Get a diagnosis
Go to your GP with IBS symptoms - bloatedness, constipation, diarrhoea, abdominal pain, flatulence - and what will concern him or her most is whether you have cancer, ulcerative colitis or Crohn's disease. This is checked via mini camera work at one end or the other, and if you're given the all-clear the likelihood is you'll be told you have IBS and you'll just have to live with it.
It's time to get more specific, so a focused, know-your-enemy approach can be taken. The cause varies from person to person and, according to the Oxford-based IBS & Gut Disorder Centre, can be any one, or combination, of the following: food intolerances, yeast overgrowth, unfriendly bacteria, parasites. Blood tests, conducted by nutritionists or nutritional therapists, can detect individual food intolerances - in athlete Denise Lewis's case, cashews and garlic were among the culprits. A comprehensive digestive stool analysis test can check whether the other three factors are at work. Visit ibs-solutions.co.uk for details.
Avoid antibiotics
More like indiscriminate killers than eagle-eyed assassins, antibiotics kill off both good and bad bacteria in your intestines, thus leaving space for yeast to overgrow. This in turn irritates the stomach lining and you end up with yeast toxins in the bloodstream. Result: excess gas and bloating - classic IBS symptoms. Reach, then, for probiotics, in drink, supplement or yogurt form. Don't opt for a sweetened variety, though: sugar is a prime gut irritant.
Eat properly
You've had the blood tests, so you know what foods to avoid, but how you eat is vital, too. "Our stomachs should be treated lovingly, like a classic car," says clinical nutritionist and IBS specialist Michael Franklin. "Eat slowly. Always eat sitting down, never while walking or standing. Don't panic-eat and don't have very hot drinks while eating. Ideally, we should be like the French, spending an hour and a half at meals."
Caffeine should be avoided because of its stress-inducing and gut-irritating tendencies. As for alcohol: "It's an aggressive entity," says David Nicolson of the Institute for Optimum Nutrition. "It burns and burns and burns. Fizzy flavoured drinks aren't advisable, either. They retain their bubbliness via phosphoric acid, and that's an irritant."
Deal with stress
Stress and stomachs are inextricably linked. When we get that knotted feeling, or butterflies, it means we're going into fight-or-flight mode, and that involves the blood vessels in the stomach contracting and sending blood to the muscles used in scrap or scarper scenarios. The result is our digestive system shuts down and IBS can rear its head. As stress avoidance is nigh on impossible, try to deal with it via regular meditation and counselling. Hypnotherapy sessions, in which descriptions of what happens to the intestines when we're uptight are given, along with methods of coping, are useful. A British clinical hypnotherapist, Michael Mahoney, has developed an IBS-specific self-hypnosis method called the "IBS Audio Program 100", to be practised by IBS patients in their own time, at home.
Exercise
Gentle exercise can do wonders. Yoga - the yoking of the physical and spiritual - is especially recommended, and a 2004 study published in Applied Psychophysiology & Biofeedback found that the downward dog posture can reduce the prevalence of diarrhoea slightly better than a drug regime.
Take calcium and magnesium
If diarrhoea dominates in your IBS, then contraction of the gut muscles is required. Calcium's a big hitter in this area, so your diet needs plenty of it. However, dairy products - the classic source of the mineral - often trigger IBS, so supplements may be preferable. Supplements don't require digestion, they go straight into the bloodstream - a big plus when your digestive system's playing up. Magnesium performs the opposite effect to calcium, relaxing the muscles of those with constipation.
Take flaxseed
Dietary fibre is vital for the swift and comprehensive passage of waste products, but many IBS sufferers react badly to wheatgrain products such as cereals and bread. A gentle, less harsh alternative is flaxseed. "Ground flaxseeds, also called linseeds, are the best form of fibre for IBS sufferers," says David Nicolson. "The fibre in the outer husk is able to absorb very large amounts of water, causing it to swell and form a soothing gel. Within the inner seed of flax there is a good supply of omega-3 essential fatty acids, which are known to support the immune and digestive systems. The flaxseed should be ground, otherwise the outer husk will not be broken down and the EFAs will pass out of the body.
