Irritable bowel syndrome (IBS) is a group of symptoms that can cause abdominal pain and changes in bowel movements. Up to 15% of Americans suffer from IBS, with women being affected almost twice as much as men.
1. Abdominal Pain
The most common symptom of IBS is abdominal pain. You may feel pain anywhere in the abdomen, but it is most commonly felt in the lower abdomen. The occurrence of abdominal pain is often unpredictable and can change over time. Terms commonly used to describe IBS abdominal pain include:
- Aching
- Cramping
- Sharp
- Stabbing
- Throbbing
2. Bloating
IBS is a functional gastrointestinal disorder, meaning the brain-gut interactions don’t always align, resulting in IBS symptoms. Digestion may slow down, which can cause gas to be retained in the abdomen. Slowed digestion can cause the abdomen to distend, creating the feeling and appearance of bloating.
Research is unclear on the underlying reasons for IBS, but researchers do know that it has not been linked to permanent intestinal damage.
3. Constipation
IBS has different subtypes, one of which is constipation-predominant IBS or IBS-C. Constipation can be a symptom of IBS-C. Constipation is a condition characterized by:
- Fewer than three bowel movements weekly
- Hard, dry, or lumpy stool
- Difficult to pass or painful bowel movements
- Incomplete bowel movements (you might not feel that all the stool has been passed from your intestine)
Some people with IBS suffer from both constipation and diarrhea.
4. Diarrhea
Another subtype of IBS is diarrhea-predominant IBS (IBS-D). Diarrhea is characterized by bowel movements where the stool is loose or watery and occurs three or more times a day. In IBS-D, the brain-gut interaction can cause food to pass too quickly, leading to diarrhea.
Diarrhea can lead to other complications, including:
- Dehydration: The loose, watery stools associated with diarrhea often mean the body is losing valuable fluids and electrolytes. The loss of fluids and electrolytes can cause lightheadedness, excessive thirst, and muscle cramps.
- Malabsorption: When you have frequent, loose stools, food passes through the intestines too quickly, making it challenging for the intestines to absorb adequate nutrients. Due to the inability to absorb adequate nutrients, the body might become malnourished.
How to Treat IBS
Once a qualified healthcare provider has diagnosed you with IBS, treatment might consist of some or all of the following:
- Avoiding gluten
- Eating more fiber
- Following a low FODMAP diet
- Getting plenty of sleep
- Increasing physical activity with a goal of 150 minutes a week
- Reducing stress
Depending on the severity and type of bowel movement symptoms, a healthcare provider may recommend medications:
- IBS-C: Medications that can assist with reducing constipation include fiber supplements, laxatives, Amitiza (lubiprostone), Linzess (linaclotide), or Trulance (plecanatide).
- IBS-D: Medications that can help decrease the incidence of diarrhea include Imodium (loperamide), Xifaxan (rifaximin), Viberzi (eluxadoline), and Lotronex (alosetron).
- General abdominal discomfort: Abdominal pain can be managed with antispasmodics, antidepressants, or coated peppermint oil capsules.
What Is a Low FODMAP Diet?
A low FODMAP diet reduces or eliminates fermentable oligosaccharides, disaccharides, monosaccharides, and polyols—specific carbohydrates that are difficult to break down and digest. The low FODMAP diet has been successful in reducing IBS symptoms. Consult a healthcare provider, such as a registered dietitian, for personalized guidance and to ensure your dietary needs are adequately met.
When To See a Healthcare Provider
Differentiating IBS from other gastrointestinal conditions, such as celiac disease or inflammatory bowel disease, is crucial for receiving the most effective treatment.
A healthcare provider specially trained in treating gastrointestinal disorders, such as a gastroenterologist, can help you get the treatment you need. Consider seeking a qualified health care provider evaluation for any of the following symptoms:
- Abdominal pain or cramping
- Change in bowel movement appearance or frequency
- Diarrhea or constipation
- Fever
- Mucus or blood with bowel movements
A healthcare provider will do one or more of the following to diagnose and treat IBS:
- Complete a full health history
- Do a physical examination
- Order laboratory testing, such as blood and stool tests
- Perform a hydrogen breath test to check for bacterial overgrowth or problems digesting carbohydrates
- Do an upper endoscopy to check for celiac disease
- Perform a colonoscopy to check for colon cancer or inflammatory bowel disease
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