Irritable bowel syndrome: Symptoms of IBS, foods to avoid, and treatment options

Irritable bowel syndrome (IBS) is a common disorder that affects 25 to 45 million people in the U.S. IBS can cause uncomfortable symptoms, including abdominal pain, constipation, diarrhea, cramps, excessive gas, and bloating. It can also change how often you have a bowel movement and the appearance of your stool. Fortunately, if you suffer from IBS, you can often manage your symptoms through dietary and lifestyle changes.

What is IBS?

IBS is a functional gastrointestinal (GI) disorder that can result when there is a problem with how your gut and brain work together. Your digestive tract can become be very sensitive and change how your bowel muscles contract. Most people with IBS develop their first symptoms before the age of 40—often during times of emotional stress—and many experience symptoms during childhood, adolescence, or young adulthood.

While IBS doesn’t damage the tissue of the digestive tract or increase the risk of colorectal cancer, you should see a doctor if your symptoms prevent you from experiencing a full quality of life.

The different types of IBS

The type of IBS you have depends on the nature of your bowel movements. It’s possible to have normal bowel movements some days and abnormal ones on other days. IBS types include:

  • IBS with constipation
  • IBS with diarrhea
  • IBS with mixed bowel habits

It’s important to understand the difference between irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). IBS and IBD may sound similar but are two very different conditions. IBS is a chronic syndrome made up of a group of symptoms, while IBD refers to chronic inflammation of the GI tract. Common forms of IBD include Crohn’s disease and ulcerative colitis.

IBS symptoms

People with IBS often experience both constipation and diarrhea. Symptoms such as bloating and gas usually go away after a bowel movement, while other symptoms may flare up when you’re under stress.

Common symptoms of IBS include:

  • Bowel movements that are harder or looser than usual
  • Diarrhea, constipation, or both
  • Excess gas
  • Pain or cramps in the lower half of the abdomen
  • Bloating
  • Feeling that you didn’t completely empty your bowels (incomplete evacuation)
  • Mucus in the stool

For some, symptoms of IBS may vanish, only to return later, while others experience persistent symptoms for months or even years.

Risk factors for IBS

In some cases, IBS may be the gut’s reaction to stress and anxiety. The condition is more common among women than men, and the risk for developing IBS increases if you have a family history of IBS.

Other risk factors include food intolerance, depression or anxiety, a history of sexual, physical, or emotional abuse, and digestive tract infections. People who experience stress during childhood often have symptoms of IBS as they age.

What causes IBS?

While researchers don’t know exactly what causes IBS, they have identified a combination of factors that can lead to the condition, including hypersensitivity of the nerves in the wall of the digestive tract. IBS may be the result of a disturbance between how the nerves in the gut communicate with the brain and how the brain processes the information.

During the normal digestive process, the body absorbs water and nutrients as contractions move food through the digestive tract and create a stool that is passed in a bowel movement.

People with IBS often have irregular contractions. In addition, the nerves in the bowel are hypersensitive, and the nerves that control the muscles of the gut are unusually active. If irregular contractions cause a bowel movement to be delayed, the stool may lose too much water in the colon, which can lead to constipation. Spasms can also push a stool through the colon so fast that the body can’t absorb the fluid, which can cause diarrhea.

Home remedies for IBS

Many people find that making lifestyle changes—like adding more fiber to your diet and exercising regularly—can improve the symptoms of IBS.

Avoiding foods that trigger IBS flare-ups can also help. Lactose intolerance is more common in people with IBS, so ask your doctor if you should limit the amount of cow’s milk and other dairy products you consume. Other common triggers include caffeine, wheat, deep-fried or spicy foods, carbonated drinks, beans, cabbage, citrus fruits, red peppers, green onions, chocolate, and red wine.

If you experience high amounts of stress, consider practicing relaxation techniques or ask your doctor if you should start seeing a behavioral therapist. For some people with IBS, herbs such as ginger, peppermint, and chamomile may help to relieve their symptoms.

When to see a doctor for IBS

If you have symptoms of IBS that prevent you from experiencing a full quality of life, going to work, or engaging in activities you enjoy, schedule an appointment with your primary care doctor.

While no lab test or imaging test can specifically diagnose IBS, your doctor may order a blood test, stool sample, X-ray, or other test to help rule out other conditions that are similar to IBS.

In addition to a performing a physical exam, your doctor may ask a number of question, including:

  • Do you have a family history of IBS?
  • What symptoms are you experiencing?
  • How often do you have symptoms?
  • When did your symptoms start?
  • Do you take any medicines or supplements?
  • Have you recently been under stress?
  • Have you recently had a GI infection?
  • Have you noticed a change in how often you have bowel movements?
  • Have you noticed any changes in the appearance of your stool?

Your doctor may recommend a low FODMAP diet. A FODMAP is a type of carbohydrate found in certain foods that may be linked to common digestive issues like IBS.

A low FODMAP diet for IBS

A low FODMAP diet seeks to reduce sugars that that the small intestine has trouble absorbing and can help people with IBS determine which foods trigger their symptoms. This type of diet is a temporary eating plan that eliminates many foods and is not a diet anyone should follow for long.

It’s essential to work with your doctor or a dietitian who can make sure you follow the diet correctly and maintain proper nutrition.

A low FODMAP involves three steps:

  1. Stop eating certain high FODMAP foods for two to six weeks.
  2. Slowly reintroduce the foods one at a time to see which ones cause symptoms.
  3. Avoid or limit foods that cause IBS symptoms.

High FODMAP foods include:

  • Cow’s milk, yogurt, and ice cream
  • Wheat-based products such as cereal, bread, and crackers
  • Beans and lentils
  • Artichokes, asparagus, onions, and garlic
  • Apples, cherries, pears, and peaches

Low FODMAP foods include:

  • Almond milk
  • Rice, quinoa, and oats
  • Eggs and meat
  • Brie, Camembert, cheddar, and feta cheese
  • Eggplant, potatoes, tomatoes, cucumbers, and zucchini
  • Grapes, oranges, strawberries, blueberries, and pineapple

Living with IBS

Treating IBS can be frustrating as you try to figure out what works for you. It may take a few weeks or even several months before you notice improvements in how you feel. While there is no cure, it’s possible to relieve the symptoms of IBS through dietary and lifestyle changes. The first step is talk to your doctor. Together, you can create a treatment plan that is right for you.