Irritable bowel syndrome (IBS) service

Irritable bowel syndrome (IBS) is a common condition that affects the digestive system.

It causes symptoms like stomach cramps, bloating, diarrhoea and constipation. These tend to come and go over time, and can last for days, weeks or months at a time.

On this page, you'll find information on diagnosis, treatment, and support available from the IBS clinic at York Hospital.

Referral into the service

For referral into our service, you will first need to be referred to one of our gastroenterology consultants by your GP.

The consultant will confirm an IBS diagnosis before referring you to our team.

What we do

This specialist nurse-led service offers an Initial Holistic Assessment and follow-up appointments as required. We provide information about practical measures and lifestyle changes which can improve irritable bowel syndrome (IBS) which is a functional gut disorder (FGD). Our clinical service supports the population of York and the surrounding area for patients with a diagnosis of IBS/FGD. This involves telephone clinics, attend anywhere clinics and, under certain circumstances, a face-to-face clinic appointment at York Outpatients.

Our team members come from a range of specialist backgrounds and will work with you to decide the most appropriate way to investigate and treat your IBS/FGD. You may be referred for assessment and treatment by other members of the IBS/FGD multidisciplinary team, including dietitians and psychologists.

The process of treating you is highly individual and personal to you. We want you to feel as comfortable as possible with us and be confident that any information you give us remains strictly confidential.

The IBS/FGD specialist nursing team

There are two IBS/FGD Nurse specialists based in York. They play a key role in assessing patients, providing advice and information, and supporting patients manage their symptoms. They are also the first point of contact for advice and support in between appointments.

The IBS/FGD service provides patients with information and support, while providing access to advice and treatment when needed. This can include

Providing patient education
Providing advice and support and working within the NICE guidelines
Co-ordinating care and referring to other health professionals
Providing gut-directed hypnotherapy after a full assessment and identifying if this is appropriate for the individual needs of the patient

The IBS/FGD specialist nurses will:

Review patients in clinic to assess if treatments trialled have been beneficial in reducing symptoms, change treatments where indicated, and provide ongoing education and support.
Provide advice by telephone to patients and other health professionals
Assess, monitor, and support patients receiving care
Refer to and liaise with other health professionals as required
Provide a link between hospital and community delivering information on education stands

Benefits of this service

The IBS/FGD Nurse-led service aims to help you improve control of your symptoms without any invasive treatment and to help reduce the severity of the symptoms, anxiety, and stress. We understand that IBS/FGD can be debilitating and may affect the quality of life for some. There are many things that you can do to improve your health and reduce your symptoms. Effective treatment can vary from one person to another and depends on your symptoms.

It is important to remember that IBS/FGD:

Is a very real physical condition and is taken seriously
Is not life threatening
Will not change into any other condition or disease
Does not make you more likely to develop any other bowel condition
It is not contagious

Referral into the service

For referral into our service, you will first need to be referred to one of our gastroenterology consultants by your GP.

The consultant will confirm an IBS diagnosis before referring you to our team.

IBS diagnosis

A diagnosis may be given if symptoms of abdominal pain are related to:

Defecation (opening your bowels), and/ or:
Associated with altered stool frequency (increased or decreased), and/or
Associated with altered stool form or appearance (hard, lumpy, loose, or watery); and there are at least two of the following:
- Altered stool passage (straining, urgency, or incomplete evacuation)
- Abdominal bloating (more common in women than men), distension or hardness
- Symptoms worsened by eating
- Passage of rectal mucus, and alternative conditions with similar symptoms have been excluded

Diagnostic tests

You may only need to have a few of the investigations and tests listed below.

Blood tests

There are several blood tests which are used to help support a diagnosis.

Full blood count
Iron deficiency
C - Reactive Protein and Erythrocyte Sedimentation Rate
Antibody testing for Coeliac disease
Liver function tests
Urea and electrolytes

Stool samples

Fresh stool samples can be examined to check if your symptoms are caused by an infection.

Faecal calprotectin stool tests can be used to detect an increased level of specific proteins in the stools, which can be a sign of inflammation. Doctors are increasingly using this type of test to help with the initial diagnosis.

Endoscopies

Endoscopy is the name for a type of test that allows healthcare professionals to look directly at the inside of the digestive system.

Visit the Trust website endoscopy page for more information on endoscopy.

IBS initial appointments

On your first appointment within the IBS/FGD service, the specialist nurses will carry out an initial holistic assessment with you. This will include discussing symptoms, treatments tried, basic diet and fluid intake, lifestyle/psychosocial factors, completion of an IBS severity score, and a management plan with ongoing support. Your initial appointment may take up to an hour, and your follow-up appointment may take up to 30 minutes.

If you need to change or cancel your appointment, please call the contact centre on 01904 726400. Unfortunately, two missed appointments without cancelling or changing will result in you being discharged back to your GP.

IBS treatments

It is important to remember there’s no single diet or treatment that works for everyone with IBS. However, making some small changes can be very beneficial to some patients who have been diagnosed with IBS.

See guidance on medications and diet and lifestyle changes that can help with improving IBS on the NHS website.

Non-pharmaceutical treatments for IBS/FGD

Psychological therapies for IBS/FGD

Behavioural therapy involves a therapist helping someone to manage their symptoms in a variety of ways without the use of medication. The treatments most used for IBS/FGD are cognitive behavioural therapy (CBT), hypnotherapy, and mindfulness. A GP, gastroenterologist, or an IBS nurse specialist may suggest a referral to the clinical gastropsychologist.

Hypnotherapy for IBS/FGD

Hypnotherapy can improve symptoms, including non-colonic symptoms, and help reduce anxiety levels. Within the IBS/FGD service, hypnotherapy is carried out on an individual basis by one of the IBS nurses specialists, who are qualified therapists and are trained to use “gut-focused” techniques.

Visit the NHS website's IBS pages for more information about help from dieticians and psychologists to ease IBS symptoms.

Further information