We asked Simon Darnley, author of Understanding Irritable Bowel Syndrome, to answer member's questions about IBS on our Allergies & Special Diets board

Irritable Bowel Syndrome (IBS) is a chronic condition that affects between 10 and 20 per cent of the UK population. According to NHS Direct, it is most commonly suffered between the ages of 20 and 30 and is twice as common in women as in men. Symptoms include regular abdominal pain, sporadic diarrhoea and often alternating constipation.

Cl-bettybaby - 'What are the main symptoms of IBS?'

Simon: The most common symptoms of IBS are:

• Pain and discomfort that may occur in different parts of the abdomen. Pain usually 'comes and goes'. The length of each bout of pain can vary greatly. The pain often eases when you pass stools or wind. Many people with IBS describe the pain as a 'spasm'. The severity of the pain can vary from mild to severe, both from person to person, and from time to time in the same person.
• Bloating and swelling of the abdomen may develop from time to time. You may pass more wind than usual.
• Some people have bouts of diarrhoea, and some have bouts of constipation.
• Sometimes the stools become small and pellet like. Sometimes the stools become watery or ribbony. At times, mucus may be mixed with the stools.
• People often have a feeling of not emptying their rectum after going to the toilet.
• Some people have urgency, which means you have to get to the toilet quickly. A 'morning rush' is common. This is often during and after breakfast.
• Other symptoms sometimes occur and include: nausea, headache, belching, poor appetite, tiredness, back ache, muscle pains, feeling quickly 'full' after eating, heartburn, and bladder symptoms (an associated 'irritable bladder').
• Some people have occasional mild symptoms. Others have unpleasant symptoms for long periods. Many people fall somewhere in between, with flare-ups of symptoms from time to time.

Some doctors group people with IBS into one of three categories:

1. Those with abdominal pain or discomfort, and the other symptoms are mainly bloating and constipation.
2. Those with abdominal pain or discomfort, and the other symptoms are mainly urgency to get to the toilet and diarrhoea.
3. Those who alternate between constipation and diarrhoea.

However, in practice, many people will not fall neatly into any one category, and considerable overlap occurs.

Please note: passing blood is not a symptom of IBS. You should tell a doctor if you pass blood.

Mellers - 'How do you deal with a high-fibre diet?'

Simon: With regards the issue of fibre, it used to be thought that a high-fibre diet helped IBS but this has now been found not to be the case. However, fibre, which comes in two types, soluble (fruits, veg, oats, barley) and insoluble (skins, husks, wheat, rice, nuts) does help with constipation in IBS and is important for good passage.

The ideal balance of soluble and insoluble fibre is different for each person but too much insoluble fibre can be a powerful trigger for IBS. As you are eating lots of fibre I suggest reducing the amount of insoluble fibre in your diet by peeling veg/fruit and reduce the amount of raw veg/fruit. Also increase the amount of soluble fibre foods such as pasta.

Wholewheat bread should not be avoided, but eaten with care as it contains a lot of insoluble fibre. Insoluble fibre should be eaten not on an empty stomach, in large quantities or without soluble fibre foods.

Exercise is also important in losing and maintaining weight loss but did you know it is also very important in IBS. I suggest that you maintain a regular programme of physical exercise and activity; for example, walking three times a week for a minimum of 30 minutes.

sezza2005 asked about the links between IBS and stress

Simon: While IBS may not be initially caused by stress and anxiety we do know that it does make all of the symptoms worse. We also know that many people suffering from stress will experience many symptoms of IBS without having full-blown IBS.

However, people with IBS will be more reactive as they already have a hypersensitive gut. This makes you more likely to suffer from increased symptoms when experiencing any kind of stress.

So, although IBS may have physical causes that we have yet to discover, what a person does, thinks and feels will aggravate and maintain many of the IBS symptoms. IBS is likely to be connected to our lifestyle, level of anxiety and the way we view the world.

There are many other things you can do. Anxiety management can really help. Your GP surgery may have a counsellor or psychologist attached to them where you can get anxiety management and there are many good books which include techniques for reducing your anxiety levels.

One of the most important is accepting the IBS itself. This sounds easy to say but is very important and can reduce your symptoms significantly. For example, what do you say to yourself when you get symptoms of IBS. If you think 'Oh my god, I've started to feel bloated, it's bound to get worse and then ruin my night out' this is more likely to lead to increased worry, stress and focusing on the bloating.

The way we think about our IBS will affect our symptoms. Recognise when this is happening and challenge those thoughts.

Acceptance of the IBS is the key to living with it and not letting it beat you or stop you from having a good and enjoyable life. It's also OK to have IBS. It's nothing to be ashamed or apologetic about.

You need to be aware that your IBS is very sensitive to stress levels and do everything you can to plan your work and avoid that last-minute rush (my daughter is also at university, so I am very aware of this at the moment).

Cl-bettybaby - 'Is excessive wind related to the effects of working long shifts?'

Simon: I hope your partner is not too embarrassed that you shared his wind problem with the world. I wish more people would speak about these things openly! The answer to your question is 'very likely'.

Unfortunately, shift work comes with many ongoing problems as it upsets the internal body clock. It would be important for your partner to eat on a regular basis, take breaks and watch his overall stress levels. Eat regularly, do not skip meals.

Skipping meals plays havoc with one's metabolism. It also results in poor cognitive functioning. Recent research has shown that those who skip meals are more likely to be overweight than those who eat regularly. Meal skippers have a greater propensity to overeat, especially large quantities of high-fat foods.

Have three meals per day or spread the same amount of food into six meals per day and start each day with a healthy breakfast.

Wind is caused by many foods and differs from person to person. I often get people to make a list of foods they have eaten once they have a particular bad bout of wind so they can identify them and limit them in their diets. It is important here to say he should not avoid any foods, and always be aware of a healthy inclusive diet, but he may find by reducing specific foods this will reduce his wind.

He is doing a great job and many people who work shifts can mange with the disruption. I hope this helps in some small way.

chocolatemousse - 'Is there a link between IBS and menstruation?'

Simon: Unfortunately, we know that IBS symptoms do appear to be influenced by changes in the level of female hormones, and symptoms like looser stools and cramping can become worse at certain times of the cycle, particularly at the time of your period. It is reported as more intense in women with IBS, than in healthy women without IBS.

Even though your IBS is better at other times of the month it is still important to lay solid foundations that will help with IBS generally. See my other posts for advice on stress levels, diet, the role of fibre, healthy regular eating and, most important of all, accepting IBS and not letting it ruin your life.

With regard the diarrhoea, as long as you are not getting it more regularly than during your period, then you can treat it with Imodium (loperamide) as this acts on the gut alone and is not absorbed into your system. This means it has very few side effects and is quite safe.