IBS is a syndrome. That means it is a complex of different things. A mix of symptoms, a mix of possible precipitating factors and a range of maintaining factors too. But when your doctor is telling you that your problem is IBS, he is also telling you that there is no physical damage to your gut. So that is good news.

Because it is a syndrome, the symptoms are very varied. You can have constipation or diahorrea or both. You can have a bloated belly or not. Your belly might be tender. Getting rid of these symptoms is a key goal.

Symptoms like these come from problems in the transportation system. When things travel slowly, we get bloating and constipations. When things whizz through too fast, we get diahorrea.

Jean Jacques Rousseau, a famous French philosopher said his secret for happiness was a good bank account, a good cook and a good digestion.
Those of us who have suffered with IBS will agree that a poor digestion is a source of misery.

While we may not be able to remember what caused IBS in the first place, we can look at things that maintain it. We might avoid fruit and veg because we think they will give us the runs. Or we might at the same time be trying to diet, so we skip meals during the day. The impact of things like this could be to keep the symptoms driving us to despair. And the despair triggers stress and anxiety, both of which are known to make IBS worse.

When you come for IBS therapy, we will look at a whole range of things that might be involved. When you are dealing with a  complex syndrome, there will not be one single solution. Complex problems require complex solutions. But they don`t have to be hard to achieve.

Most of us are likely to think that bran will help with some of the symptoms of IBS. Bran absorbs water and this helps digestive transit. Drs Francis and Whorwell at South Manchester University Hospital who work in the IBS clinic, decided to check whether this widely held view is true. It isn't. These doctors got the impression that wholemeal wheat and bran products make the condition worse. They questioned 100 patients to resolve this issue.

55% of patients were made worse by bran. 10% found it helpful. All symptoms of irritable bowel syndrome were exacerbated by bran, with bowel disturbance most often adversely affected, followed by abdominal distension and pain. They are also concerned that encouraging bran consumption might be creating new cases of irritable bowel. So that seems clear enough. Wholemeal wheat and bran should be eaten in moderation and should not be used by people who already have symptoms of IBS.

But what does work then?

Dr Whorwell and his colleague Dr Prior ran a controlled trial of ispaghula husk in 80 patients with IBS. Ispaghula is also known as psyllium husk. This was found to work for 82% of patients taking ispaghula and 53% of the placebo group who took something with no active ingredient, so this means it really does make a difference. Bowel habit was unchanged in the placebo group, while constipation significantly improved in patients taking ispaghula.

Transit time decreased significantly in those taking ispaghula, especially in patients with initially slow transit time. Abdominal pain and bloating improved in both groups, with no significant differences between ispaghula and placebo.

Ispaghula significantly improves overall well being in patients with irritable bowel syndrome, and in those with constipation favourably affects bowel habit and transit time. So that is clear too. IBS sufferers should try psyllium husk.