Too much knowledge is a dangerous thing.  You should never try to diagnose your own illness.  Go to a doctor!      


That’s all very well, but gut symptoms are so common that if everybody went to their doctor for every abdominal twinge or bowel upset, our medical services would be swamped.  Warren Alexander, chief executive of Core, the Digestive Disorders Foundation, said: “One third of the population regularly suffers from digestive conditions such as constipation, diarrhoea, stomach-aches, nausea and sickness.”  The overwhelming majority of these are not the result of a serious abdominal disease,  but are probably caused by dietary indiscretions, a frenetic life style or the specific trials of their lives.  Although doctors may diagnose such complaints as Irritable Bowel Syndrome, the available treatments are all too often ineffective.  It is therefore important to learn how your gut reacts and to have strategies by which you can treat yourself, while not ignoring symptoms that may indicate pathology.            


But how do you know when you can manage your own chronic gut complaints with confidence and when you  should be concerned and seek medical advice?  My experience  is that the symptoms of  the Irritable Bowel Syndrome and other unexplained illnesses affecting the gut tend to be quite predictable within a given patient.  They have a pattern to them – quality of pain, type of bowel upset, association with other symptoms,  time of day, triggering factors, emotional reaction – that is as individual as a DNA profile.  People tend to know their symptoms; they have lived with them a long time. They learn what brings them on and what takes them away.  You may well realise that if you are upset about something it tends to go to your guts.  Perhaps there is a particular event that always induces symptoms, like when your mother comes to stay or your husband has too much to drink.  Predictable symptoms that have been going on for years are unlikely to be caused by serious pathology.  In most cases, they have been  investigated previously  and nothing found.  It’s the symptoms that are out of the ordinary, the illness that changes its character for no obvious reason, the unfamiliar and unpredictable and in particular what are often called ‘red flag’ symptoms,  that need to be taken seriously.   


‘Red flags’ are symptoms that may indicate inflammation or cancer or allergy affecting the gut.  They include the presence of blood in the stool, weight loss, fever and a disturbance in bowel habit coming on later in life with no obvious cause.  If you have any of these symptoms you should consult your doctor.   


But let’s assume there are no red flags.  You have Irritable Bowel Syndrome or an associated functional disorder of the gut. It has been going on for years and your doctor has exhausted all possibilities and is just offering bland reassurance. How can you help yourself?     


Ten top tips to manage Irritable Bowel Syndrome


  1. Keep a diary of symptoms, diet and life events.  This can help to identify those factors and life situations that regularly bring on the symptoms.   


  1. Reduce or eliminate from the diet any item that reproducibly causes symptoms.  Test this  scientifically by eliminating one item at a time for several days and noting the symptom  response


  1. Eat regular meals and allow time to relax and enjoy your food.  Do not skip meals and do not overindulge. 


  1. Remember that fatty foods, hot spicy foods, excessive alcohol and high consumption of fruit, vegetables and cereal fibre can all upset the bowels.


  1. Lead a balanced life – work, rest and play.  Take time out to relax each day and have frequent holidays. Take regular exercise.


  1. Know what medications do and try to find out how best to use them. Remedies for  indigestion, diarrhoea, constipation and abdominal pain can be purchased over the counter at all high street chemists.  Ask your chemist about them and look them up on google. 


  1. Bear in mind that all drugs have side effects and what may work for one symptom may make another worse.  Do not continue to take medications that do not help.  


  1. Talk to a friend or a counsellor or psychotherapist about anything that is troubling your guts.  Try to find a way through.     


  1. Consider alternatives.  Complementary medicine attempts to understand you in relation to your condition; the therapies provide a focus of confidence and healing.  They can help!     


  1. Join a self help organisation.  The Gut Trust ( is a charity specifically devoted to helping people with IBS and related conditions.  There is, on the website, a comprehensive Self Management Programme that includes all the resources you are likely to need to understand and manage your condition.



As Jonathan Blanchard Smith, chairman of The Gut Trust, said,  ‘Illness makes all of us feel helpless and scared, but if you can understand your condition, then you can learn to manage it, either by living within its limitations or most often by resolving the factors that underpin the symptoms.  This can then help you have a more informed and productive dialogue with your family, friends, line managers and health professionals.’      



This article was published in The Healthy Gut, a supplement to The Times, on Wednesday.