Irritable Bowel Syndrome

Also known as: IBS

Irritable bowel syndrome (IBS) is a disorder of the intestines. It is not a disease, but a group of symptoms caused by changes in the way the intestines work including how they move, secrete, absorb, and transit pain sensations. It is fairly common, but the cause is not well understood. There are other conditions that cause IBS symptoms, so make sure to speak with your provider to make sure that further evaluation isn't needed.

Symptoms of IBS include:

  • Belly pain, discomfort, and cramping

  • Diarrhea

  • Constipation or dry, hard stools

  • Mucous stool

  • Bloating

  • Feeling of incomplete bowel movements

It usually results in one of 3 patterns of symptoms:

  • Chronic belly pain and constipation

  • Recurring episodes of diarrhea, with belly pain or discomfort

  • Alternating diarrhea and constipation

Home care

The goal of treatment is to control and relieve your symptoms, so you can lead a full and active life. There is no cure for IBS. But it can be managed.

Diet

Your diet did not cause your IBS, but it can affect it. Diet and food choices may cause IBS symptoms in some people, but not everyone. No one diet works for everyone. Finding the best foods for you may take trial and error. Keep a food log to help find what foods made your symptoms worse. Below are some tips that may help you.

  • Eat more slowly. Eat smaller amounts at a time, but more often. Remember, you can always eat more, but cannot eat less once you’ve eaten too much.

  • In general, fiber is very helpful for both constipation and diarrhea. However, insoluble fiber can worsen bloating, cramping, and gas. Insoluble fiber can be found in wheat bran, certain vegetables, and whole-grains. Soluble fiber is in such foods as oat bran, barley, nuts, seeds, bean, lentils, peas, and some fruits and vegetables. Increase fiber slowly and choose a product that includes soluble fiber. It helps to keep a food diary and write down the symptoms you have with certain foods.

  • Try lactose-free dairy products. many people are intolerant to lactose.

  • Try cutting out foods that are high in fat and fatty meats.

  • You can control bloating or passing excess gas. Be careful with “gassy” vegetables and fruits like beans, cabbage, broccoli, and cauliflower.  Other foods called FODMAPs are a type of carbohydrate that can cause these symptoms and diarrhea. They are poorly digestible carbohydrates. Some FODMAP examples include honey, apples, pears, nectarines, lima beans, and cabbage. Talk with your provider about how to choose low FODMAP foods if you are sensitive to them.

  • Be careful with carbonated beverages and fruit juices. They can make your bloating and diarrhea worse.

  • Caffeine, alcohol, and stimulants can make symptoms worse. These include coffee, tea, sodas, energy drinks, and chocolate.

  • IBS diet guidelines can be confusing. Ask your provider for a referral to a registered dietitian. This professional can help you make sense of IBS diet suggestions.

Lifestyle

  • Look for factors that seem to worsen your symptoms. These include stress and emotions. 

  • Although stress does not cause IBS, it may trigger flare-ups. Counseling can help you learn to handle stress. So can self-help measures like exercise, yoga, and meditation.

  • Depression can occur along with IBS. Your healthcare provider may prescribe antidepressant medicine. This may help with diarrhea, constipation, and cramping, as well as with symptoms of depression.

  • Smoking doesn't cause IBS, but can make the symptoms worse.

Medicines

Your healthcare provider may prescribe medicines. Take them as directed. For acute flare-ups of your illness, your provider may give you prescription medicines.

  • Check with your healthcare provider before taking any medicines for diarrhea.

  • Don't take anti-inflammatory medicines like ibuprofen or naproxen.

  • Long-term medicines can be helpful for chronic symptoms

  • If you have lost enough weight to make you need nutritional supplements, talk to your provider. This may point to another more serious condition.

Follow-up care

Follow up with your healthcare provider, or as advised.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

  • Belly pain gets worse or does not improve after a bowel movement

  • Constant belly pain moves to the right-lower belly

  • You can't keep liquids down because of vomiting

  • You have severe, persistent diarrhea

  • You have blood (red or black color) or mucus in your stool

  • You have lost significant weight

  • You feel very weak or dizzy, faint, or have extreme thirst

  • You have a fever of 100.4ºF (38.0ºC) or higher, or as directed by your healthcare provider