What is Irritable Bowel Syndrome (IBS) and How is it Treated

Irritable Bowel Syndrome or IBS is signified by experiencing a mixture of discomfort and pain in the belly or lower abdomen and changing bowel habits. You may feel like you need to go more or less often than usual. You may also have different kinds of stool such as hard, soft, thin, or liquid. It’s not a life-threatening condition and having an IBS diagnosis doesn’t necessarily mean you are at a greater risk for other colon conditions or colon cancer. However, it can be a long-lasting, life-altering problem. Sometimes people who have IBS miss work or school often. They may not feel like participating in daily activities. You may need to change your work setting such as working remotely, changing your work hours, and some cannot work at all. 

Symptoms of IBS

The symptoms of IBS can vary greatly between individuals. The most common symptoms include:

  • Bloating, cramping, or abdominal pain related to passing bowel movements
  • Changes in the way bowel movements look
  • Changes in the frequency of bowel movements

There are also a large number of possible symptoms that can occur such as:

  • Diarrhea
  • Constipation
  • Alternating constipation and diarrhea
  • Lower abdomen cramps
  • Harder or looser stools than normal
  • Mucus in your feces
  • Feeling like you need to go immediately after going
  • Food intolerance
  • Tiredness
  • Anxiety
  • Depression
  • Headaches
  • Heartburn & indigestion

When you have Irritable Bowel Syndrome, symptoms may last for three to six months before subsiding temporarily. Women often have more symptoms around the time of their periods. It can also cause sexual problems or urinary symptoms. Increased stress often makes symptoms worse.

How is IBS diagnosed?

IBS often goes undiagnosed because there’s not a definitive lab test that can be used. When you visit your doctor, they will see if your symptoms point to an IBS diagnosis. They may run some other tests to rule out other conditions with similar symptoms. Lab tests may include testing for food intolerances or allergies, an infection, or an enzyme deficiency that affects the ability to digest food properly. The doctor may also test for other inflammatory bowel diseases like Crohn’s disease or ulcerative colitis. Some of the tests your primary care physician may order to diagnose IBS include:

  • Colonoscopy or sigmoidoscopy to check for signs of intestinal inflammation or blockages
  • Upper endoscopy if you suffer from indigestion or heartburn
  • X-rays
  • Blood work to check for thyroid problems, signs of infection, or anemia
  • Stool tests to check for infection or the presence of blood
  • Tests for celiac disease, gluten allergy, or lactose intolerance
  • Tests to see if the bowel muscles are not functioning properly

Who is at risk for developing Irritable Bowel Syndrome?

Most people will experience symptoms of IBS occasionally. However, some are more at risk for developing the condition. You may be at risk if you are:

  • Under the age of 50
  • Female
  • Have a family history of Irritable Bowel Syndrome
  • Suffer from anxiety, depression, or other mental health issues

When do I need to see a doctor?

If you have persistent changes in your bowel movements or other signs of IBS, it’s time to see your doctor. The symptoms of IBS are similar to those experienced with serious conditions like colon cancer. Along with the typical IBS symptoms, you may experience more serious symptoms like:

  • Unexpected weight loss
  • Diarrhea especially at night
  • Rectal bleeding
  • Unexplained vomiting
  • Trouble swallowing
  • Persistent pain not relieved by gas or a bowel movement
  • Iron deficiency

Preparing for Your Doctor’s Visit

Your doctor is going to ask you a lot of questions to determine the nature and severity of your symptoms. They will look at your symptoms and may order tests to rule out other conditions first. Some of the questions they may ask include:

  • What types of symptoms are you having?
  • When did these symptoms first begin?
  • Have you noticed anything in particular that triggers the symptoms? Or do they seem random?
  • Have you experienced unplanned weight loss?
  • Have you had a fever?
  • Have you experienced blood in your stools?
  • Has your stress level increased recently?
  • Have you gone through a significant life event, emotional difficulty, or sudden loss?
  • What does your typical daily diet look like?
  • Have you been diagnosed with a food allergy or intolerance?
  • Does your family history indicate bowel disorders or colon cancer?
  • How much are your symptoms disrupting your daily life, affecting relationships, or your ability to function at work or school?

What treatment options are available?

Each person can have a unique set of symptoms. For this reason, treatment usually focuses on relieving symptoms. Many times, mild symptoms are controlled by managing stress or by making a few diet or lifestyle changes. You can try to alleviate symptoms by:

  • Avoiding foods known to trigger symptoms
  • Eating more foods high in fiber
  • Regular exercise
  • Getting adequate sleep

Your doctor may suggest a few foods be eliminated from your diet including:

  • Gas-causing foods. If you often have gas or bloating, you may want to avoid carbonated and alcoholic drinks and foods that tend to increase gas.
  • Gluten. Some medical professionals suggest removing gluten from the diet to help avoid symptoms like diarrhea. 
  • FODMAPs. Some people have sensitivities to specific carbohydrates like fructose, lactose, fructans, and other types known as FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols). These are found in certain dairy products, grains, fruits, and vegetables. 

You may want to discuss your symptoms with a dietician to help you make the dietary changes. If your symptoms range from moderate to severe, then your doctor may consider recommending counseling to help alleviate stress or depression.

Are there any medications to take for IBS?

Based on your symptoms and their severity, a doctor may recommend some medications such as:

  • Fiber Supplements. Taking a fiber supplement and extra liquids can be helpful for controlling constipation.
  • Laxatives. If fiber isn’t helpful for alleviating constipation, your doctor may suggest some over-the-counter laxatives. 
  • Anti-Diarrheal Medications. Some over-the-counter medications can help reduce or control diarrhea. Loperamide, or Imodium A-D, is a common medication. They may prescribe a bile acid binder. However, a bile acid binder can increase bloating. 
  • Anticholinergic Medications. These medications can help relieve bowel spasms. Doctors often prescribe them for individuals who have frequent bouts of diarrhea. Even though the medications are safe, they can cause constipation, blurred vision, and dry mouth.
  • Tricyclic Antidepressants. This medication can help relieve depression and also reduce intestinal pain by inhibiting the activity of neurons. 
  • SSRI Antidepressants. If you suffer from depression accompanied by pain and constipation, your physician may prescribe a selective serotonin reuptake inhibitor.
  • Pain Medications. Some pain medications such as gabapentin or pregabalin may ease severe bloating and pain.

There are also a few medications that are approved and prescribed for people who suffer from IBS. Here are the prescription medications often used to help ease symptoms.

  • Alosetron. Also known as Lotronex, this medication helps relax the colon and slows the movement of waste through the lower bowel. It’s given in severe cases and to those whose body hasn’t responded to other treatments.
  • Eluxadoline. This medication helps ease diarrhea by reducing fluid secretion and muscle contractions in the intestine. It does have some side effects.
  • Rifaximin. The antibiotic helps decrease bacterial growth and relieve diarrhea.
  • Lubiprostone. This medication increases fluid secretions in the small intestine to help pass stool. It’s usually prescribed for women who haven’t responded to other treatments.
  • Linaclotide. Like Lubiprostone, this medication increases fluid in the small intestine to help pass stool. It can cause diarrhea but taking it right before eating can help.

Alternative Treatment Options

There is no scientific proof that alternative treatment options are effective at reducing the symptoms of Irritable Bowel Syndrome. However, for those who want to try alternative measures they may offer some relief. Be sure to ask your primary care provider before trying any of these treatment options. Alternative therapies include:

  • Hypnosis – A trained professional helps you achieve a more relaxed state, then guides you in relaxing abdominal muscles. Hypnosis may help reduce bloating and abdominal pain. 
  • Peppermint – Real peppermint oil may help ease urgency, abdominal pain, and bloating. It is usually consumed as a small, coated pill.
  • Probiotics – Your gut contains “good” bacteria. These are beneficial and are found in various foods or taken as supplements. Some experts believe probiotics can help ease IBS symptoms such as diarrhea, bloating, and abdominal pain.
  • Stress Reduction – Reducing stress can help you manage IBS symptoms. Yoga and meditation are both useful for helping to relieve stress for many people.

Managing Symptoms with Food

IBS and food create a complicated relationship. It can be difficult to find the exact foods that are causing problems. Depending on which foods trigger IBS for you, it can be difficult to find a well-balanced diet that is nutritionally sound and causes the least disruptions to your lifestyle. Here are a few tips to help you with the process. Remember it’s a trial-and-error journey and you have to find what works for you.

  • Avoid overeating, large meals, and high-fat foods. Fatty foods and heavy meals can cause more colon contractions which may cause cramping. Eating smaller meals with lower fat foods can often help reduce the occurrence of cramps.
  • Eat regularly. You may be tempted to skip meals thinking that it will reduce or prevent your symptoms. But your goal is regularity. To help your body become regular it’s important to eat smaller, more frequent meals while staying on a regular eating schedule. 
  • Slowly increase your fiber intake. Fiber is important for having regular bowel movements. It can help relieve constipation. You may try experimenting with different types of fiber to find what works for you. In general, if your symptoms include diarrhea, you may want to increase soluble fiber. However, if you predominantly have constipation, you’ll want to experiment with insoluble fiber. Discuss your options with your healthcare provider!
  • Introduce new food options when symptoms are calm. You may find yourself eating a narrow range of foods you consider “safe.” You may need to try other foods in order to get a wide variety of nutritional benefits. Try introducing new foods when your symptoms are calm or your stress level is low.

Role of Your Healthcare Provider

Your healthcare provider can help you manage IBS symptoms. The first thing you need to do is to get a definitive diagnosis. This alone will answer a lot of your questions and give you some peace of mind. Talk to your doctor about the lifestyle changes you have made. If they are not working, the doctor may provide new insights and ideas on other things you can try. 

If your medication is not helping to alleviate symptoms or discomfort, ask about other options. Your healthcare provider may be able to write a prescription for more effective medication, or they may run more tests to eliminate other possibilities. They are partners on your health journey and can help you develop a plan that works for you.

If you or your loved ones are suffering from IBS symptoms, let a medical professional help treat your symptoms. Take a moment to reach out to a board-certified GI specialist near you. 

Make an Appointment