Worked example by condition

PIP answers for irritable bowel syndrome (IBS)

A worked example showing how the 12 PIP activities can be described for someone living with irritable bowel syndrome. Every answer is written in the first person, in the plain wording assessors look for, and each one weaves in the reliability factors that decide how an activity scores.

How IBS affects a PIP claim

IBS is easy to undersell on a form because the name sounds so ordinary. Most people have had an upset stomach, so the words "irritable bowel" on their own tell an assessor very little. What they can actually mean is cramping pain that bends you double and often only eases once you have been to the toilet, bloating that leaves your stomach tight and swollen by the evening, spells of constipation and straining, diarrhoea that arrives with barely a minute's warning and a tiredness that hangs on after a flare. Underneath all of it sits the constant question of where the nearest toilet is. IBS is not the same as Crohn's disease or ulcerative colitis. There is no inflammation or visible damage to the gut and no single test that shows it, and the tests you have had were mainly to rule other things out, which can leave you feeling you have to justify symptoms that are very real. If you have been diagnosed with inflammatory bowel disease instead, our worked example for Crohn's and colitis will fit you better. Bleeding from the bottom and unexplained weight loss are not typical of IBS, and the NHS advises getting them checked urgently rather than putting them down to it.

IBS comes and goes. There are better days and there are flare-ups, sometimes set off by food, stress or anxiety and sometimes by nothing obvious at all, and the better days are not the test. An activity only counts as something you can do if you can do it safely, to an acceptable standard, repeatedly and in a reasonable time. If you start cooking but have to leave a pan on the hob to rush to the toilet, if you spend forty minutes on the toilet straining in pain or if you can only leave the house after hours of planning and a dose of loperamide, then you cannot reliably do it, and that is what your answers need to show. The same goes for anything you can manage on two days a week but not the rest.

Two habits make an IBS form far clearer. The first is to count: how many times you open your bowels on a normal day and in a flare, how much warning you get, how often you do not make it, how long a flare lasts and how often it comes back. Keeping a simple diary for a couple of weeks before you fill in the form turns guesses into honest numbers. The second is to put each difficulty under the right question. Accidents and pads belong under using the toilet. The fear that stops you setting off belongs under planning and following a journey. Avoiding people because of wind, noises or the risk of an accident belongs under mixing with other people. An assessor can only take account of what you write down, so there is nothing to be gained by being polite about it. The example below shows how, activity by activity. The DWP always makes the final decision, but describing your day accurately gives your form the strongest chance of being understood.

How your health condition affects youPIP2 · Q7
7. Using the toilet and managing incontinence
Does your condition affect you using the toilet or managing incontinence? (Put a cross in one box below)
✓ Yes
Tell us about the difficulties you have using the toilet and how you manage them.
My IBS affects my bowels every day and I cannot manage my toilet needs reliably without incontinence pads. Most mornings I have to rush to the toilet three or four times in the first couple of hours, with cramping pain low in my stomach that bends me over and only eases once I have been. When the urge comes I get a minute or two of warning at most, and on about three days a week I do not make it in time, usually first thing or straight after eating. Because of that I wear pads every day and keep wipes, spare underwear and a change of trousers in a bag by the door. I have a flare every two or three weeks that lasts from a few days to over a week, and then I can be going eight to ten times a day, often passing mucus. The skin around my bottom gets so raw from wiping that I have to rinse with the shower head instead of using paper. In between I get spells of constipation where I sit on the toilet for thirty or forty minutes straining in pain and still feel I have not finished, which leaves me shaky and worn out for the rest of the morning. Without the pads, wipes and spare clothes I could not manage this to an acceptable standard, and on constipation days it takes me far longer than a reasonable time even with them.
★ Suggested descriptor · 7b · 2 points
Pads count as an aid for this activity. Give the number of trips on a normal day and in a flare, the warning you get and how often you do not make it in time.
How your health condition affects youPIP2 · Q13
13. Planning and following a journey
Does your condition affect you planning and following journeys? (Put a cross in one box below)
✓ Yes
Tell us more about the difficulties you have with planning and following journeys and how you manage them.
I know my way around and I can work out a route, but because of my IBS and the anxiety disorder my GP diagnosed alongside it, I cannot set off on a journey unless someone encourages me out of the door and comes with me. The problem is never finding the way. It is the fear of being stuck somewhere without a toilet. I have had an accident on a train and another in a supermarket queue, and since then the anxiety starts the night before any trip. My stomach churns, the cramps build and I am back and forth to the toilet before I have even left, which only makes the fear worse. I look up every toilet on the route in advance. I carry a RADAR key and a Just Can't Wait card, and I take loperamide before I go. I will not get on a bus at all because there is no toilet and I cannot get off when I need to. I only use trains that have one and I sit in the carriage next to it. If it is out of order I get off at the next station. On most days, if my partner is not there to talk me round and come with me, I cancel. Last month I got as far as the station twice and went home both times when the panic got too much. A fifteen minute trip to the shops takes hours of planning, and in a typical month I get there perhaps three or four times. Without someone to prompt me and go with me the distress is overwhelming, and I could not make any journey repeatedly.
★ Suggested descriptor · 13b · 4 points
This activity is about setting off and completing a journey, not about walking. If a doctor has diagnosed anxiety alongside your IBS, name it here, then say who has to prompt you, how often you cancel or turn back and what happened on the trips that went wrong.
The other activities

What to cover for each one. Your paid form writes the full answers for you.

Q3

Preparing food

What to mention

Describe what happens when cramps or urgency hit partway through cooking: a pan left on the hob or the oven left on while you rush to the toilet is a real safety risk, and so is standing bent over the worktop in pain. Mention how often you abandon a meal half made, whether the exhaustion after a flare leaves you living on things that need no cooking and any perching stool you use. Following a careful diet is not a cooking difficulty on its own, so keep the focus on whether you can safely prepare a simple meal on your worst and most common days.

Q4

Eating and drinking

What to mention

This question is about getting food and drink into you once it is ready, including remembering or being encouraged to eat, not about which foods you can tolerate. What can count is the fear of setting off symptoms being so strong that you go most of the day without eating or stop eating before any outing, and somebody has to encourage you to eat at all. If you eat normally once a meal is in front of you, even on a restricted diet, leave this one alone.

Q5

Managing your treatments

What to mention

List what you actually take and when, such as antispasmodics or peppermint oil before meals, loperamide timed around going out, laxatives such as fibre sachets and any low-dose antidepressant your GP has prescribed for gut pain, and say whether you manage it all reliably on your own. If anxiety, low mood or tiredness mean you forget doses or get muddled switching between medicines for diarrhoea and for constipation, describe who reminds you or keeps an eye on it. Many people with IBS manage their own medicines, and if that is you, an honest answer is the right one.

Q6

Washing and bathing

What to mention

If you have accidents, describe what they mean for washing, such as cleaning your whole lower body straight away however tired or sore you are, and say roughly how often that happens in a week. Mention skin around your bottom made raw by frequent diarrhoea, any shower head, bidet attachment or help you need to get properly clean and how long it all takes. If you can wash normally the rest of the time, say so, so the assessor sees exactly where the difficulty lies.

Q8

Dressing and undressing

What to mention

Most people with IBS can physically dress, so be honest if that is you. What can count is needing help when cramps leave you bent over and unable to reach your feet, or dressing taking far longer because you have to stop and rush to the toilet partway through. It also helps to explain why you now only wear loose, elasticated clothes, because a waistband pressing on a bloated stomach is too painful.

Q9

Talking, listening and understanding

What to mention

IBS does not affect your speech or hearing, so for most people this is an honest no. The only thing that might belong here is pain or exhaustion in a flare that leaves you unable to follow what a doctor or nurse is telling you, so that somebody has to come to appointments to take it in for you. Having to leave a conversation to get to a toilet is not a talking difficulty; put that under mixing with other people instead.

Q10

Reading

What to mention

Reading is very rarely affected by IBS, and if you can read and understand letters, labels and signs, say so plainly. If constant pain, broken sleep or the anxiety that often travels with IBS means you cannot take in a hospital letter or a form without someone going through it with you, describe that honestly. Keep it about understanding written information, not eyesight.

Q11

Mixing with other people

What to mention

Describe how the fear of wind, stomach noises, smells or an accident in front of other people has made you pull away from people, including friends and family. Mention the encouragement or company you need before you will meet anyone, how many plans you have dropped recently and whether you now only see people in your own home, near your own toilet. Keep this about being with people, not about the journey to reach them.

Q12

Managing money

What to mention

IBS does not usually change your grasp of bills, prices or budgeting, so this is often an honest no. What can count is anxiety or low mood alongside your IBS that means post goes unopened and bills are missed, or relying on a partner to check your account because pain and exhaustion stop you keeping track. Describe that support if it is real, and leave this one alone if money is fine.

Q14

Moving around

What to mention

Most people with IBS have no physical limit on how far they can walk, and if that is true for you, say so. If cramping pain in a flare stops you after a short distance and you have to stand bent over or sit before you can go on, give the distance and how long you need before you could walk it again. Fear of being too far from a toilet belongs under planning and following a journey, not here, because this question is only about the physical act of walking.

Your own answers, for every activity

The tips above are general pointers. Your paid form gives you a full, ready-to-copy answer for all 12 activities, written from your exact conditions, medication, aids and bad days, not a general example. This is a worked example for IBS; yours is written for you. £99.99 one-off.

How to use this example

This is a worked example, not a script. It shows one honest way a person with IBS might describe their flares and their worst days, so you can see the level of detail and the plain wording that assessors are trained to look for. Please do not copy it word for word. Your own answers should reflect your IBS, whether it is mostly diarrhoea, mostly constipation or a mix of both, your worst and most common days, the aids you actually use and the help you actually need or go without, because that is what the assessment is about and that is what makes an answer ring true.

Notice that not every activity has to be claimed. Being honest about what IBS does not change makes the difficulties you do describe more believable, so there is no need to stretch every question. If you would rather start from your own words, tell us about your health and we will write your answers from your own conditions, in the same first-person style, ready for you to read, edit and copy onto your PIP2 claim form or AR1 review form.

K
Karol Slusarczyk
Founder, FillMyPIP · t/a Benefits Expert · ICO:00014179042

I have spent years helping people describe their conditions accurately on PIP forms, and I built FillMyPIP from that experience. I wrote this worked example to show, honestly, the kind of detail and wording that helps an assessor understand a real day with IBS. I am not a solicitor, a doctor or a DWP employee, and this is guidance, not legal or medical advice.

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