Irritable Bowel Syndrome: Everything You Need to Know About IBS
Medically Reviewed by Madeline Hubbard, RN, BSN
Irritable bowel syndrome is a common disorder of the gastrointestinal tract that impacts the large intestine. It typically begins in late adolescence or adulthood, and, although it impacts people of all genders, it is twice as likely to affect women than men. Often referred to as IBS, the syndrome can cause intestinal discomfort and other uncomfortable symptoms, but it’s not clear if IBS causes permanent damage to the gastrointestinal (GI) tract or colon. Typically, careful management of one’s diet, stress levels, and lifestyle can improve the symptoms associated with irritable bowel syndrome.
What Is IBS?
Irritable bowel syndrome is not a disease — rather, it’s a collection of symptoms that occur concurrently. IBS is categorized by a change in gastrointestinal (GI) tract function, making it a functional gastrointestinal tract disorder. Functional GI disorders produce frequent symptoms but do not cause lasting damage to the GI tract. IBS should not be confused with IBD, otherwise known as inflammatory bowel disease. People with IBS have structurally typical bowel tissue, while those with IBD do not.
What Causes IBS?
The distinct cause of irritable bowel syndrome is unknown. Healthcare professionals believe the cause may be a combination of environmental, physical, and genetic factors. Furthermore, it is possible that the connection between the brain and the gastrointestinal system, also known as the brain-gut interaction, plays a role in this disorder.
Conditions associated with IBS include:
- Motility changes in the GI tract, including spasms
- Hypersensitivity of the bowels
- History of psychological problems such as anxiety, depression, PTSD, and panic disorder
- Infection in the stomach caused by bacteria
- An overgrowth of otherwise normal bacteria in the small intestine, known as SIBO
- A change in hormones during menstruation, menopause, or ovulation
- Sensitivity to certain foods
- Stressful events, including trauma or abuse
Symptoms Associated With IBS
The symptoms associated with IBS can range from mild to severe, with the majority of patients experiencing mild to moderate symptoms. Symptoms vary greatly from patient to patient, so while some individuals will experience cyclical symptoms that worsen over time only to dissipate for a while, others will experience symptoms on a more consistent basis.
Symptoms of irritable bowel syndrome may include:
- Pain or cramping in the abdomen
- Weight loss
- Gas and bloating
- Feeling of fullness
- Abdominal pain
- Bleeding from the rectum
- Loose or watery stools
- Bouts of diarrhea followed by constipation or vice versa
- Difficulty controlling bowel movements
Predominately, individuals with IBS experience constipation, or diarrhea, or a mix of both gastrointestinal symptoms.
Risk Factors & Triggers
While there is no distinct cause for IBS, certain risk factors may predispose a person to developing the symptoms associated with this condition. These include:
- Age: Most people experience the first symptoms of IBS under the age of 50.
- Assigned Sex at Birth: IBS occurs more commonly in females than males. Menopausal people who are on an estrogen replacement therapy tend to have an increased risk of developing IBS as well.
- Family History: Those who have a close relative with IBS, such as a parent or sibling, are more likely to develop IBS symptoms. Researchers believe it is the combination of genetics and environmental factors that ultimately leads to development of the condition.
- Mental Health: Those with chronic anxiety, depression, or a history of physical, sexual, or emotional abuse have an increased risk of developing IBS symptoms.
In addition to these risk factors, those with IBS may be aware of certain triggering activities or foods that lead to an increase in symptoms. Some of these triggers are:
- Periods of Increased Stress: Both temporary and chronic stress can lead to an increase in IBS symptoms, however these stresses typically just exacerbate existing symptoms and do not actually cause them to occur.
- Certain Foods: People with IBS tend to experience more severe symptoms after eating certain irritating foods, such as spicy food, greasy food, dairy products, certain citrus fruits, and wheat products. These foods may not necessarily worsen your symptoms if you have IBS, but you should be aware that they may upset your GI system.
How Is IBS Diagnosed?
There is no single test specifically designed to diagnose irritable bowel syndrome. Typically, tests are performed to rule out any underlying conditions that may be producing similar symptoms. The diagnosis of IBS relies largely upon a complete and thorough medical history, review of symptoms, and physical examination.
To aid in the diagnosis, researchers have created a set of criteria called the Rome criteria. In order to be diagnosed with irritable bowel syndrome, you must have pain in the abdomen or abdominal discomfort at least one day per week in the prior 12 weeks, and two or more of these additional symptoms:
- Pain with defecation
- Change in the frequency of bowel movements
- Changes in the consistency of your stool
Additional diagnostic tests may be utilized to rule out underlying causes of symptoms — or to check for possible infection. These tests may include:
- CT scan
- Upper GI series or endoscopy
- Bacterial overgrowth breath tests
- Lactose intolerance tests
- Blood tests
- Stool cultures
Because irritable bowel syndrome does not have a singular cause and cannot be cured, most treatment options aim to manage the symptoms associated with IBS. Typically, mild cases of IBS can be controlled by making adjustments to one’s diet, lifestyle, or stress management plan. Treatment suggestions include:
- Taking fiber supplements or eating high-fiber foods
- Over-the-counter anti-diarrheal medications
- Avoiding foods that cause bloating or gas, such as carbonated beverages, alcohol, gluten, certain fruits and vegetables, and dairy products
- Increasing daily water intake
- Anticholinergic medications, such as dicyclomine, to relieve painful bowel movements
- Antidepressants to treat depression and pain associated with IBS
- Antibiotic medication if an overgrowth of bacteria is present
- Medications to increase the fluid production in the small intestine that aids in the passage of stool
- Counseling, especially if stress is a trigger for your IBS
Simple alterations in one’s lifestyle may provide much needed relief of the symptoms associated with irritable bowel syndrome. Some home remedies to consider include:
- Avoiding foods that worsen symptoms
- Eating small, more frequent meals
- Choosing dairy products carefully, especially in cases of lactose intolerance
- Drinking plenty of water each day
- Exercising daily to relieve stress-associated symptoms
- Using anti-diarrheal medications with caution (Note: If overused, these medications can worsen symptoms.)
- Adding fiber to your diet, in the form of whole grains, vegetables and fruits
Can You Prevent IBS?
The best way to prevent flare-ups of irritable bowel syndrome? Manage your stress and diet. Stress-related conditions can worsen, occurring more intensely and frequently, over time. Positive coping mechanisms for stress include:
- Counseling or therapy
- Relaxation exercises such as meditation
- Deep breathing
In addition, food choices may impact the severity of your flare-ups, as mentioned above.
Tips for Living with IBS
Living with irritable bowel syndrome can be a difficult day-to-day challenge. If you’ve been diagnosed with IBS, it’s important for you to learn about your condition so that you can take charge of your symptoms. Moreover, identifying your IBS triggers, so that you can try to avoid them, can be helpful. And, lastly, finding community with an IBS support group can help you develop new coping mechanisms.
- “Irritable Bowel Syndrome — Overview” via Mayo Clinic
- “Irritable Bowel Syndrome” via Medline Plus
- “Symptoms & Causes of Irritable Bowel Syndrome” via National Institute of Diabetes and Digestive and Kidney Disease, U.S. Department of Health & Human Services
- “About Irritable Bowel Syndrome (IBS)” via International Foundation for Gastrointestinal Disorders