I have abdominal pain. Could it be bowel syndrome?

Irritable bowel syndrome (IBS) is characterised by recurrent abdominal pain associated with changes in bowel habits (diarrhoea, constipation or both), with symptoms occurring at least once per week over the last three months and symptom onset at least six months before diagnosis. Symptoms must be related to defecation and/or changes in stool frequency or form. Abdominal bloating is common but not mandatory.

Diagnosis is clinical and based on the Rome IV criteria, as recommended by the American College of Gastroenterology. [1–2] IBS is diagnosed after exclusion of organic causes and alarm features such as weight loss, blood in stools, anaemia, fever, family history of colorectal cancer or inflammatory bowel disease. [1–2] Colonoscopy should be considered in cases of diagnostic uncertainty or presence of alarm signs.

Behavioural therapies, including cognitive behavioural therapy (CBT), gut-directed hypnotherapy and mindfulness-based techniques, have demonstrated significant efficacy in symptom reduction. [1][4–5] Regular physical activity is recommended as an adjunct, with a positive impact on overall symptom burden.

Table 1 - The Role of Food in the Treatment of Bowel Disorders: Focus on Irritable Bowel Syndrome and Functional Constipation

1. Diagnosis and Treatment of Irritable Bowel Syndrome: A Review. Camilleri M. JAMA. 2021;325(9):865-877. doi:10.1001/jama.2020.22532.

2. The Ten Dietary Commandments for Patients With Irritable Bowel Syndrome: A Narrative Review With Pragmatic Indications. Siragusa N, Baldassari G, Ferrario L, et al.Nutrients. 2025;17(15):2496.

3. Behavioral and Diet Therapies in Integrated Care for Patients With Irritable Bowel Syndrome. Chey WD, Keefer L, Whelan K, Gibson PR. Gastroenterology. 2021;160(1):47-62. doi:10.1053/j.gastro.2020.06.099.

4. Meditation Over Medication for Irritable Bowel Syndrome? On Exercise and Alternative Treatments for Irritable Bowel Syndrome. Asare F, Störsrud S, Simrén M. Current Gastroenterology Reports. 2012;14(4):283-9. doi:10.1007/s11894-012-0268-2.

5. The Role of Food in the Treatment of Bowel Disorders: Focus on Irritable Bowel Syndrome and Functional Constipation. Singh P, Tuck C, Gibson PR, Chey WD. The American Journal of Gastroenterology. 2022;117(6):947-957. doi:10.14309/ajg.0000000000001767.