IBS: Symptoms, Causes, Diagnosis & Treatment

Janis

By Janis | Updated December 4, 2023

Irritable bowel syndrome (IBS) is a frequently occurring chronic condition that impacts the stomach and intestines, also called the gastrointestinal tract, and necessitates long-term management. 

The condition is characterized by a range of gastrointestinal symptoms, which can vary from person to person and affect millions of people worldwide. 

Understanding the symptoms, causes, and available treatment options can help those affected by IBS better manage their condition and lead healthier lives. Careful diagnosis, lifestyle modifications, stress management, and proper medication can help individuals manage their IBS.

Symptoms and Types of IBS

This chronic gastrointestinal disorder is characterized by a variety of symptoms. Diarrhea-predominant, constipation-predominant, mixed, and unclassified are the four main types of IBS when considered from a symptom-based perspective. 

It is important to note that these symptoms may vary in intensity and frequency and that not every individual with IBS experiences all of them.

Abdominal Pain or Discomfort

One of the primary symptoms of Irritable Bowel Syndrome (IBS) is abdominal pain or discomfort. 

This pain is often related to bowel movements and might be accompanied by bloating or a sense of fullness. It’s important to note that IBS-related abdominal pain typically lessens after a bowel movement. 

Bowel Movement Changes

Bowel movement changes are a characteristic symptom of IBS. Individuals may experience constipation (IBS-C), diarrhea (IBS-D), or alternate between both (IBS-M). 

Stools may also appear loose and watery or hard and lumpy. These changes can be accompanied by a feeling of incomplete evacuation, urgency, or mucus in the stool.

Bloating and Gas

Bloating and excessive gas are common complaints among people with IBS. Dietary triggers and irregular bowel habits can lead to increased gas production and a bloated feeling, often causing discomfort and pain.

Mucus in stools

Mucus may also be present in the stools of individuals with IBS. This is another symptom that can vary greatly from person to person. Some may experience excessive mucus in their stools, while others may not notice any at all.

Causes, Risk Factors, & Triggers

In a healthy system, the muscles in the intestinal walls contract and relax in a steady rhythm as food travels from the stomach and into the entire digestive tract. 

When these contractions slow down or speed up, so does the movement of food through your system, leading to symptoms of IBS. The exact cause of IBS is not clear, but it is believed to be related to a combination of factors and triggers.

Gut Health Imbalance

One potential cause of IBS is an imbalance in the gut bacteria. The gastrointestinal tract contains trillions of bacteria that play a crucial role in maintaining a healthy gut environment. 

Any disruption to this delicate balance can lead to IBS symptoms.

Genetics

Genetics may also play a role in IBS, as the condition tends to run in families. If you have a close relative with IBS, you may be more likely to develop the disorder. 

It is important, however, to note that not all individuals with a genetic predisposition end up experiencing IBS symptoms.

Diet and Food Intolerance

IBS can be triggered by certain foods, such as dairy products, high-fat foods, and artificial sweeteners. Certain foods, such as those high in fat, caffeine, or alcohol, as well as carbonated beverages, can trigger IBS symptoms. 

Additionally, it has been found that individuals with IBS may have difficulty digesting lactose and fructose, which can exacerbate their symptoms.

Stress and IBS

Stress, depression, and anxiety are also strongly linked to IBS. Emotional stress can trigger an increase in symptoms, and managing stress levels effectively is key to reducing flare-ups.

While not considered direct causes, these psychological factors can exacerbate symptoms and trigger flare-ups, creating a cycle that further aggravates mental health issues.

Hormonal Changes and Age

Women with IBS may notice a worsening of symptoms during their periods. This is due to the hormonal changes that occur during menstruation, which can further exacerbate IBS symptoms.

IBS is more common in women and people under 50, making gender and age significant risk factors. 

Diagnosis & Tests

Doctors usually diagnose IBS based on the patient’s symptoms and medical history and by ruling out other gastrointestinal conditions such as inflammatory bowel disease (IBD) or celiac disease through a combination of tests.

A physical exam is crucial to understand the pattern of your symptoms and rule out other health problems. Several tests may be included during the diagnosis process:

Blood tests

Blood tests can help identify anemia, inflammation, or possible infections that might be causing your symptoms.

Blood tests are commonly used in diagnosing IBS, primarily to rule out other conditions. While no specific blood test can definitively diagnose IBS, they are a helpful tool in the broader diagnostic process. 

Stool tests

A stool test can help detect the presence of blood, signs of infection, or parasites in your stool, which can provide insight into the cause of your symptoms.


Moreover, stool tests can detect blood, which might point toward other conditions like inflammatory bowel disease or colon cancer. 

Specific procedures may be performed to investigate your digestive system further:

Colonoscopy 

This is a procedure where a small, flexible tube with a camera is inserted into the rectum to examine the entire length of the colon, which helps rule out other causes of your symptoms, especially if you have abdominal pain.

It allows your healthcare provider to check for inflammation, ulcers, and other abnormalities that might impact your bowel function.

Additional Diagnostic Tests

In some cases, additional diagnostic tests like CT scans or upper endoscopy may be necessary to rule out other illnesses mimicking IBS. A CT scan provides detailed abdomen images, while an endoscopy allows direct viewing of the upper digestive system.

These examinations can help identify or confirm conditions such as peptic ulcer disease or gastroesophageal reflux disease (GERD). 

Medications & Treatment Options

Treatment options for IBS aim to manage symptoms and enhance patients’ quality of life. Many turn to medications to manage their IBS symptoms. These treatments aim to alleviate discomfort and promote a better quality of life.

Over-the-Counter Medications

Medications like laxatives may provide relief for those experiencing constipation. 

Some common laxatives include osmotic agents like magnesium hydroxide (Milk of Magnesia) and polyethylene glycol (Miralax).

Constipation Medications

If constipation remains a significant concern, prescription constipation medications can prove helpful. 

These medications work by increasing the fluid secretion in the intestines, aiding the passage of stool.

Diarrhea Treatment

For those with diarrhea-predominant IBS, medications which affect opioid receptors in the digestive system are prescribed to relieve abdominal pain and diarrhea.

It’s essential to consider these medications’ potential for addiction and use it under the supervision of a healthcare provider.

Antidepressants for IBS

In some cases, healthcare providers might prescribe antidepressants to help manage IBS symptoms. Tricyclic antidepressants can help reduce abdominal pain and diarrhea, while selective serotonin reuptake inhibitors (SSRIs) may improve overall well-being and gut function.

Always consult your healthcare provider for guidance on the best treatment approach tailored to your specific needs.

Lifestyle Changes for IBS Management

Making certain lifestyle changes can significantly improve the symptoms of irritable bowel syndrome (IBS) to minimize discomfort. 

Exercise and Gut Function

Regular physical activity is another key component of IBS management. Exercise can not only improve digestion-gut function but also help reduce stress.

Set goals for a minimum of 30 minutes of moderate-intensity physical activity, like brisk walking, cycling, or swimming, on most days of the week. Start slowly and gradually increase the intensity and duration of your exercise sessions to prevent exacerbating IBS symptoms.

Good Sleep Habits

Maintaining a consistent sleep schedule and creating a relaxing bedtime routine can further promote better sleep quality, leading to reduced stress levels and improved emotional well-being.

Establish a consistent sleep routine, create a calm and comfortable sleep environment, and try relaxation techniques before bed to promote quality sleep. 

Hydration for Proper Digestion

Staying hydrated is vital for proper digestion and preventing constipation. 

Drinking sufficient water throughout the day helps regulate bowel movements and reduces the chances of diarrhea, nausea, and other IBS-related symptoms.

Bowel Movement Routine

Establishing a routine for bowel movements can improve bowel habits and alleviate symptoms. Designating a specific time of day for bowel movements, without forcing yourself, can foster regularity and ease constipation. 

Furthermore, never ignore the urge to use the restroom, as delaying can exacerbate IBS symptoms.

Dietary Approaches

Incorporating the right diet is crucial in managing the symptoms of irritable bowel syndrome (IBS). 

Increased Fiber Intake

Increasing your fiber intake can help regulate bowel movements, especially if you have constipation-predominant IBS. To ensure adequate fiber consumption, consider incorporating fruits, vegetables, and whole grains into your meals. Drinking enough water is also crucial to a fiber-rich diet.

However, if you have diarrhea-predominant IBS, reducing fiber intake might be more helpful. In either case, it’s essential to monitor your fiber intake and adjust it based on your symptoms.

Low FODMAP Diet

One popular dietary approach is the low FODMAP diet, which consists of limiting certain types of carbohydrates that are poorly absorbed in the small intestine. These carbohydrates are called FODMAPs, which stands for Fermentable Oligo-, Di-, Mono-saccharides, and Polyols.

In order to adopt a low FODMAP diet, it is essential to consume less fermentable carbohydrates, including some fruits, vegetables, and grains. Opt for low-FODMAP fruits and vegetables as well as whole grains such as brown rice, quinoa, and oats to boost your fiber intake and promote healthy bowel movements.

Probiotics for IBS

Probiotics can also be beneficial for individuals with IBS. These good bacteria support gut health and can help alleviate symptoms such as bloating, gas, and diarrhea. 

Some good sources of probiotics include yogurt, kefir, and fermented foods like sauerkraut and kimchi.

Avoidance of Trigger Foods

Food intolerance is another factor to consider. Identifying and avoiding trigger foods can significantly help improve IBS symptoms. Common sources of intolerance include lactose, gluten, and certain artificial sweeteners. It’s essential to monitor these foods and adjust your diet accordingly to avoid triggering IBS flare-ups.

Stress Management & Emotional Support

Stress and emotional factors, such as anxiety and depression, can significantly impact individuals with this condition. It is essential to manage stress levels and seek emotional support to alleviate IBS symptoms and improve overall well-being.

Relaxation and Stress Management

Managing stress is another essential aspect of IBS management. High stress levels can exacerbate symptoms, so integrating stress-reducing activities into your daily routine can be beneficial. 

Techniques like meditation, deep-breathing exercises, and progressive muscle relaxation can assist in reducing stress and improving symptoms.

Understanding Stressors

One of the steps in stress management is understanding your stressors and finding effective ways to cope with them. 

From work anxieties to emotional strains, addressing these stressors could involve time management strategies, conducting self-care activities, or seeking therapy.

Mental Health Therapies

For individuals struggling with anxiety or depression, seeking professional help may be beneficial. 

Therapies such as cognitive-behavioral therapy (CBT) and psychotherapy can help patients understand their thoughts and emotions, develop coping mechanisms, and improve overall mental health. 

IBS Support Groups

Joining a support group can provide emotional support and encouragement from people who understand the challenges of living with IBS. 

Sharing experiences, learning from others, and gaining insights into successful coping strategies can be invaluable for managing IBS symptoms and improving overall quality of life.

Complications & Seeking Medical Advice

This common chronic gastrointestinal disorder can cause a range of symptoms, which may affect activities of daily living. Although IBS does not typically damage the digestive tract, it can lead to certain complications if left unmanaged.

Weight Loss

One potential complication of IBS is weight loss. 

While not all IBS sufferers will experience this issue, it can occur in cases where severe diarrhea or restricted diets result from attempts to manage symptoms. 

Iron Deficiency Anemia

Another concern is the development of iron deficiency anemia, which can occur due to malabsorption or recurrent diarrhea. 

It’s essential to work with a healthcare provider to monitor weight and nutritional status.

When to Seek Immediate Help

It’s crucial to seek medical advice when experiencing symptoms that might suggest a more serious gastrointestinal condition. It’s important to consult with a healthcare professional to rule out these possibilities.

Rectal bleeding

If you notice blood in your stool or on toilet paper, seek medical help. 

Although it might indicate hemorrhoids, it’s essential to rule out other gastrointestinal issues.

Fever

A fever of 100.4°F (38°C) or higher, combined with diarrheal symptoms, could signal an infection or inflammatory bowel disease. 

While IBS can cause discomfort and changes in bowel habits, it doesn’t usually present with fever. Thus, a fever along with IBS symptoms could signal a different or additional medical condition, such as infection or inflammation.

Severe pain

Persistent or intense abdominal pain that doesn’t improve with passing gas or bowel movements should warrant a visit to the doctor. 

It could indicate a severe gastrointestinal issue, such as a bowel obstruction.

Frequently Asked Questions

What are the common symptoms of IBS?

Irritable bowel syndrome (IBS) is a collection of gastrointestinal symptoms. Common symptoms include excessive gas, abdominal pain, and cramps. 

Sufferers might also experience either constipation, diarrhea, or even a combination of both.

How is IBS diagnosed?

There is no specific test for IBS. Doctors usually diagnose the condition based on the patient’s symptoms and by ruling out other serious conditions. 

The diagnosis often considers whether the symptoms fit into one of the four IBS types: constipation-predominant, diarrhea-predominant, mixed, or unclassified.

What factors contribute to the development of IBS?

The exact cause of IBS is not well understood. It can occasionally evolve after a severe episode of infectious diarrhea or physical trauma, but in many instances, there is no particular event that singularizes the condition.

Combinations of genetic, environmental, and psychological factors might contribute to the development of IBS.

Are there any effective treatments for IBS?

Treatment for IBS does not follow a one-size-fits-all approach. Patients often work with their healthcare providers to find a combination of medications, dietary changes, and stress management strategies to manage symptoms. 

Some people find relief in peppermint oil for easing abdominal pain and discomfort. It is essential to discuss potential treatments with a healthcare provider before implementing any regimen.

How can IBS symptoms be prevented?

Preventing IBS symptoms requires lifestyle changes, such as modifying one’s diet by identifying trigger foods, staying well-hydrated, eating smaller meals, and avoiding caffeine and alcohol. 

It is also essential to manage stress, as stress can exacerbate IBS symptoms. Regular exercise and getting enough sleep can also help in preventing IBS symptoms.

Which foods should be avoided for IBS sufferers?

People with IBS may need to avoid foods that can trigger their symptoms. Common triggers include high-fat foods, caffeine, alcohol, dairy products, and foods high in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols). 

It is essential to work with a healthcare provider or dietitian to develop a tailored diet plan that helps manage symptoms and maintain adequate nutrition.