Everyone experiences the discomfort of constipation or diarrhea at some point. Constipation could simply be the result of not eating enough fiber, while diarrhea could be caused by consuming foods you’re allergic to or overusing laxatives.
But if you’re experiencing diarrhea, constipation or both on a chronic basis, you may be dealing with irritable bowel syndrome, or IBS. Typically marked by gut pain or discomfort, IBS is a common disorder that affects the intestines and can manifest in different ways.
What Is Irritable Bowel Syndrome?
IBS is a common gastrointestinal disorder that occurs when there’s dysfunction in the way the brain and gut communicate.
Your gastrointestinal tract is covered with nerves that detect what’s in your GI tract and help move its content through your bowels. If that brain-gut connection is impaired, you might receive incorrect signals to the brain, causing the GI tract to move too quickly or slowly, resulting in symptoms such as bloating, constipation or diarrhea.
About 40% of all referrals to gastroenterologists are related to IBS, according to research published in the Journal of Clinical Medicine.
[Read: Common Causes of Lower Right Abdominal Pain]
[SEE: Top Pharmacist-Recommended Stomach and GI Products.]
Types of IBS
IBS is characterized by the predominant symptoms you’re experiencing, including:
— IBS-C. If you have IBS with constipation, you experience hard stools and may have difficulty passing bowel movements regularly.
— IBS-D. If you have IBS with diarrhea, you regularly experience loose stools and a frequent and urgent need to empty your bowels.
— IBS-M. IBS with mixed bowel habits involves a combination of symptoms, including both constipation and diarrhea. To be diagnosed with IBS-M, more than a fourth of your stools should be hard or lumpy and more than a fourth should be loose or watery.
— IBS-U. IBS with undefined bowel habits is a subtype that doesn’t neatly fit into the other three diagnostic categories, as you may have inconsistent and unpredictable symptoms over time.
IBS vs. IBD
IBS may be easily confused with Crohn’s disease or ulcerative colitis, which — unlike IBS — are both forms of inflammatory bowel disease, or IBD.
IBS and IBD are vastly different, confirms Dr. Christine Lee, a gastroenterologist at Cleveland Clinic.
“IBS, or irritable bowel syndrome, is when your bowels are structurally normal but function in a spastic way — motility is awry, causing havoc of symptoms,” Lee explains. “IBD, or inflammatory bowel disease, is an autoimmune disease of your intestines, and objective inflammatory changes or ulcerations can lead to significant damage and can increase your risk for cancer.”
[READ Ulcer Diet: Foods to Eat and Avoid]
Causes of IBS
What precisely causes IBS isn’t known.
These factors, however, could play a role:
— Muscle contractions in the intestine. The walls of the intestine are lined with layers of muscle that contract as they move food through your digestive tract. Contractions that are stronger and last longer than normal can cause gas, bloating and diarrhea. Weak intestinal contractions, on the other hand, can lead to hard, dry stools.
— Nervous system abnormalities. Abnormalities in the nerves of your digestive system may cause greater than normal sensitivity or discomfort when your abdomen stretches from the presence of gas or stool.
— Inflammation in the intestines. Some people with IBS have an increased number of immune system cells in their intestines. This immune system response is associated with pain and diarrhea.
— Severe infection. IBS can develop after a severe bout of diarrhea, or gastroenteritis, caused by bacteria or a virus. IBS might also be associated with a surplus of bacteria in the intestines.
— Changes in the bacteria in the gut. Your gut microbiome, or community of microorganisms like bacteria within the gastrointestinal tract, influences digestion and plays a key role in immunity and overall health. Research suggests that the balance of “good bacteria” in people with IBS might differ from those without the condition.
Signs and Symptoms of IBS
IBS signs and symptoms include:
— Constipation
— Diarrhea
— A change in stool frequency
— Alternating constipation and diarrhea
— Abdominal pain or cramps
— Mucus in the stool
— Gas and bloating
— Pain with bowel movements
— A change in stool form or appearance
If you’re experiencing these symptoms, especially if symptoms are persistent or severe, you should be evaluated by a health care professional.
[SEE: Staying Regular on Vacation: 11 Secrets from Frequent Travelers]
Risk Factors for IBS
IBS can occur at any stage of life, but it is more common in women. People under 50 are also more likely to develop the condition than those over 50, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
GI tract infections can be risk factors, but not everyone who experiences a GI infection will get IBS.
IBS also tends to be more common in patients with a history of:
— Anxiety
— Stressful or difficult events in childhood
Having a family member who has IBS may increase your chances of having the condition as well.
IBS Triggers
Symptoms of IBS can be triggered by a number of factors, including:
— Hormonal changes, such as during a woman’s menstrual cycle
— Taking a strong course of antibiotics
— Following a bout of infectious gastroenteritis
— Certain foods, such as spicy or greasy foods, processed foods, alcohol or dairy
— Significant narcotic pain medication exposure. Pain medications can slow the colon’s motility, or ability to move things along the digestive tract and function properly, Lee says.
Diagnosing IBS
There’s no widely accepted lab exam, like a blood test, that can diagnose IBS. Rather, clinicians rely on the Rome IV criteria for diagnosing the condition. Under this criteria, a person who experiences recurrent abdominal pain and changes in bowel habits at least one day per week during the previous three months could have IBS.
Your doctor will first evaluate your symptoms, discussing how long they’ve occurred, their severity and any patterns. They may perform a physical examination, checking for abdominal tenderness or bloating, for example, that could indicate issues within your GI tract.
“IBS is a diagnosis of exclusion,” says Dr. Hardeep M. Singh, a gastroenterologist with Providence St. Joseph Hospital in Orange, California. “Routine labs should be done to assess for signs of inflammation, bleeding and infection. Other diseases should be ruled out, such as thyroid issues or celiac disease.”
Your health care provider may conduct certain tests to determine if your symptoms are caused by a condition other than IBS, such as those above as well as colon cancer, colitis, Crohn’s disease or an infection.
These tests could include:
— Endoscopy or colonoscopy
— Abdominal ultrasound
— CT scans or MRIs
— Barium studies, which are a type of imaging test to examine the GI tract
— Blood tests
— Stool tests
— Breath tests
Complications of IBS
IBS doesn’t shorten your life or cause physiological issues, such as inflammation or bleeding, Singh says.
However, it can affect your sense of well-being and quality of life.
IBS Treatment
There’s no cure for IBS, but there a number of treatment approaches that can be effective in managing symptoms.
Treatment and management options include:
— Anti-diarrheal medications. Some antispasmodic drugs can help alleviate diarrhea and cramps.
— Probiotics. Probiotics are live microorganisms that can help your body’s digestive system maintain a healthy balance of bacteria. They can be found in some foods, such as fermented foods, and are available as over-the-counter supplements. They can sometimes help with gas, bloating and diarrhea.
— Antibiotics. Specific types of antibiotics can help some people with IBS target and reduce “bad bacteria” in the gut, according to the International Foundation for Gastrointestinal Disorders.
— Stress reduction. Seeing a trained therapist or trying medications for depression or anxiety could help alleviate IBS symptoms for some people.
— Exercise. Research published in the American Journal of Gastroenterology suggests that people who participated in physical activity had fewer IBS symptoms than those who did not exercise.
[READ: 10 Reasons Your Stomach May Be Hurting.]
IBS and Diet
You are what you eat — and that’s especially true when it comes to IBS.
Food and nutrition tips for managing IBS include:
— Follow a low FODMAP diet. FODMAPs — which stand for fermentable oligosaccharides, disaccharides, monosaccharides and polyols — are short-chain carbohydrates that can cause digestive distress in some people. A low FODMAP diet is an elimination-style diet that limits or cuts out foods high in FODMAPs, such as onions and garlic, wheat and rye food products, legumes and lactose, which is found in yogurt and milk.
— Eat more fiber. If constipation is an issue, consuming fiber can help soften your stool and make it easier to pass. Dietary fiber, in general, promotes overall digestive health, acting as a prebiotic to nourish “good bacteria” in the gut.
— Limit processed and fatty foods. Greasy foods loaded with unhealthy fats can worsen IBS symptoms for many people. High-fat foods can also slow down digestion and increase inflammation, contributing to symptoms like bloating, gas and abdominal pain.
— Practice portion control. Overeating large portions at once can exacerbate symptoms of IBS.
Keeping a food diary can help you identify problem foods and guide your treatment options.
More from U.S. News
How to Tell You Have a Hernia? Signs and Symptoms
Best and Worst Foods to Eat for an Upset Stomach, According to Dietitians
Food Poisoning: Prevention, Symptoms and Treatment
A Patient’s Guide to Irritable Bowel Syndrome originally appeared on usnews.com
Update 10/28/24: This story was previously published at an earlier date and has been updated with new information.
