IBS

Do you have ongoing gut problems—abdominal cramps with bouts of diarrhea or constipation—without a known cause? You could have irritable bowel syndrome.
By Stephanie Booth
Updated September 16, 2021

Do you have ongoing gut problems—abdominal cramps with bouts of diarrhea or constipation—without a known cause? You could have irritable bowel syndrome.

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What is it?

Irritable bowel syndrome  (IBS) is a chronic condition that affects how your gastrointestinal system functions. Because 100 million nerve cells in your gut communicate back and forth with your brain, IBS is often also referred to as a gut-brain disorder.

People with IBS have especially sensitive nerve endings in their bowel walls. If those nerve endings get irritated, you can see symptoms like bloating, cramping, and gas, and abrupt changes to your bathroom habits that can be inconvenient at best and painful at worst.

Anyone, at any age, can have IBS, but women under the age of 50 are at higher risk. At least part of the reason may be due to monthly changes in female hormones, which can affect bowel function. (If you have IBS, you may notice that your symptoms get worse around your period.)

Although IBS isn't life-threatening and doesn't lead to more serious G/I conditions, getting diagnosed and treated can help you manage your symptoms and not let them get in the way of your life.

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Types

People with IBS may be symptom-free and have completely normal bowel movements on some days. What happens on the other days is what determines the type of IBS you have.

If you have IBS-C (IBS with constipation), you'll have mostly lumpy and hard stools, or fewer than 3 bowel movements a week. Straining or feeling like your bowel's not completely emptying are also signs of IBS-C.

People with IBS-D (IBS with diarrhea), have mostly loose, watery stools. That may be due to overactivity of your gut muscles — when they move faster than normal, your intestine doesn't have a chance to absorb water from your food. Occasionally, some people can also get IBS-D after having a gut infection.

IBS-M (IBS with mixed habits) means that you experience both hard, lumpy stools and loose, watery stools, maybe even on the same day.

As awkward as it may be, it's important to share details about your bathroom experiences with your doctor. They'll decide the best treatment for you based on the type of IBS you have.

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Symptoms 

IBS symptoms typically come and go. But when a flare hits, you could experience any of the following:

  • Abdominal pain and/or cramps (often in your lower belly).
  • Bloating.
  • Bowel movements that are harder or softer than usual.
  • Changes in how often you have a bowel movement.
  • Diarrhea, constipation, or alternating between both.
  • Feeling like you can't finish a bowel movement.
  • Feeling heavy or full in your belly.
  • Gas.
  • Whitish mucus in your stool.

Although many women notice symptoms ramp up during their period, IBS symptoms can also be completely unpredictable.

The severity of symptoms can also vary. Some people only have mild symptoms. Others have intense pain or an urgency to get to the bathroom that impacts their entire day.

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Causes

There's no single cause of IBS. A combination of things is likely responsible, and they can differ from person to person. Some factors that could be at play include:

  • Your genes. You're two to three times more likely to have IBS if a family member has it.
  • How quickly or slowly food moves through your gut. Your intestinal walls are lined with muscles that squeeze food through. Overly strong or long contractions can cause gas, bloating, and diarrhea. Weak contractions result in hard, dry stools.
  • Food intolerances or sensitivities. Many people with IBS feel worse after eating certain foods, although which kinds are different for everyone.
  • A gut infection. For instance, sometimes a virus or bacterial infection that causes severe diarrhea can bring on IBS.
  • Your gut health. People with IBS may have different bacteria in their gut than people who don't have this condition.
  • Your mental health. It's common for IBS symptoms get worse when you're under a lot of stress.
  • Childhood trauma. People who've had a traumatizing experience early on in life are more likely to have IBS.

IBS symptoms often get worse when you're under a lot of stress. That doesn't mean that your mental health causes IBS, just that it can trigger a flare.

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Diagnosis

Your doctor will do a physical exam and ask questions about:

  • Your overall health, including other problems you've had.
  • Any family history of G/I conditions.
  • Medications and supplements you take.
  • Any recent illness or infections.
  • Recent stressful events.
  • What your diet is usually like.
  • Your current symptoms.

Since there isn't a specific test that confirms IBS, your doctor may go ahead and diagnose you if you have abdominal pain and at least two of the following are true:

  • You've noticed a change in the frequency of your bowel movements.
  • You've noticed that your stool looks different.
  • Your pain shares a connection to your bowel movements (for instance, it gets worse after you go).

Your doctor could also order additional lab tests or procedures to rule out other G/I issues.

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Treatment 

There's no cure for IBS, but your doctor can suggest ways to keep your symptoms from flaring — or relieve them once they do. Some things that could help include:

Medication. Based on your symptoms, your doctor could suggest:

  • IBS medications that regulate how your large and small intestine function.
  • Over-the-counter products like fiber supplements, probiotics, or peppermint. capsules.
  • Laxatives.
  • Anti-diarrhea products.
  • Drugs that stop bowel spasms.
  • Antidepressants (A low-dose can help reduce pain and general IBS symptoms).
  • Pain medication.

Avoiding foods that trigger your symptoms. For instance, some people with IBS feel better if they skip foods with gluten or carbonated drinks. Others notice an improvement on a low FODMAP diet. (FODMAP = Fermentable oligosaccharides, disaccharides, monosaccharides and polyols. They are certain carbs found in a variety of foods like cow's milk, chickpeas and lentils, and some fruits and veggies.)

Counseling. Cognitive behavioral therapy (CBT) is a type of therapy that helps you become more aware of negative thought patterns so you can better cope with stressful situations. Studies show that CBT can help improve not just the physical symptoms of IBS, but your overall quality of life.

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Prevention

To try to stave off a flare:

Eat foods that are gentle on your gut. For many people with IBS that can mean:

  • Chicken, turkey, and fish.
  • Cooked veggies (instead of raw).
  • Low-fat yogurt.
  • Egg whites.
  • Gluten-free oatmeal and brown rice.

Foods that could set off your IBS symptoms include:

  • High-fiber foods.
  • Gas-producing foods (like broccoli, cauliflower, and beans).
  • Fried foods.
  • Caffeine.
  • Spicy foods.

Get on a schedule. Try not to skip meals or go too long without eating. It's best for your bowel to have regular meals and snacks.

Stay hydrated. To keep things moving smoothly, aim for 8 glasses of H20 or other non-caffeinated or non-alcoholic drinks each day.

Find ways to manage your stress. Regular exercise or listening to music can help calm your nerves. You may also want to experiment with meditation or deep breathing exercises.

Think ahead. If you live with IBS, it's a good idea to always be prepared for a flare, especially if you're traveling. Keep medication on hand. You can also download an app that points you towards the nearest public bathroom.

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