When you have the occasional upset stomach, you may hardly notice, and it usually doesn’t affect your daily life. But if you’re experiencing stomach cramps, diarrhea, constipation and other gastrointestinal problems regularly – and you feel like your bathroom habits are affecting your daily life – you may need to reach out to your doctor. There may be something more going on in your body, like irritable bowel syndrome (IBS).
While IBS can disrupt your life, it doesn’t have to. It can be very treatable by making lifestyle and diet changes. Here, we cover the types of IBS, symptoms, common triggers that can cause an IBS flare-up, and ways to effectively treat IBS and get your bathroom habits back to normal.
Irritable bowel syndrome is a disorder that affects the large intestine
Irritable bowel syndrome is a bowel disorder that can cause symptoms that range from mild to severe. Although 10-15% of adults in the U.S. experience symptoms, only 5-7% of adults have been diagnosed with it.
IBS can develop at any age, but it most commonly begins in teen years or early adulthood, and it is less likely to occur in people over 50. It affects everyone differently, and women are twice as likely as men to be diagnosed with it.
Doctors aren’t sure what the exact cause of IBS is. However, IBS has been linked to chronic pain conditions, food intolerance, digestive tract infections, mood disorders, gut health, genetics and more.
Types of IBS
Even though symptoms are similar to each other, there are different types of IBS, and they’re categorized by how your stool (poop) looks:
- IBS with constipation (IBS-C) – Poop is lumpy and hard.
- IBS with diarrhea (IBS-D) – Poop is watery and loose.
- IBS with mixed bowel movements (IBS-M) – Bowel movements are either hard and lumpy, or watery and loose.
Irritable bowel syndrome vs. inflammatory bowel disease
You’ve likely heard of IBS, but you may not have heard of inflammatory bowel disease (IBD). IBD is a chronic disease involving gastrointestinal (GI) damage from inflammation. IBS is a GI disorder with uncomfortable symptoms, but no long-term health complications.
Inflammatory bowel disease affects the GI tract, but can cause non-GI related symptoms as well, including:
- Anemia
- Blood in the stool
- Fever
- Malnutrition (more common in children diagnosed with IBD than adults)
- Rectal bleeding
- Significant weight loss
IBD can greatly affect quality of life, and some symptoms can be life-threatening, so it’s important to speak to your doctor if you’re experiencing any unusual symptoms. While there’s no cure for IBD, it can be effectively managed to improve your quality of life, especially if treatment starts early on.
It can be easy to dismiss some of the milder symptoms of IBS. But it’s important to identify when you experience them, so you’re able to treat them right away. Symptoms that men and women experience are similar, but women are more likely to experience severe symptoms.
- Bloating
- Constipation or diarrhea, or a combination of the two
- Excess gas
- Fatigue
- Feeling like you can’t have a complete bowel movement
- Mucus in your poop
- Stomach pain
IBS symptoms not related to the intestines
Anyone can experience symptoms that are not related to the intestines, including:
- Chronic pain in the stomach
- Fibromyalgia
- Migraines
- Mood disorders, like anxiety and depression
- Sleep problems
When you should be concerned about IBS symptoms
You may notice abdominal symptoms that seem like they’re related to IBS, but they can be a cause for concern. Contact your doctor immediately if you experience any of the following symptoms along with the IBS symptoms, including:
- Blood in your poop
- Fever
- Severe stomach pain that doesn’t lessen once you pass gas or poop
- Severe diarrhea
- Unexplained weight loss
- Vomiting
Possible lifestyle triggers of IBS
If you are diagnosed with IBS, you’ll probably notice that there are certain things that trigger your symptoms to flare up. Triggers don’t cause IBS, but they can make your condition worse. Common triggers include:
- Menstrual cycles – IBS symptoms are often worse before a period starts and after ovulation.
- Diet – In general, there are foods that can make constipation and diarrhea worse, but with IBS, it’s important to be careful with your diet and select foods and drinks that won’t cause your symptoms to flare up.
- Stress – Stress can be caused by a lot of things, such as traffic, pressure at work and issues with money, and it can trigger IBS, making your symptoms worse.
- Prescription and over-the-counter medication – Medicines you can buy over the counter, like cough syrup, may contain sorbitol, which is a sugar substitute that can cause diarrhea in some people. And some antibiotics and antidepressants can cause symptoms of constipation and diarrhea to flare up.
Foods and drinks that can trigger IBS symptoms
Foods that can cause diarrhea and constipation can be difficult to avoid, and you may not realize that what you’re eating may be making your symptoms worse. These include:
- Alcoholic beverages – Moderate or light alcohol use likely won’t trigger symptoms of IBS. But heavy alcohol use can irritate the GI tract, which may trigger IBS symptoms like constipation or diarrhea, cramping and bloating.
- Artificial sweeteners – These are in many foods and drinks, and you may not even know it. While it’s important to limit your sugar intake for overall health, replacing natural sugar with artificial sweeteners can make your symptoms worse, potentially causing diarrhea, bloating, excess gas and stomach cramps.
- Caffeine – While caffeine doesn’t affect everyone with IBS, it can cause diarrhea in some people. Coffee is well known to contain caffeine, but it can be present in things like chocolate, soda, tea and even over-the-counter products used for pain relief. If you’re trying to control IBS symptoms, it’s important to read labels of anything you ingest to see if it contains caffeine.
- Carbonated drinks – Carbonation can make symptoms worse and cause bloating and gas. If you’re trying to avoid a symptom flare-up, avoid carbonated beverages like sparkling water, soda and beer.
- Fiber – It’s an important part of any diet, but too much fiber, or the wrong kind, can make symptoms worse. While fiber can help with constipation for some people, too much can cause diarrhea.
- High FODMAP food – FODMAP is short for fermentable oligosaccharides, disaccharides, monosaccharides and polyols, which are a group of carbohydrates that your body may have trouble digesting. They can be found both naturally and artificially in food. Things like onions, garlic, apples, pears, foods made with specific grains, most processed foods, dairy and some beverages are considered high FODMAP foods. They can all cause symptoms to flare up.
- High-protein foods – Protein is healthy and important to include in your diet, but eating too many foods that are high in protein, such as red meat, can cause constipation.
- Refined grains – While they don’t cause everyone to experience IBS flare-ups, some foods made with refined grains, like white flour, can cause constipation.
- Fried or fatty foods – These foods are difficult for your body to digest. Fat slows digestion, which can cause symptoms of IBS like bloating, gas, nausea and stomach pain.
- Processed foods – The ingredients in processed foods, particularly high fructose corn syrup, can aggravate IBS symptoms and cause bloating, gas and diarrhea.
It’s important to remember that it’s not even the “bad” foods you need to avoid if you have IBS. There are also healthy foods that can make your symptoms worse, including certain fruits, nuts and grains. When you have a symptom flare-up, noting what you had eaten recently can help you figure out which foods you may want to avoid.
Getting a diagnosis of irritable bowel syndrome
There isn’t a specific test to diagnose IBS. Your doctor will start by asking questions about your medical history and the medical history of your family. They’ll also ask about what types of symptoms you have, if you’re experiencing a combination of symptoms, and how frequently you have them.
They’ll then likely order tests to rule out other conditions, like IBD. These tests can include:
- Lab tests – Your blood and stool may be tested to check for another condition that may be causing your symptoms. Your doctor may also order a breath test (which can check if your gut bacteria is off or if you have a food intolerance), a stool test, and a lactose intolerance test.
- Imaging tests – These determine if you have inflammation or unusual gut bacteria. They can include a colonoscopy to check for inflammatory bowel disease, polyps or cancerous growths; an upper endoscopy to rule out celiac disease, a CT scan of your abdomen and pelvis, and other imaging tests to check what’s causing your symptoms.
Ways to effectively treat IBS
Controlling IBS may mean significant diet and lifestyle changes, as the main goal of treatment is to relieve symptoms you may be experiencing. There isn’t one specific treatment, as people experience IBS differently, but your doctor may suggest things like adjusting your diet, lifestyle changes or medicine to help you control your symptoms.
Making lifestyle changes to control IBS symptoms
Things you may be doing in your daily life may be making your IBS symptoms worse. Small lifestyle changes can help. These include:
- Adjusting when and how you eat – Eat meals at regular times, chew slowly and eat smaller portions. Try not to skip meals or wait too long between meals.
- Drinking plenty of water – Staying hydrated is important, and water helps with digestion. It can also help control symptoms like bloating, stomach pain and constipation, and can help prevent diarrhea-related constipation.
- Increasing your physical activity – There aren’t any studies that specifically prove that working out helps IBS symptoms but increased physical activity is good for your overall health. Studies do show, however, that working out can significantly help with constipation, so it’s worth it to get moving.
Following a low FODMAP diet
For up to 84% of people who experience IBS symptoms, diet is the main triggering factor. Foods that are high in fructose, lactose, sorbitol and other carbohydrates and sugar alcohols might be difficult for your body to digest, so your doctor may suggest that you follow a low-FODMAP diet for a short period of time. Foods on a low-FODMAP diet may include lean meats and certain seafood, fruits, vegetables and legumes.
While the low-FODMAP diet is low on foods containing lactose and gluten, there aren’t any studies that conclusively prove that lactose and gluten can aggravate IBS symptoms. Instead, it’s more likely people are experiencing lactose or gluten intolerance, which can have the same symptoms as IBS.
Also, keep in mind that foods that contain FODMAPs aren’t all bad, and some are important for a balanced diet. That’s why a low-FODMAP diet is only meant for the short term – to identify potential IBS triggers and gain control over your symptoms. Eventually, you’ll be able to reintroduce foods that don’t cause symptoms, but you may need eliminate the foods that cause stomach troubles long-term.
Medication can help control symptoms of IBS
Based on your symptoms, your doctor may recommend medication. This includes both over-the-counter and prescription medications and supplements. Some over-the-counter medications they may recommend include:
- Anti-diarrheal medication to help control diarrhea
- Fiber supplements or laxatives to help with constipation
- Probiotics to help with gut flora
Your doctor may prescribe medications that can help, including:
- Prescription pain medication to help with severe pain
- Low-dose antidepressants to help with pain and constipation
- Medications approved specifically for people with IBS
- Muscle relaxants to relieve and prevent intestinal cramping
Cognitive behavioral therapy (CBT) can help you manage your IBS symptoms
If diet and lifestyle changes alone aren’t helping with IBS symptoms, cognitive behavioral therapy may be an option. While diet and lifestyle changes are good ways to help with the physical aspects of IBS, cognitive behavioral therapy can help identify behaviors, thinking patterns and other mental aspects that may aggravate IBS.
For example, maybe you have anxiety about how to control your symptoms away from home, or your symptoms are causing your mental health to take a hit. Both stress and anxiety trigger chemicals in your brain that can cause your gut to react, potentially causing you to experience IBS symptoms. With CBT, you can identify these triggers and learn coping mechanisms to effectively work through or avoid flare-ups.
If you have moderate to severe IBS and changes you’ve made haven’t been working well enough to help with your symptoms, speak to your doctor. They may be able to refer you to a cognitive behavioral therapist that can help.
What you can do if you have an IBS flare-up
Even if you’re doing all of the right things to manage IBS, it’s possible for IBS to flare up. With a flare-up, you may experience more intense and painful symptoms, but the symptoms usually only last a few hours. If you experience a flare-up, it may help to:
- Apply a heating pad to where you’re experiencing cramps
- Avoid any trigger foods while in the flare-up
- Get moving with light to moderate exercise
- Reduce your caffeine intake
- Try to manage your stress as best as you can
If you have irritable bowel syndrome, it’s important to get treatment
While it doesn’t lead to serious GI problems like Crohn’s disease or colon cancer, IBS isn’t something you need to suffer through. If you’ve been experiencing IBS symptoms or if you’re not able to manage your symptoms on your own, reach out to your doctor. They’ll work with you to find a treatment plan to manage the IBS or refer you to a gastroenterologist that can help.