What Is IBS, Exactly?

IBS symptoms can vary from person to person, but the most common are recurring abdominal pain along with diarrhea, constipation or both.
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If abdominal pain, bloating, an inability to go to the bathroom or sudden urges to rush to it are part of your day-to-day life, you may be suffering from irritable bowel syndrome (IBS).

IBS can range from a slight inconvenience to a debilitating condition that interrupts everyday activities like going to work and the store.

Irritable bowel syndrome is a group of symptoms that occur together, and while uncomfortable and inconvenient, it doesn't cause any visible damage or signs of disease in the digestive tract, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

Here's what else you need to know about IBS.

What Causes IBS?

Unfortunately, no one knows what causes IBS, according to Harvard Health Publishing.

Some studies have found that people with IBS have nerves in the colon that are more sensitive than those without the condition. These extra-sensitive nerves may cause pain, intestinal spasms and an irregular pattern of bowel movements. But the verdict is still out, and many more factors may play a role.

"Because IBS is so heterogenous, the actual cause is unknown, though it likely could involve stress, the gut microbiota, abnormalities in the movement of the gut or changes in how the brain and the gut communicate and work together," Andrea Hardy, RD, IBS and gut health-focused registered dietitian and owner of Ignite Nutrition, tells LIVESTRONG.com.

"Many people think IBS isn't a 'real condition.' It absolutely is, and getting the right diagnosis is key."

Harvard Health Publishing notes that stress does not cause IBS but can increase the frequency and severity of symptoms.

"Irritable bowel syndrome is, by definition, characterized by both abdominal pain and a change in bowel habits — diarrhea, constipation or both," gastroenterologist Will Bulsiewicz, MD, tells LIVESTRONG.com. "We know that all patients with irritable bowel syndrome will have these particular symptoms, while many will also have gas, bloating, abdominal distension, nausea, fatigue and food intolerances."

Dr. Bulsiewicz believes these issues are a result of damaged or imbalanced gut bacteria.

Constipation is a common symptom of IBS that's typically treatable by changes in diet.
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Symptoms of IBS

Irritable bowel syndrome symptoms vary widely from person to person, but the Mayo Clinic lists the following as common symptoms for IBS sufferers:

  • Diarrhea or constipation, or alternating between the two
  • Distended (enlarged) abdomen
  • Bloating and gassiness
  • Always feeling as though a bowel movement is incomplete
  • Bowel movements that contain mucus
  • Severe or mild abdominal discomfort, cramping and abdominal pain that usually subsides after a bowel movement

Symptoms of IBS can ebb and flow. Symptoms can often increase in severity due to stress, hormones and diet. Sufferers may find that symptoms even disappear completely at times.

What Is IBS Pain Like?

Each person experiences IBS pain a bit differently, but it's often described as cramping, stabbing, aching, sharp or throbbing and can be felt anywhere in the abdomen but most often in the lower region, according to the International Foundation for Gastrointestinal Disorders.

Diagnosing IBS

Diagnosing IBS can be difficult, as symptoms are typically inconsistent.

IBS appears to occur more frequently in people who are:

  • Younger than 50
  • Female
  • Have anxiety or depression
  • Have a history of physical or emotional abuse
  • Have a family history of IBS

There are no specific tests for IBS, according to Harvard Health Publishing. Diagnosis usually occurs when symptoms are typical for the condition and other digestive disorders — such as celiac or inflammatory bowel disease — have been ruled out.

Before diagnosing IBS, your doctor will most likely run tests to check for infections, colon integrity and potential food allergies, such as gluten and dairy.

"Many people think IBS isn't a 'real condition.' It absolutely is, and getting the right diagnosis is key," Hardy says.

Leafy greens and salmon are both considered IBS-friendly foods.
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IBS Treatment

1. Dietary Changes

"Nutrition is the most powerful tool that I've seen for managing IBS symptoms," nutritionist Adrian Chavez, PhD, nutritionist and functional medicine practitioner, tells LIVESTRONG.com. "Many people can become nearly symptom-free just by identifying and avoiding problem foods."

What Are the Worst Foods for IBS?

The following foods are common triggers for IBS symptoms, according to Harvard Health Publishing:

  • Caffeine
  • Alcohol
  • Dairy products
  • Fried foods
  • Fatty foods (including avocados)
  • Raw fruits
  • Cabbage, broccoli, kale, legumes and other gas-producing plant foods
  • Foods that contain artificial sweeteners or sorbitol
  • Gum

Indeed, changes in diet can improve symptoms drastically, according to both the Mayo Clinic and Harvard Health Publishing. But those who suffer from IBS should keep in mind that it can take a long time to discover which dietary limitations work best for each person.

Symptoms can change as well, so while one dietary pattern may work well for awhile, it may need to be altered down the road for continued symptom control.

In addition to specific foods, the way you eat may also exacerbate symptoms. Large amounts of food at one time can cause diarrhea and cramping, for example. Experts recommend eating smaller, more frequent meals to help reduce IBS symptoms.

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2. Adding Key Nutrients

"Usually my first approach is with a prebiotic fiber supplement, like wheat dextrin or acacia powder, plus magnesium supplements," Dr. Bulsiewicz says. "The fiber feeds the gut microbiome, gives the stool form and also helps to keep things moving through. The magnesium is a [stool] softener. Often the doses are adjusted until we get into that sweet spot where there's a good bowel rhythm."

If your IBS symptoms include constipation, you may need to add fiber to your diet to help regulate bowel movements. Fiber can increase gas in the intestines, though, so adding small amounts of fiber to your diet over several days is a smarter strategy than adding large amounts of fiber all at once. Doing it slowly will help to ensure limited side effects.

While natural sources of fiber like fruits, vegetables and whole grains are best from a nutritional standpoint, fiber supplements that contain methylcellulose or psyllium are usually good options for those with IBS, per Harvard Health Publishing.

"In terms of treatment, as a dietitian I always like to say food first! Nutrition, changes in lifestyle, stress management, changes in exercise and good sleep habits have all been shown to help with the management of irritable bowel syndrome," Hardy says. "If this is inadequate or your symptoms are severe, medication may be appropriate as well."

3. Medication

Harvard Health Publishing notes the following as common medications for IBS sufferers:

  • Pain-reducing agents, including amitriptyline and desipramine
  • Antispasmodics like dicyclomine to reduce abdominal and intestinal cramping
  • Antidiarrheals like loperamide and diphenoxylate
  • Contispation drugs including lubiprostone and linaclotide

Tip

Discussing symptoms with your doctor is important. Your doctor or dietitian will help to identify food triggers, strategies for symptom management and any necessary medications that might be needed.

While irritable bowel syndrome cannot be cured, symptom management strategies can greatly reduce the effect of IBS on daily activities and quality of life.

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