4 Common IBS Symptoms You Should Know About, According to Experts
The symptoms you experience depend on the type of IBS you have.
Irritable bowel syndrome (IBS), a group of symptoms that occur together, is fairly common. It's estimated that about 12% of people in the US have this disorder of the large intestine. While IBS symptoms vary from person to person, there are hallmark symptoms associated with the condition.
"The most common symptoms of IBS are pain, change in bowel habits, bloating, diarrhea, constipation, and gas," Lisa Ganjhu, DO, from the division of gastroenterology and hepatology at NYU Langone Health, tells Health.
Here's a closer look at the different IBS symptoms.
What are the main IBS symptoms?
Abdominal (belly) pain is the most common IBS symptom, according to the International Foundation for Gastrointestinal Disorders (IFFGD). In someone who doesn't have IBS, the gut and brain work in harmony to manage digestion, relying on hormones, nerves, and signals from the gut's good bacteria. But with IBS, the signals don't work as they should, causing cramping in the digestive tract muscles.
People with IBS most often report pain in their lower abdomen, but it can be felt anywhere in the belly, the IFFGD explains. It may worsen shortly after eating, potentially lessening after a bowel movement (though some people find it gets worse after going to the bathroom).
To treat pain associated with IBS, doctors take into account the severity of the pain as well as how the pain impacts the person's daily life. Antispasmodic drugs may help to alleviate belly pain by targeting and relaxing the smooth muscles of the digestive tract, according to The IBS Network. Diet modifications, such as a diet low in FODMAPs (types of carbohydrates found in certain foods, including wheat and beans), may also improve pain, per the American Society for Gastrointestinal Endoscopy (ASGE).
There are different types of IBS, each based on the change in bowel movements a person with IBS experiences. "IBS is categorized into four main subtypes: IBS with constipation (IBS-C), IBS with diarrhea (IBS-D), IBS with mixed symptomatology (IBS-M), and unclassified IBS," James J. Lee, MD, a gastroenterologist at Providence St. Joseph Hospital in Orange, California, tells Health.
Of these IBS-related changes in bowel habits, constipation is the one that's most common, Dr. Lee says. That's because IBS is more common in women and, of the IBS subtypes, women are more likely to present with IBS-C.
With IBS-C, on days when you have at least one abnormal bowel movement, more than a quarter of your stools are hard or lumpy and less than a quarter of your stools are loose or watery, per the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Practitioners use the Bristol Stool Chart, which divides stool into seven types, to help identify IBS subtypes, according to Dr. Lee. "People with IBS-C have type 1 (separate, hard lumps like nuts, which are hard to pass) and type 2 (sausage-shaped but lumpy) stools," he explains. "Typically, they have bowel movements less than three times a week."
An important note: The constipation that comes with IBS is different from "functional" constipation, which is chronic constipation not caused by another disease, the IFFGD explains.
To help relieve constipation that's being caused by IBS, the ASGE recommends dietary modifications, like the low-FODMAP diet; probiotic products; and lifestyle modifications, like improving sleep habits, getting regular exercise, and reducing or avoiding alcohol and tobacco products.
With IBS-D—another one of the four subtypes of IBS—diarrhea is the predominant symptom (together with pain). This can result in a sudden, immediate urge to have a bowel movement, which can be a huge source of stress. Also, the stool tends to be loose and watery and may contain mucus, per the ASGE.
To fit the diagnostic criteria for IBS-D, on days when you have at least one abnormal bowel movement, more than a quarter of your stools are loose or watery and less than a quarter of your stools are hard or lumpy, according to the NIDDK.
Referring to the Bristol Stool Chart, Dr. Lee explains that people with IBS-D have type 6 (mushy consistency with ragged edges) and type 7 (liquid consistency with no solid pieces) stools. He adds that people with diarrhea as a symptom of IBS frequently have more than three bowel movements per day.
The ASGE recommends lifestyle modifications, psychosocial therapy, and medications to treat IBS-D. Dietary changes can also make a big difference. Although there are no specific tests to identify what foods trigger symptoms, people with IBS-D often find that foods containing lactose or gluten are problematic and that avoiding those can provide some relief.
Bloating and gas
Bloating and gas are bothersome symptoms of IBS. Past research has suggested that bacteria may be behind these symptoms. Some experts think that excess gas within the gut of patients with IBS causes bloating, according to the IFFGD. Patients with IBS might have this excess gas because their bodies have a harder time transporting the gas.
Since IBS is associated with the retention of gas and bloating, making dietary changes—such as cutting down on gas-producing foods like beans, cabbage, broccoli, and raisins—might provide some relief, per the IFFGD. Having fewer carbonated and alcoholic drinks can also help with bloating and gas, the Mayo Clinic says.
How do you know if it's IBS that is causing these symptoms?
There's no test to definitively diagnose IBS. Instead, your doctor will ask about your IBS-like symptoms and their patterns. Because it's the most common IBS symptom, abdominal pain is a key factor in diagnosis, Dr. Ganjhu explains. And so, according to the NIDDK, a doctor might diagnose you with IBS if you have pain in your abdomen along with two or more of the following symptoms:
- Your pain is related to your bowel movements.
- You notice a change in how often you have a bowel movement.
- You notice a change in the way your stools look.
Typically, to be pinned on IBS, these symptoms had to have first started at least six months ago and have happened at least once a week in the last three months, per the NIDDK. "Your doctor may diagnose IBS even if you've had symptoms for a shorter length of time. You should talk to your doctor if your symptoms are like the symptoms of IBS," according to the NIDDK.
How do you treat IBS symptoms?
"Treatment is targeted towards the main symptoms of IBS, based on its subtypes, after considering and ruling out other causes such as cancer, inflammatory bowel disease, infection, medication-induced [symptoms], gluten sensitivity, bacterial overgrowth, and endocrine causes (to name a few)," Dr. Lee says.
There's no cure for IBS, but managing stress and making changes to your diet and lifestyle may be enough to relieve symptoms in people with mild IBS, the Mayo Clinic reports.
If you have more severe IBS symptoms, the Mayo Clinic says your doctor might prescribe fiber supplements, laxatives, anti-diarrheal meds, or anticholinergic meds for painful bowel spasms. Medications approved for certain people with IBS include the antibiotic rifaximin (Xifaxan), which can decrease bacterial overgrowth (an overgrowth of bacteria in your intestine is believed to worsen IBS); eluxadoline (Viberzi), which decreases muscle contractions and fluid secretion in the intestine; and alosetron (Lotronex), which relaxes the colon and slows the movement of stools through the lower bowel.
But every patient's treatment plan is highly individualized, and it can take time to find the right combination of drugs and lifestyle modifications. All the while, keeping your doctor in the loop about your symptoms is key.
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