, and people often find that stress makes their IBS symptoms worse. In many cases, reducing stress can help to relieve some of the symptoms. Increasingly research suggests that what you eat can have an important effect on IBS, so making some simple dietary changes may also help.

Is it dangerous?

IBS does not damage the intestines or lead to cancer. Nor, even though some of the symptoms are similar, is it related to inflammatory bowel diseases such as Crohn's disease or ulcerative colitis.

What causes it?

Although it is not clear what causes IBS, it is one of the most common digestive problems. In England 10-20% of people have IBS at some time in their lives, and twice as many women get it as men. This may be due to the menstrual cycle, and differences in the way men and women perceive pain coming from inside the body. Many people with IBS have a more sensitive colon. This means their bowel reacts to things that might not bother other people, such as stress, big meals, wind (gas), some medicines, certain foods, caffeine or alcohol.

Something else that plays a part in IBS is called 'visceral hyper-sensitivity'. Air and other gases collect in the gut (produced by digestion but also through air-swallowing). If this stretches the intestine, this stretching may be felt as pain. Researchers have recently discovered that about half the people who get IBS feel this discomfort sooner than would be expected. This 'stretch-sensitivity' is not some sort of weakness or failure - in fact many IBS patients seem to have a greater than usual tolerance of pain in other parts of their bodies.

People therefore seem to feel internal pain in different ways. Some people are more sensitive to it, possibly because of the way the nerves in their intestines work, or perhaps because their brains are more attuned to sensing discomfort inside their bodies. It's also known that people become more sensitive to some kinds of pain when they feel stressed. And some people are more prone to feeling stressed than others.

A number of small studies have indicated that people who have experienced early physical or sexual trauma are more likely to develop IBS. Perhaps this is because, understandably, such traumatic experiences leave behind feelings of vulnerability and increased concern about pain and other feelings in the body. People who have suffered abuse may be more prone to depression and/or anxiety too, which probably make the uncertainties of an illness like IBS harder to cope with.

IBS is also linked to several other health problems that involve increased sensitivity to internal sensations. For instance, people who get IBS are more likely to get migraine, chronic fatigue, period pains and restless leg syndrome. A 2006 study, involving 125,000 people, some who had IBS and some who didn't, found that IBS sufferers were 60% more likely to have migraine, 40% more likely to experience depression, and 80% more likely to suffer from fibromyalgia.

IBS and Periods

Many women get constipation and/or diarrhoea just before their period comes on. Women who get IBS are more likely to be bothered in this way. Yet sometimes even severe IBS goes away during pregnancy. It isn't clear why: possibly because of hormonal changes, or because during pregnancy the body has to become less sensitive to things stretching inside.

Self-help Techniques:

Here are some simple tips that may ease your IBS:

What other information might be helpful

For more information see MindBodyDigestive or NHS Choices.

When to see the doctor instead of using this information

IBS does not actually cause harm to the digestive system, even though it can affect your quality of life. But IBS symptoms always need investigating to rule out serious problems, particularly if you have a family history of bowel cancer or ovarian cancer, or if you are over 50 years old and your bowel habits have recently changed for more than six weeks.

See your doctor if you have had:

simplechangesMake Some Simple Changes


pencil IBS and diet

OverviewIt is always important to eat a healthy diet with enough vitamins and minerals, fruit, vegetables and whole grains. But people with IBS may need to limit their intake of certain foods (see below).

The National Institute for Health and Clinical Excellence (NICE) suggests that people with IBS should have regular meals, drink plenty of fluid (e.g. 8 cups of non-caffeine based fluid per day) and eat a wide variety of foods. However, NICE also notes that people with IBS often find they have to take care about the kind of dietary fibre they eat, and be aware that lactose (milk and dairy foods) can cause IBS in some people, NICE agree that probiotics, prebiotics and water soluble dietary fibre are potentially beneficial.

People with IBS will benefit from the following dietary tips:

- Avoid foods that irritate the colon and eat foods that soothe and regulate it.

- Eat frequent small meals rather than big ones, and reduce your intake of tea and coffee, alcohol and soft drinks.

- Don't eat foods rich in insoluble fibre, such as wholemeal bread, brown rice and cereals containing bran.

- Eat fruit but no more than three portions a day, as most fruit has some acidic content, which can make IBS symptoms worse.

- Adding soluble fibre to your diet seems to help bloating and diarrhoea as well as constipation. Soluble fibre can be found in oats and linseed. Eat a tablespoon of each daily in porridge or muesli. Ispaghula powder, a plant-based soluble fibre made from certain seeds, is available from pharmacies and healthfood shops.

- Consider limiting resistant starches (often found in processed or recooked foods), which can be difficult for people with IBS to digest.

- Sorbitol is an artificial sweetener found in some sugar-free sweets, fizzy drinks and diet products. If you get diarrhoea, avoid products containing sorbitol, as it may worsen your symptoms.

pencil Making some simple lifestyle changes

OverviewA healthy diet, a regular daily routine and managing stress are the best ways of improving IBS symptoms. If anxiety or stress plays a part in your IBS, try exercising and getting more good-quality sleep. Learning a relaxation technique could be helpful too. Keeping an IBS diary may help you to spot foods, activities or causes of stress that trigger your symptoms. Once you know what the triggers are, you can do something about them.

pencil Tackling Stress

OverviewIn someone with IBS, psychological stress can change the way the intestines work. Anything that reduces stress could therefore make your intestines work better again. There are a number of things that you can do to help you relax, which may ease your IBS symptoms. See below for more information.

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simplechanges Cutting down on alcohol and stopping smoking

OverviewIBS sufferers already have a sensitive stomach and intestines, and tobacco can over-stimulate and irritate them. Some people find tobacco smoke triggers IBS symptoms. Inhaling tobacco smoke can cause reflux and heartburn, as well as bloating, burping and gassiness.

Moderate drinking means no more than two drinks a day for men and one drink a day for women. A unit of alcohol is half a pint of ordinary strength beer, lager or cider or a small pub measure (25 ml) of spirits or a standard pub measure (50 ml) of fortified wine such as sherry or port (20% alcohol by volume). A small (125ml) glass of basic wine is 1 and a 1/2 units.
EvidenceThere have been some studies to see if alcohol and smoking are linked to IBS. It seems that there may be a link. Smoking tobacco and drinking large amounts of alcohol can certainly worsen indigestion, heartburn and reflux.
SafetyCutting down on smoking and alcohol is safe, but if you are cutting down from heavy use, there can be side-effects, including loss of appetite and difficulty sleeping. There are unlikely to be side-effects if you are cutting down from a moderate alcohol intake. If you are a very heavy drinker, it is a good idea to see your GP and ask for some help while you're cutting down.
CostThere are no costs. In fact you will save money.
Find out moreFor more information, see the NHS information sensible drinking.

If you are giving up or cutting down on smoking you can order a Quit Kit from SmokefreeNHS. You can also phone the NHS Free Smoking Helpline on 0800 022 4332.
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simplechanges Exercise

OverviewYou don't have to use the gym to exercise; even 30 minutes brisk walking every day is enough to make a useful difference to your overall health and well-being. Being active does more than keep you fit. It makes your heart and lungs work better, tones your muscles, and strengthens your bones and joints. It also stimulates blood flow to your brain and internal organs and boosts your immune system. It helps protect you against osteoporosis, triggers brain chemicals that lift your mood and can generate a glowing sensation of well-being. It has been shown to improve all sorts of health problems. In mild to moderate depression, it can be as effective as anti-depressant medication.

Exercise can include aerobics such as stepping and walking; strengthening exercises such as lifting weights or using resistance machines; and stretching for flexibility. Other types of exercise are Tai Chi, Qigong and yoga.
EvidenceResearch shows that keeping active is generally helpful to health. Moderate exercise such as walking may help with IBS symptoms. But very vigorous exercise may make some symptoms, particularly diarrhoea, worse.
SafetySupervised exercise programmes are safe for most people. But at first you might feel more tired. If you're not used to being active, start off slowly and build up gradually, doing a bit more every other day. If you feel worse, cut back, and increase your activity more slowly. If you think it isn't helping or that you're getting worse in any way, check with your doctor. Anyone with severe osteoporosis, joint problems, acute back pain or recent injuries should first get advice about exercise from a doctor or physiotherapist.
CostYou can exercise at home for nothing - walking and gardening is all exercise - although you should get advice on the best exercises to do from a trainer first. There will probably be a small cost (usually £5-£8 a class), if you join an organised programme.
Find out moreNatural England is one of several organisations that organise walking schemes designed to help people improve their health. The Walking for Health Programme has about 600 local groups, and around 40,000 people take part in short local walks every week. Find out about Green Gyms where volunteers take on voluntary projects outdoors. Many local councils organise Health Walks for people who want to get active in company.

Check your local leisure centre for exercise classes. See also the Classes section for more information.
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simplechanges Following an exclusion diet

OverviewKeeping a food diary should help you to find out whether certain foods make your symptoms worse. Write down what you eat and make a note of how you feel a couple of hours afterwards, bearing in mind that the effects of food might be felt some time after you've eaten them.
EvidenceSome research suggests that cutting out certain foods from your diet might help. In the studies that have been carried out, people with IBS have tried cutting out a wide range of different foods.
SafetyIt can be quite difficult to exclude certain foods and still have a balanced diet. If you want to make big changes to what you eat, it is a good idea to see a dietician. They can help you make sure you are still eating a healthy diet and getting all the nutrients you need.
CostEating a healthy diet and excluding some foods need not cost you anything. But if you consult a dietician there will be a charge, unless this is a service provided by your GP's practice.
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simplechanges Meditation

OverviewMeditation is a state of mind, not a religion, though it features in most major religions, especially Eastern ones. Meditation seems to harmonise the activity between the two sides of the frontal brain, and encourages a 'relaxation response'. The relaxation response happens when the body and mind do the opposite of what they do when you feel stressed. In meditation the body is relaxed while the mind is alert. You don't need an experienced teacher or a spiritual faith in order to take up meditation. You can learn the basics from a book or a podcast. Meditation is easily accessible, and it is remarkably effective, both for rapid stress reduction and as a way of promoting long-term health.
EvidenceA small study of people with IBS who learnt meditation, then practised at home, showed that their symptoms improved after about three months. More recently, research has shown that mindfulness meditation may be a promising treatment for IBS symptoms, but further research is needed to confirm this.
SafetyThere are generally no safety problems with meditation unless you have a severe or long-standing mental health problem.
CostMeditation involves certain (simple) techniques that can be easily practised at home. There are many books and audio aids available and some people find it useful to join a class initially.
Find out moreVisit The British Holistic Medical Association for podcasts and leaflets. See also Yoga in the Classes section.
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simplechanges Probiotics

OverviewWe live in harmony with bacteria on our skin, and in our gut and urinary tract. Too many of the wrong sort may make us ill, but too few may make us more prone to illness. Probiotics are bacteria that occur naturally in the gut, or which are found naturally in certain foods (eg cider vinegar, miso, yogurt), or added to foods for particular benefits when eaten. Many kinds of probiotics and mixtures have been researched in clinical trials for IBS. They generally (but not always) show a modest reduction of symptoms including pain, wind, bloating and stool frequency.
EvidenceMany different types of probiotics have been studied in people with IBS. Some studies report that symptoms such as pain, wind, bloating and stool frequency improved. The size of effect is only small though and not all studies found effects.
SafetyProbiotics are generally safe and well tolerated. Avoid if you are allergic or hypersensitive to probiotics. Use with care if you are lactose intolerant. Although probiotics seem to be helpful and safe for people with IBS, the type and best dose is still not clear.
CostProbiotics can be found in certain yoghurts and probiotic drinks and can also be bought in capsule and tablet form.
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simplechanges Relaxation techniques

OverviewRelaxation training can make you more aware of how your body reacts to the situations or pressures that bother you, and help you control the stress response. For instance, stress raises your blood pressure, speeds up your heart, makes your muscles tense and may increase your sensitivity to pain. It also affects the way your stomach and intestines work. The gut is very sensitive to stress, and many people find that stress makes their IBS symptoms worse. Methods that have been found to help IBS include biofeedback and relaxation training (such as slow breathing and progressive muscular relaxation, self-hypnosis or imagery techniques), or a combination of techniques.
EvidenceResearch shows that using relaxation or stress management techniques may help with some IBS symptoms. Studies have not yet proved that these techniques ease IBS pain.
SafetyThese techniques are generally safe unless you have a severe or long-standing mental health problem.
CostNo costs are involved, although you may need to buy a CD, DVD or book.
Find out moreRelaxation techniques can be learned from a book, CD, DVD or during exercise classes such as yoga classes. No costs are involved, although you may need to buy a CD, DVD or book. See the information about yoga in the Classes section and our leaflet on Stress and Anxiety. Visit The British Holistic Medical Association for podcasts and leaflets.
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simplechanges Taking soluble fibre

OverviewTaken with fluids, soluble fibre can relieve diarrhoea as well as constipation. But insoluble fibre, such as bran, is not effective for IBS and may make some people's symptoms worse.
EvidenceResearch has shown that certain types of fibre are better than others in easing IBS symptoms. Insoluble fibre (found in wheat bran and the skins, husks and peels of foods such as nuts, raw vegetables and brown rice) is less likely to help. Soluble fibre is much more beneficial. This is found in foods such as oats, oat bran, barley, quinoa and in ispaghula powder.
SafetyIt is safe to gradually increase the amount of soluble fibre in your diet.
CostNo extra costs are involved.
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buysomethingBuy Something


pencil Before You Buy

OverviewFor safe use of over-the-counter medicines, herbal remedies and supplements:

Consult a qualified person (such as a pharmacist) before buying or taking any medicine, remedy or supplement:
- if you have a serious medical condition
- if you are breast-feeding, pregnant or planning to become pregnant
- if you are already taking other medicines, herbal remedies or supplements
- if you suffer from allergies

Always read the package insert before taking any product.
Avoid taking the product if you think you may be allergic to any of the ingredients.
Do not combine any over-the-counter medicines, remedies or supplements with other medicines, remedies or supplements unless you have first checked with a qualified person (such as the pharmacist in your local chemist).

Seek advice from your doctor or pharmacist:
- If your symptoms do not get better
- if your symptoms get worse
- if you get new symptoms or have a side effect

The information here, including dosages, only applies to adults (over 16 years). Keep all medicines out of the reach of children.

pencil Over the counter medicines

OverviewA number of medicines may help with IBS. Which ones to choose depends on which symptoms you find most troublesome. It would be worth discussing this with your doctor or pharmacist.

An antispasmodic, such as Colofac (mebeverine), can help with colicky abdominal pain. For people with constipation, a bulk-forming laxative is best (such as ispaghula or sterculia). Lactulose is not advisable for IBS. If there is diarrhoea, an antimotility drug such as Imodium (loperamide) can be useful. Your pharmacist will advise you on what to try and the right dosage. The aim is to produce a soft, well-formed stool.

pencil Spices to aid digestion

OverviewSpices have been highly prized for centuries. Before we had refrigerators to keep food fresh, spices were used to flavour food, and to help settle the digestion and relieve stomach aches and colic, flatulence and indigestion. Many spices contain oils that are known to relax the muscles of the digestive system. Since spices are foods, they are safe in reasonable amounts and there are few risks in trying them out at home (unless you are one of the very few people with allergies to certain spices).

Each spice has its own properties so it's best to try them one by one, made into tea with hot water, to see which might work for you. Fennel, ginger, cardamom, cinnamon and aniseed are most widely used for these purposes. Herbs like camomile, peppermint and lemon balm are traditional home remedies for upset stomach and colic and are safe to try as teas.

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buysomething Iberogast

OverviewIberogast is a commercially manufactured liquid herbal formulation containing a mixture of herbs, including:

- German chamomile (Matricaria recutita) flower
- clown's mustard (Iberis amara) plant
- angelica (Angelica archangelica) root and rhizome
- caraway (Carum carvi) fruit
- lemon balm (Melissa officinalis) leaf
- celandine (Chelidonium majus) aerial part
- licorice (Glycyrrhiza glabra) root
- peppermint (Mentha x piperita) leaf.
EvidenceResearch has shown that Iberogast might be helpful in managing IBS symptoms, but the evidence is only from one study.
SafetyAs with all herbs you should be aware of possible drug interactions and adverse effects. It is advisable to check with a qualified herbalist, doctor or pharmacist.

Always read the package insert before taking any remedy. Avoid if you think you may be allergic to the product.
CostIberogast on average costs £30 for a 100ml supply.
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buysomething Laxatives

OverviewGentle laxatives can help relieve constipation but they should only be taken for a few days at a time. Soluble-fibre laxatives, such as ispaghula powder, can help with diarrhoea as well as constipation.
EvidenceLaxatives are helpful for constipation but people with IBS should avoid taking lactulose.
SafetyAlways read the package insert before taking any medicine. Avoid if you think you may be allergic to the product. Do not take anything with other medicines, remedies or supplements unless you have checked with a qualified person (for example a pharmacist).
CostLaxatives can be bought for relatively low cost from most pharmacies. Your GP may prescribe them for you.
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buysomething Medicines that relax the bowel

OverviewAntispasmodics such as mebeverine hydrochloride (e.g. Colofac) work on the muscles that move the contents of the intestines along. These muscles have to contract and relax in time with one another. If muscles in one part of the intestine tense up in a spasm, the intestine nearby will tend to get stretched, as the contents back up. People who get IBS feel this as cramps and bloating.
EvidenceThere is research to show that antispasmodics ease the pain from cramps and may also help with bloating.
SafetyAlways read the package insert before taking any medicine. Avoid if you think you may be allergic to the product.
Do not take anything with other medicines, remedies or supplements unless you have checked with a qualified person (for example a pharmacist).
CostBowel relaxing medicines can be bought for relatively low cost from most pharmacies. Your GP may prescribe them for you.
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buysomething Medicines that stop diarrhoea (eg Imodium)

OverviewThese medicines are safe for short-term use if you are certain the cause is IBS.
EvidenceResearch studies have shown that loperamide can be useful in diarrhoea where there is no pain.
SafetyThese medicines are safe for short-term use if you are certain the cause is IBS. Always read the package insert before taking any medicine. Avoid if you think you may be allergic to the product.

Do not take anything with other medicines, remedies or supplements unless you have checked with a qualified person (for example a pharmacist).
CostMedicines that stop diarrhoea can be bought for relatively low cost from most pharmacies. Your GP may prescribe them for you.
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buysomething Peppermint oil capsules

OverviewPeppermint is a common flowering plant that grows all over Europe and North America. Some small studies suggest that peppermint's fragrant oil (which relaxes the intestine muscles) may improve IBS symptoms. Avoid peppermint oil if you think you are allergic or hypersensitive to peppermint or menthol. Peppermint is safe in non-allergic adults, unless you have gall bladder disease or are known to have G6PD deficiency.
EvidenceResearch suggests that peppermint oil (taken in a capsule designed to reach the colon) can help with cramps and bloating.
SafetyAlways read the package insert before taking any medicine. Avoid if you think you may be allergic to the product.
Do not take anything with other medicines, remedies or supplements unless you have checked with a qualified person (for example a pharmacist).
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attendvisitAttend Classes / Visit Practitioner


attendvisitTreatment Options:


attendvisit Acupuncture

OverviewAcupuncture is a traditional treatment that was first used in China thousands of years ago. Thin needles are inserted into the skin at certain points on the body, which practitioners believe will help restore health. The treatment sometimes also involves heat, pressure, electrical currents or soft-laser light. In the UK, acupuncture is most commonly used for pain relief.
EvidenceSome research indicates that acupuncture may help some people with IBS symptoms. But there is not enough good research to suggest that this is generally the case.
SafetyAcupuncture is generally safe if practised by a trained acupuncturist. The most common side-effects are slight discomfort (common) and bruising (occasionally).
CostA session may cost £35-£50. Frequency of treatment will depend on you and your practitioner.
Find out moreIt is important to find a practitioner who is registered with one of the following professional organisations:
Acupuncture Association of Chartered Physiotherapists
British Academy of Western Medical Acupuncture
British Acupuncture Council
British Medical Acupuncture Society
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attendvisit Hypnotherapy

OverviewA hypnotised person is awake, alert and focused, but also more susceptible to suggestion. The therapist therefore uses suggestions to bypass the conscious mind in order to bring about changes in behaviour, emotions or attitudes. Hypnosis is used to help people stop smoking or cope with stress or phobias, and the side-effects of therapeutic treatments, and to promote healing. Hypnosis may help some people to manage their IBS pain.
EvidenceMany individual research studies have suggested that hypnotherapy can reduce IBS symptoms in people who don't get good relief from the usual sorts of medication. But we can't yet be certain that gut-directed hypnotherapy works well enough to be routinely recommended. It will be very valuable for some people however.
SafetyThe safety and effectiveness of hypnotherapy largely depends on the skill of the practitioner and how you feel about working with them. It is unlikely that hypnotherapy will be formally regulated in the foreseeable future. Those who are doctors or psychologists have strong regulatory organisations (see below). Use cautiously if you have a longstanding mental illness or seizures.
Costsession may cost [pounds' target='_blank' class='to'>35-[pounds' target='_blank' class='to'>60. Frequency of treatment will depend on you and your practitioner.
Find out moreAll full members of The British Association of Medical Hypnosis hold a medical or dental professional qualification in addition to their hypnotherapy training.
The National Council for Hypnotherapy and
The Hypnotherapy Association both claim to register approved hypnotherapists.
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attendvisit Psychological therapies

OverviewWhen people think of 'talking therapies' they usually mean either counselling or psychotherapy. Counselling and psychotherapy aim to help people change thoughts, feelings and attitudes. Counsellors help you talk about difficult feelings and understand conflict. It can be helpful just to have time alone with a counsellor to talk in confidence about how you feel. Spending time reflecting on problems often brings insight and puts things into perspective. Psychotherapy helps people learn better ways of thinking or behaving that can reduce their symptoms, disability and distress. Some psychotherapists are trained to help you explore possible causes of distress or symptoms in your past. Cognitive behavioural therapy (CBT) is the type of psychotherapy that is currently most widely available in the NHS.

Instead of exploring causes of distress or symptoms in the past (like many other types of therapy), CBT looks for ways to improve your state of mind right now. The therapist does this by helping you spot unhelpful thought processes and change them. The Royal College of Psychiatrists says "CBT can help you to change how you think ('cognitive') and what you do ('behavioural')". For instance, CBT can help you make sense of what seem like overwhelming problems by breaking them down into smaller parts. This makes it easier to see how they are connected and how they affect you..
EvidenceCBT has been shown to improve IBS symptoms in a number of studies. If you have seen your doctor and tried the prescribed medicines and self-care methods for a year and they have not given you enough relief, it would be worth trying CBT.
SafetyThese techniques are safe in most people if carried out by or under the guidance of a qualified counsellor or psychologist.
CostIn most areas your GP can refer you for CBT or a psychological therapist in the NHS. There are often long waiting lists. A session of CBT or psychological therapy may cost between £20-£50. Frequency will depend on you and your therapist. A typical course of CBT lasts between 6-12 weekly sessions.
Find out moreIt is important to find a qualified counsellor or psychologist. Contact The British Psychological Society
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attendvisit Yoga

OverviewYoga, as taught in the UK, generally includes physical postures or stretches, breathing techniques, meditation and relaxation. There are several different types of yoga. Some of them are mainly based on the physical exercises (some types are much more strenuous than others). Others focus more on meditation.
EvidenceYoga provides a gentle form of exercise and may help with relaxation. There is little research into the use of yoga for IBS.
SafetyYoga is generally safe when practiced appropriately and at the right level. Classes are run for different ability levels so look for one that is right for you. Yoga stretches should be increased slowly. If in doubt, check with your doctor, osteopath or physiotherapist. Avoid with severe osteoporosis or acute joint or back pain, or recent injuries.
Cost
Finding a classClasses are run in most areas by both private tutors and by adult education services. To find a qualified teacher near you see also the The Yoga Alliance
and the The British Wheel of Yoga.
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