IBS Symptoms, Solutions, and Treatment | Ashcroft Pharmacy

IBS (irritable bowel syndrome) affects your gastrointestinal tract, causing chronic stomach issues and intestinal symptoms.

It is a common condition that leads to painful or uncomfortable abdominal symptoms such as bloating, gas, diarrhea, constipation, etc.

Although irritable bowel syndrome does not cause the risk of colon cancer, damage your digestive tract, or changes in bowel tissue, it is an ongoing condition and requires long-term management via medication, lifestyle, and diet changes.

What is irritable bowel syndrome (IBS)?

IBS causes belly discomfort and difficulty with bowel habits, such as different kinds of stool (hard, thin, soft, or liquid) or less or more than normal (constipation or diarrhea).

It is a chronic (long-term) condition that can last for months, weeks, or days and interferes with your daily routine. Usually, doctors call other names instead of IBS, such as:

• Nervous colon
• IBS colitis
• Spastic colon
• Mucous colitis
• Spastic bowel

Living with IBS is frustrating, letting you change your working hours, work setting, working mode (from office to remote), or even not working at all. There is no cure for IBS but diet changes and medications help you control IBS symptoms efficiently. 

Types of irritable bowel syndrome (IBS): What are the four stages of IBS?

Researchers have categorized IBS based on how your poop/stool looks when you are on IBS flare-up symptoms. The types of IBS include:

• IBS-C (IBS with constipation) — Poop is hard and lumpy
  
  
• IBS-D (IBS with diarrhea) — Poop is loose and watery
  
  
• IBS-M (IBS with mixed bowel habits) — Both lumpy and hard bowel movements and loose and watery movements. 
  
  
• IBS-U (undefined subtype) —- Symptoms vary
  
  
• Certain treatments work for specific types of IBS, so knowing the difference between them is important. 

IBS symptoms vary from person to person. Some experience severe symptoms, while others do not get any symptoms.

Sometimes, symptoms go away completely, you will have normal bowel movements, and at other times, they return. The signs and symptoms of IBS are:

• ✅ Abdominal/stomach cramps and pain
• ✅ Excess bloating and gas (flatulence)
• ✅ Swelling of stomach
• ✅ Mucus in poop (whitish poop)
• ✅ Constipation, diarrhea, or alteration between two
• ✅ Feeling that you are unable to empty your bowels even after pooping
• ✅ Heartburn and indigestion
• ✅ Lethargy (lack of energy)
• ✅ Feeling sick
• ✅ Stress, anxiety, or depression
• ✅ Food tolerance 
• ✅ Headache 
• ✅ Sticking out belly
• ✅ Urge to pee a lot
• ✅ Brain fog
• ✅ Joint pain
• ✅ Urgent need to poop
• ✅ Backache 
• ✅ Unable to control poop (bowel irregularities/incontinence)

Irritable bowel syndrome symptoms in children 

IBS affects 1 in 6 children, and the symptoms may include:

• ✅ Diarrhea, constipation, or both
• ✅ Belly pain or discomfort
• ✅ Mucus in your poop
• ✅ Bloating
• ✅ Urgent need to poop
• ✅ Cramping
• ✅ Excessive flatulence (farting)
• ✅ Nausea
• ✅ Vomiting
• ✅ Weight loss
• ✅ Sensation of incomplete evacuation

 Sometimes, children experience red-flag symptoms that are more concentrated than IBS. They include:

• ✅ Ongoing vomiting
• ✅ Difficulty in swallowing 
• ✅ Frequent diarrhea at night
• ✅ Ongoing pain in the lower or upper side of the belly
• ✅ Arthritis
• ✅ Bloody vomiting, bleeding from the rectum, or other signs of gastrointestinal bleeding.
• ✅ Slowed growth
• ✅ Unexplained weight loss
• ✅ Delayed puberty 

Symptoms of IBS in females

IBS (Irritable Bowel Syndrome) can be classified based on the main symptoms people experience. These include IBS with constipation (IBS-C), IBS with diarrhea (IBS-D), IBS with both symptoms (IBS-M), and IBS that doesn't fit into a specific category (unclassified IBS).

According to a study in (JNMjournal.org 2018), IBS is more common in women, with women being about 2 to 2.5 times more likely than men to seek medical care for the condition.

For example, if 10 women and 10 men were to experience IBS, around 2 to 2.5 times more women would visit a doctor for treatment.

When it comes to gender differences, IBS affects men and women differently. For example, IBS with constipation (IBS-C) is more common in women, while IBS with diarrhea (IBS-D) is more common in men.

A study reviewing 22 research papers found that women with IBS are more likely to experience symptoms like abdominal pain and constipation, while men tend to have more diarrhea-related symptoms.

The study also showed that about 40% of women with IBS have IBS-C, compared to 21% of men. On the other hand, 31% of women have IBS-D, while 50% of men have it.

For IBS with both constipation and diarrhea (IBS-M), the numbers are about the same in both genders, with 25.8% in women and 25.0% in men.

IBS in females often occurs as a combination of systematic and gastrointestinal symptoms. It includes bloating gas, abdominal pain, and changes in bowel habits such as constipation or diarrhea or alteration between the two. 

In females, the hormonal fluctuations during menstruation elevate the symptoms, making them more severe. Some women even reported backache, depression, fatigue, or anxiety associated with IBS.

However, the type and intensity of symptoms vary from person to person, so consult your doctor for personalized advice. 

Emergency Symptoms of IBS:

❇️ Nighttime diarrhea

❇️ Bleeding from your rectum

❇️ Weight loss

❇️ Ongoing pain with gas or pooping

❇️ Unexplained vomiting

IBS is a neuro-gastrointestinal condition that affects gut-brain interaction. Its causes include:

Dysmotility: In this condition, the problem occurs during GI (gastrointestinal discomfort) muscle contraction, causing food to move through your GI tract. Your colon (large intestine) muscles contract more, causing pain and cramps. 

Gut bacteria: People with IBS have altered bacteria in their GI tract. Each person has different types and amounts of gut bacteria, and alteration causes IBS symptoms. 

Visceral hypersensitivity: If you have extra-sensitive nerves in your GI tract, you will have lower pain tolerance than others and a higher risk for IBS. So, you will experience severe discomfort or unexplained stomach pain.

Severe infection: If you recently have a severe infection by a virus or bacteria (diarrhea, etc), you may have a chance of developing IBS symptoms. 

Food intolerance: If you have an allergy or sensitivity to some food, you may get IBS.

Childhood stress: IBS is more common in people with severe childhood stress, such as sexual, physical, or emotional base, resulting in stress-induced digestive issues. 

Nervous system: If an issue occurs with the GI nerves (alteration in gastrin and serotonin chemicals that control nerve signals),

it results in chronic digestive discomfort. The poorly coordinated signals between your brain and intestine let your body overreact, causing pain, chronic constipation, or diarrhea. 

IBS triggers — What will trigger IBS?

IBS triggers vary from person to person. So, you must identify those triggers to manage IBS symptoms effectively.

The symptoms of IBS are triggered by:

Certain foods include dairy products (ice cream or cheese), gluten (such as wheat), beans, cabbage, milk, citrus fruits, alcohol, artificial sweeteners, and carbonated drinks. 

Stress — Increased stress does not cause IBS but worsens your IBS symptoms. 

Periods —- If you were AFAB (assigned female at birth), you might get IBS symptoms during the menstrual cycle.

Poor sleep —- Not getting enough sleep contributes to IBS symptoms.

Foods high in fructose —- These include processed foods such as dried fruits, fruit juices, apples, and pears. 

Caffeine —- It includes tea, soda, chocolate, coffee, and over-the-counter painkillers.

Other triggers —- It may include onions, leeks, shallots, broccoli, cauliflowers, brussels sprouts, cabbage, and leafy greens (mustard and kale greens).

Risk factors for IBS: Who suffers from IBS the most?

IBS affects 25-45 million Americans. Most people get IBS in their late teens or early 40s. The risk factors may include:

• Fibromyalgia
  
  
• Chronic pelvic pain
  
  
• Chronic pain syndrome
  
  
• Diagnosis of depression, anxiety, emotional trouble, or PTSD (post-traumatic stress disorder) 
  
  
• Age
  
  
• Family history of IBS
  
  
• Medications such as antibiotics, drugs with sorbitol, and antidepressants
  
  
• Digestive disorders such as food poisoning, traveler’s diarrhea, or stomach flu
  
  
• Chronic conditions such as migraine, interstitial cystitis, and temporomandibular syndrome. 

Complication of IBS

IBS can cause further complications such as:

• Hemorrhoids (swollen blood vessels around your anus)
• Poor quality of life
• Mood disorders such as anxiety or depression
• Impact bowel movements such as fecal impaction  (stool gets blocked in your colon)
• Malnourishment (due to skipping of some food to ease IBS symptoms)

How is IBS diagnosed?

IBS (Irritable Bowel Syndrome) is diagnosed based on symptoms, medical history, and ruling out other conditions. Here's how doctors typically diagnose IBS:

Medical history

Your doctor will ask you the following questions to determine whether you have IBS symptoms:

• Is there any change in the appearance of your poop?
• Do you have pain related to bowel movements?
• When did your symptoms start?
• Do you experience abnormal bowel movements?
• What is the frequency of your symptoms?
• What medications have you used?
• Have you been sick or faced a stressful event recently?

After asking these questions, your healthcare provider will suggest lab tests to confirm the diagnosis.

Lab tests

There are no specific lab tests to diagnose IBS; however, your doctor performs some tests to filter out some conditions, such as:

• Lactose intolerance
• Food allergies
• Poor dietary habits
• Infection
• Enzyme deficiencies (maybe your pancreas is not making enough enzymes to digest/break down food)
• Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis.

The lab tests to confirm IBS symptoms are:

• X-rays
• Stool test for infection, blood, or inflammation in your bowel
• Upper endoscopy can diagnose celiac disease or other GI and stomach-related conditions (indigestion or heartburn)
• Test for gluten allergy, celiac disease, or lactose intolerance
• Blood tests to determine anemia, signs of infection, and thyroid problems
• Flexible sigmoidoscopy to figure out inflammation/blockage in your intestine
• A colonoscopy views your entire colon and diagnoses IBD, polyps, and cancerous growths by inserting a scope
• Test to evaluate problems with your bowel muscles 
• Hydrogen breath test to see the overgrowth of bacteria in your gut
• CT scan to see images of pelvis and abdomen, ruling out other symptoms even if belly pain is present

IBS Treatment — How to fix irritable bowel syndrome?

There is no specific treatment for IBS; however, various treatments are used together to manage or ease IBS symptoms, such as:

Meal changes

The dietary changes include:

• Eat fiber-rich food such as vegetables, fruits, grains, nuts, and prunes, easing constipation.
• Use supplemental fiber such as Metamucil® or Citrucel®.
• Limit dairy products such as milk and cheese. 
• Eat non-dairy and calcium-rich foods such as salmon, spinach, tofu, turnip greens, yogurt, sardines, or broccoli.
• Avoid gluten 
• Try a low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet to cut down hard-to-digest carbs
• Drink plenty of water (8-ounce/2 liters of water a day)
• Avoid caffeine (tea, soda, and coffee) and quit smoking
  
  

Activity changes

The activity changes include:

• Exercise regularly (moderate exercise for 150 minutes weekly or 30 minutes a day)
  
  
• Try relaxation techniques such as meditation, yoga, and other de-stressing techniques 
  
  
• Get enough sleep  for 7-9 hours per night 
  
  

Therapy

Some people find relief from these therapies, such as:

• Hypnotherapy
• Cognitive behavioral therapy (CBT)
• Biofeedback 
  
  

Medications 

Sometimes, doctors prescribe medicines to alleviate IBS symptoms, such as:

• Antidepressants (if you have depression with significant tummy troubles) — tricyclic antidepressants (TCAs) & selective serotonin reuptake inhibitors (SSRIs).
  
  
• Medications to ease constipation — fiber supplements and laxatives such as Linaclotide (Linzess), Lubiprostone (Amitiza), Plecanatide (Trulance), Polyethylene glycol (PEG), Tegaserod, and Tenapanor 
  
  
• Drugs to firm stools, such as antidiarrheals
  
  
• Medicines to ease intestinal distress and spasms
  
  
• Drugs to ease belly pain and chronic bloating —- probiotics and antispasmodics 

Medication to ease diarrhea —- Alosetron (Lotronex), eluxadoline (Viberzi),  bile acid sequestrants, cholesterol-lowering medications, and loperamide (Imodium)

• Hyoscyamine
• Anticholinergic medicines — Dicyclomine (bentyl)
• Painkillers —- Pregabalin (Lyrica) or gabapentin (Neurontin)
• Antibiotic —- Rifaximin (decrease bacterial overgrowth)
  
  

Future treatment aspects for IBS

Researchers are finding new techniques and treatment plans for IBS such as fecal microbiota transplantation (FMT).

This technique will restore your intestinal healthy bacteria by placing another person’s processed stool into the colon of an IBS-infected person. However, this technique is still under study. 

When should I consult a doctor?

You must consult your doctor if:

• Your symptoms persist for more than 3 months
  
  
• Your symptoms are getting worse over time, such as unexplained weight loss, rectal bleeding, vomiting, fever, severe abdominal discomfort, or severe diarrhea 
  
  
• Symptoms are interfering with your daily routine

After visiting your doctor, ask him about:

• Medications
• Food to avoid
• Lifestyle changes
• Medical follow-ups
• Duration of the treatment course

So, consult your doctor and manage your IBS symptoms as directed by your doctor. Also, combine your treatment plan with effective management techniques for the best results.  

How to tell if you have IBS?/What are the first symptoms of an IBS flare?

Watch IBS flare-ups such as bloating, abdominal pain, and changes in bowel movements such as constipation, diarrhea, or both.

If these symptoms persist for 3 months, consult your doctor and he will ask you to do some lab tests to confirm the IBS.

Is IBS caused by anxiety?

IBS is not caused by anxiety. However, anxiety and stress can worsen the IBS symptoms by targeting the gut-brain axis. In this case, stress management techniques can ease IBS symptoms. 

What is commonly mistaken for IBS?

The commonly mistaken conditions for IBS include celiac disease, IBD (inflammatory bowel disease such as ulcerative colitis or Crohn’s disease), and small intestine bacterial overgrowth (SIBO).

These disorders share similar symptoms such as bloating, abdominal cramps, etc, so different treatments will make accurate diagnoses. 

How can I check my IBS at home?

You cannot check IBS at home, and you will need a doctor to confirm the diagnosis and start treatment.

However, you can monitor IBS symptoms such as changes in bowel habits, bloating, or abdominal cramps and manage your IBS symptoms at home via certain lifestyle changes. 

How does IBS usually start?

IBS is usually triggered by dietary changes, stress, a history of digestive issues, or gastrointestinal infections. In the start, IBS symptoms are mild and can worsen over time without proper management. 

How long do IBS symptoms last?

IBS symptoms may last from a few hours to several days, depending on the triggers and individual responses. Sometimes, the symptoms come and go in cycles,

with periods of relief between flare-ups. Managing stress and triggers can reduce your IBS symptoms and their duration. 

How to cure IBS permanently?

There is no cure for IBS. However, you can manage it via stress management, dietary changes, regular exercise, and medications. 

Are IBS symptoms the same for people assigned female at birth (AFAB) and people assigned male at birth?

IBS symptoms are not the same for AFAB and AMAB. AFAB (assigned female at birth) usually experiences hormonal fluctuation, severe abdominal pain, bloating,

and constipation, while AMAB (assigned male at birth) gets more diarrhea-predominant IBS. However, the core IBS symptoms, such as discomfort, pain, cramps, and altered bowel habits, are the same. 

Can IBS cause UTI symptoms/ Are Bladder Problems Common in People With IBS?

IBS can cause UTI symptoms such as incomplete bladder emptying, urgency, and frequent urination. These symptoms occur due to pelvic floor dysfunction, inflammation, nervous system issues,

or interstitial cystitis. Medical help can address IBS and bladder systems, improving the quality of your life. 

Can IBS make you feel sick all the time?

IBS causes abdominal pain, fatigue, bloating, or nausea, making you feel sick all the time. However, the symptoms and triggers vary from person to person. 

Can IBS cause nausea and dizziness?

IBS may cause nausea due to indigestion, medication, gastroesophageal reflux disease (GERD), or gut-brain axis dysfunction. On the other hand, dizziness occurs indirectly from disrupted eating patterns, dehydration, or stress associated with IBS. 

What does IBS nausea feel like?

IBS nausea feels like a persistent unsettled or queasy stomach, accompanied by discomfort or bloating. The intensity can vary from person to person. 

Can IBS feel like morning sickness?

Most people with IBS experience nausea in the morning (most often the first thing in the morning).

It is accompanied by constipation, which sometimes may be relieved after a bowel movement or become severe to cause vomiting.

Medically reviewed by

Resources

Journal of Neurogastroenterology and Motility 2018

National Library of Medicine