Irritable Bowel Syndrome (IBS)

What is irritable bowel syndrome (IBS)?

Irritable bowel syndrome (IBS) is a disorder that affects your digestive tract, especially the large intestine. Unlike inflammatory bowel diseases, IBS doesn’t damage bowel tissue. Instead, it causes your intestines to work abnormally, leading to uncomfortable symptoms. 

IBS is very common. It’s actually the most frequent diagnosis made by doctors who specialize in digestive health. Still, only about half of people with IBS seek treatment. 

IBS is a chronic (long-term) condition, meaning it needs ongoing management. While there are no quick fixes, understanding your symptoms and finding long-term strategies can improve your quality of life. 

What are the symptoms of irritable bowel syndrome (IBS)?

If you have IBS, you may notice common symptoms including:

• Changes in your bowel habits, including diarrhea, constipation or both. These may lead to unintended weight loss or gain.
• Changes in how your stool looks
• Abdominal pain, discomfort or cramping with or before bowel movements
• Bowel movements that are more or less frequent than usual
• Bloating, gas or flatulence
• Nausea
• Mucus in your stool
• The need to pass a stool urgently
• A feeling that you still need to empty your bowels after you pass a stool

Symptoms may improve after a bowel movement. However, IBS symptoms differ from person to person.

It’s important to understand how IBS can affect your daily life so you can find support and ways to cope. If you have IBS, you may face challenges such as:

• Disruptions to your daily routines that affect your work, social activities and commitments.
• Stress, anxiety and a negative impact on your mental health.
• Dietary restrictions, which can influence your food choices and social interactions.

What causes irritable bowel syndrome (IBS)?

It’s not clear exactly what causes IBS, but one or more of these factors might play a role:

• Genetics 
• Lifestyle habits
• Environmental factors
• The way the muscles in your intestine contract
• Problems with the nerves in your digestive system
• Infection
• Stress in childhood
• Changes in your gut microbiome

Whatever the cause, some triggers can make IBS symptoms worse. Many people with IBS notice issues linked to:

• Certain foods: Milk and other dairy products, carbonated drinks, wheat, beans, citrus fruits and cabbage.
• Stress: Stress doesn’t cause symptoms, but it may make them worse.
• Menstrual cycles: Some people notice predictable changes in their symptoms that align with their periods.

Some people have a higher risk of developing IBS if they:

• Are younger than 50
• Are female, especially if they use estrogen therapy
• Have a family history of IBS
• Live with conditions like PTSD, anxiety or depression
• Have experienced past abuse 

How is irritable bowel syndrome diagnosed?

If you have symptoms of IBS, you’ll want to see a health care provider for a diagnosis. To diagnose IBS, your provider will want to confirm that you have IBS symptoms and rule out other digestive conditions that could be causing them, especially inflammatory bowel diseases (IBD). 

Diagnosis usually involves:

• A detailed medical history, focusing on what your symptoms feel like, how long you’ve had them, dietary habits and lifestyle factors.
• A physical examination to check your overall health and look for any signs related to IBS.
• Questions about how long you have had IBS symptoms. Providers often use the Rome Criteria, which includes belly pain or discomfort at least one day a week for the last three months, plus at least two of these symptoms:
  • Pain when you pass a stool
  • A change in how often you have a bowel movement
  • A change in the consistency of your stools
• Blood tests, breath tests or stool tests to rule out other conditions, such as lactose intolerance, bacterial overgrowth, celiac disease or inflammatory bowel diseases.
• Imaging studies like colonoscopy, sigmoidoscopy, endoscopy or abdominal imaging to rule out other digestive disorders.

IBS is classified into four types:

• IBS with constipation (IBS-C)
• IBS with diarrhea (IBS-D)
• IBS with mixed symptoms (IBS-M)
• IBS unclassified (IBS-U) 

How to manage IBS with lifestyle changes  

Lifestyle changes may help control your symptoms and improve your overall well-being. Responses to lifestyle changes are different for everyone, so work with your provider to tailor them to your needs.

Treatment can take some time before you see results. Staying consistent with your treatment plan may lessen your symptoms over time. Here are some strategies to try:

• Eat small, regular meals and try not to skip meals or eat close to bedtime.
• Gradually increase the fiber in your diet by adding more fruits, vegetables and whole grains. You may also want to talk to your provider about taking fiber supplements. Fiber can help regulate your bowel movements.
• Keep a food diary so you can identify and avoid foods that may trigger IBS symptoms. Common triggers include certain types of dairy, foods that cause gas, chewing gum, carbonated drinks, gluten, spicy foods and artificial sweeteners.
• Consider a low FODMAP diet, where you get the nutrients you need from foods that are easier to digest. Talk to your provider or a dietitian first, since diets like this aren’t right for everyone.
• Drink plenty of fluids, especially water.
• Reduce stress levels with mindfulness and relaxation techniques, such as deep breathing exercises or meditation. Take regular breaks to relax and unwind. Balancing work and rest is important for managing stress.
• Get regular low-impact exercise, such as walking, swimming or yoga, to help with regular bowel movements and lower stress. A consistent exercise routine may help keep your digestive system on track and improve your gut health.
• Get enough restorative sleep.
• Consider therapy so you can learn coping skills that may reduce symptoms.

What medications help with IBS?

Your provider may work with you to develop a personalized treatment plan based on your symptoms and needs. You may be able to control IBS with lifestyle changes alone. If not, your plan may include:

• Antispasmodic medications, such as hyoscyamine and dicyclomine, which help reduce muscle spasms in the intestines. This may help with pain.
• Fiber supplements, such as psyllium or methylcellulose, to help you have regular bowel movements if you have IBS-C.
• Laxatives, if fiber isn’t helping enough.
• Anti-diarrheal medications, like loperamide, if you have IBS-D.
• Selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) to help regulate bowel function and reduce symptoms.
• Tricyclic antidepressants, which can lower the activity of neurons in your intestines to reduce pain.
• Probiotics, which contain good bacteria and may promote a healthy gut microbiome and reduce symptoms.
• Other medications that can help with IBS, such as dicyclomine (Bentyl), hyoscyamine (Levsin), linaclotide (Linzess), lubiprostone (Amitiza), plecanatide (Trulance) or rifaximin (Xifaxan).

It’s important to work with a health care provider before you start taking any medication to treat IBS symptoms. A provider can tailor treatment for IBS to your needs, recommend a combination of medication and lifestyle changes, monitor you for side effects and make sure any medications you take are safe if you have other health conditions. 

Find support for IBS at Banner Health 

Living with IBS can be challenging, but you don’t have to manage it alone. With the right care and support, it’s possible to find relief and improve your quality of life. 

At Banner Health, our experienced providers can help you create a personalized treatment plan that fits your needs and lifestyle. From diagnosis to long-term management, we’re here to support your journey to better digestive health. 

Take the first step toward feeling better. Schedule an appointment with a Banner Health provider today.