IBS Symptoms, Diagnosis and Treatment

By Sally Wadyka. Medically reviewed by Tom Iarocci, MD. May 7th 2016

Your digestive troubles probably start in the large intestine and manifest as bloating, gas, inflammation and other disorders of the gastrointestinal tract. Irritable bowel syndrome (IBS) is one of the most common of these gastrointestinal (GI) disorders, affecting up to 45 million people in the U.S.

Although the condition may disturb anyone, it is more common in women — two-thirds of those affected are female – and often begins in teenage or young adult years, according to the International Foundation for Functional Gastrointestinal Disorders. 

Insults are occurrences that cause damage to a tissue or organ. “For some people there is likely a genetic predisposition to develop IBS, but then one insult, or a series of [digestive] insults, must occur,” says Brian E. Lacy, PhD, professor of medicine at Geisel School of Medicine at Dartmouth-Hitchcock Medical Center in Lebanon, N.H. "This could be an infection, inflammation, stress, trauma or surgery. Then, in the right setting, IBS symptoms may develop."

Distressing Symptoms of IBS

Signals of IBS may come and go; change over time; and occur in clusters. Potential indicators of the condition include:

  • Abdominal pain, including dull cramping or sharp pains;
  • Changes in bowel movements (including diarrhea, constipation and changes in stool consistency);
  • Bloating;
  • Heartburn;
  • Nausea;
  • Feeling too full; and
  • Urgent need to use the bathroom.

For most, IBS symptoms often improve after having a bowel movement. However, new evidence shows that women’s experiences with IBS can also be temporarily affected by monthly hormonal shifts related to their menstrual cycles as symptoms may intensify during their periods. Research shows that women are also much more likely to seek treatment for these issues.

Warning: It’s important to note that seeing blood in your stool is not an IBS symptom. Rather, it may be a side effect of something more serious, so let your doctor or health care provider know as soon as possible.

How Do You Diagnose IBS?

Unfortunately, there is no one simple test that can definitely tell you whether or not you’re suffering from IBS. Your doctor will look at a detailed history of your symptoms, as well as your overall health history and perform a thorough exam. “Most of the time, that will secure a diagnosis,” says Lacy.

Any diagnostic tests that may be performed (e.g., blood work, stool analysis and colonoscopy) are normally done to rule out other conditions, such as Celiac disease and inflammatory bowel disease. 

Interestingly, past criteria for IBS was gender-neutral, according to the International Foundation for Functional Gastrointestinal Disorders, which may have led to missed diagnoses in the past. For example, abdominal distension (i.e., abdominal swelling) is a much more common symptom of IBS in women and should be reflected in any prognosis or detailed medical history. Hormones clearly play a larger role in IBS for women, says Lacy.  

Next Steps

Once you’ve received a diagnosis of IBS, you’ll want to work closely with your doctor. Various people experience IBS and respond to treatments very differently. There is no actual cure for this condition, but it is highly treatable, Lacy says. 

Lifestyle modifications are your first line of defense since diet, as well as stress factors, can be major triggers:

  • Keep track of foods that seem to worsen your symptoms and work on techniques to help alleviate daily stress (e.g., yoga, meditation and quiet time).
  • Maintain a daily journal of food intake and symptoms to establish patterns of digestive symptoms, and then be sure to communicate them to your doctor.
  • Medications can be prescribed to treat some symptoms of IBS, such as laxatives, antispasmodics for abdominal pain and antidiarrheal agents. Many patients will need to use these only occasionally when symptoms flare up.
  • Another approach is probiotics. Since “bad” bacteria in the stomach may be partly to blame, ingesting probiotics (i.e., “live beneficial” bacteria) can help reduce symptoms. Lacy adds, “Antibiotics that target bacteria in the gut may also be used.”
  • Antidepressants are often prescribed for the treatment of IBS, and there are several reasons why they help manage the condition. “These compounds may help block muscle spasms and slow GI transit,” explains Lacy. “Plus, they also help with pain and may relieve co-existing anxiety and depression.”    

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