How to manage IBS symptoms

Irritable bowel syndrome (IBS) is a chronic disorder that affects the large intestine.

The most common symptoms include stomach pain along with changes in bowel habits. People with IBS may have diarrhea, constipation or a combination of both. It is estimated to affect between 25 and 45 million people in the U.S and about 10% to 15% of the population worldwide. IBS occurs more often in women than men and usually begins in young adulthood.

People with IBS may have some or all of these symptoms:

• Stomach pain, discomfort or cramping that usually goes away after a bowel movement
• Periods of diarrhea or constipation, or alternating between these two symptoms
• Bloating and excess gas
• Mucus in the stool

Symptoms may come and go and can change in the same person. Many women report that their IBS symptoms are worse during or around their menstrual period.

There's no specific medical test to identify IBS. Instead, healthcare providers usually make a diagnosis based on a review of your symptoms, medical history and physical exam. They may need to perform some tests, including blood tests and stool samples, to rule out other medical conditions that can cause the same symptoms as IBS.

Doctors and researchers aren't sure what causes IBS. Some studies suggest that the nerves of the intestines may be much more sensitive than usual in people with IBS. This means that normal amounts of gas or movement in the bowels that is barely noticeable in most people is perceived as painful in those with IBS. While IBS can cause a great deal of physical discomfort and emotional distress, it does not cause harm to the intestines or increase the risk of getting serious bowel diseases.

Lifestyle changes and medication can help ease the symptoms of IBS, but no treatment can cure this condition. And while neither diet nor stress causes IBS, diet or stress can worsen or trigger symptoms. Consider taking these actions to help ease your IBS symptoms:

• Keep a food diary to help determine which foods trigger your symptoms. Bring it to your healthcare provider so you can talk about which foods appear to make your symptoms worse. You may need to avoid these foods or eat less of them.
• Some people with IBS are sensitive to particular types of carbohydrates, such as fructose, fructans, lactose and others, known as FODMAPs — fermentable oligosaccharides, disaccharides, monosaccharides and polyols. FODMAPs are found in a wide range of foods, including certain grains, fruits, vegetables and dairy products. A FODMAP-modified diet can help alleviate IBS symptoms in some people. Your healthcare provider or dietitian may recommend that you follow a FODMAP-restricted diet for about two to six weeks to see if your symptoms improve in the short term. Then, you can gradually reintroduce FODMAPs one at a time to identify trigger foods. The end goal is to achieve the most varied diet possible while keeping your symptoms at bay.
• Try to reduce stress. Exercise, yoga, massage and meditation can help. Some people benefit from cognitive behavioral therapy, a type of talk therapy, or other forms of counseling to help control stress associated with IBS flares.
• Ask your healthcare provider about medication. Both prescription and over-the-counter medications are available to help manage IBS symptoms. Bulk-forming fiber supplements, anti-diarrheal medications or laxatives may help regulate constipation and diarrhea, and you can purchase them without a prescription. Talk with your pharmacist for specific recommendations.
• Prescription medicines. If your symptoms are more severe, your provider may suggest prescription medicines to help ease and control symptoms. They may prescribe antispasmodic medications to help reduce cramping associated with IBS. Commonly used antidepressants may help reduce pain and other symptoms in IBS. There are also several prescription medications approved specifically to treat IBS. Your provider will have suggestions on which ones may work for your symptoms.

If you have symptoms and think you may have IBS, you should talk to your healthcare provider. Symptoms can differ from person to person, and no specific treatment works for everyone. Your healthcare provider can work with you to find the treatment that works best for you to manage your symptoms and help you feel better.
 

Clinically reviewed and updated January 2022.