Irritable Bowel Syndrome (IBS) Symptoms, Causes ... - WebMD

IBS is a mix of belly discomfort or pain and trouble with bowel habits: either going more or less often than normal (diarrhea or constipation) ... MenuNewsReferenceSlideshowsVideosQuestions&AnswersMedicationsFindaGastroenterologistOverviewSymptoms&TypesDiagnosis&TreatmentLiving&ManagingConstipationConstipationTreatmentsDiarrheaDietforIBS-CDietforIBS-DDrugInteractionCheckerIBSMedicationsIrritableBowelSyndromeGuideMenuMedicallyReviewedbyJabeenBegumonOctober18,2021InthisArticleWhatIsIrritableBowelSyndrome(IBS)?IBSSymptomsIBSCausesandRiskFactorsIBSDiagnosisIBSTreatmentandHomeCareIBSComplicationsWhatIsIrritableBowelSyndrome(IBS)?IBSisamixofbellydiscomfortorpainandtroublewithbowelhabits:eithergoingmoreorlessoftenthannormal(diarrheaorconstipation)orhavingadifferentkindofstool(thin,hard,orsoftandliquid).DoctorsusedtocallIBSothernamesincluding:IBScolitisMucouscolitisSpasticcolonNervouscolonSpasticbowelTherearefourtypesofthecondition:IBSwithconstipation(IBS-C)IBSwithdiarrhea(IBS-D)MixedIBS(IBS-M)alternatesbetweenconstipationanddiarrheaUnsubtypedIBS(IBS-U)forpeoplewhodon'tfitintotheabovetypesIBSisn’tlife-threatening,anditdoesn'tmakeyoumorelikelytogetothercolonconditions,suchasulcerativecolitis,Crohn'sdisease,orcoloncancer.Butitcanbealong-lastingproblemthatchangeshowyouliveyourlife.PeoplewithIBSmaymissworkorschoolmoreoften,andtheymayfeellessabletotakepartindailyactivities.Somepeoplemayneedtochangetheirworksetting:shiftingtoworkingathome,changinghours,orevennotworkingatall.IBSSymptomsPeoplewithIBShavesymptomsthatcaninclude:Diarrhea(oftendescribedasviolentepisodesofdiarrhea)ConstipationConstipationalternatingwithdiarrheaBellypainsorcramps,usuallyinthelowerhalfofthebelly,thatgetworseaftermealsandfeelbetterafterabowelmovementAlotofgasorbloatingHarderorlooserstoolsthannormal(pelletsorflatribbonstools)AbellythatsticksoutMucusinyourpoopFeelinglikeyoustillneedtopoopafteryoujustdidFoodintoleranceTirednessAnxietyDepressionHeartburnandindigestionHeadachesNeedingtopeealotOtherthingsmaycausethesesymptomssometimes.Ifit’sIBS,you’lllikelyhavethesesymptomsweeklyfor3months,orlessoftenforatleast6months.WomenwithIBSmayhavemoresymptomsduringtheirperiod.Somepeoplealsohaveurinarysymptomsorsexualproblems.Stresscanmakesymptomsworse.WhentocallyourdoctorIfyouhaveanIBSsymptomthatlastsalongtime,yougetanewsymptom,oryourpainisworsethanusualoryouhavenewpain,seeyourdoctor.Ifyouusuallytakeover-the-countermedicationsbutnowtheydon’teaseproblemslikediarrhea,gas,orcramping,youalsoneedtoseeadoctor.Evenifyoudon’tthinkaproblemisphysicallypartofIBS,butitbothersyou,tellyourdoctor.Forexample,ifyou’restressedoutoranxiousaboutit,orifyou’relosingsleepovertheproblem,letyourdoctorknow.IBSusuallydoesn’tleadtomoreseriousdiseases,butthereare“redflags”tolookforthatcouldmeansomethingmoreseriousisgoingon.Ared-flagsymptomisonethatisn’tusuallyseenwithIBS.Ifyouhaveoneormore,seeyourdoctor.You’llneedteststofindoutwhat’sgoingon.Red-flagsymptomsinclude:Rectalbleeding:Itcouldjustbeasideeffectfromyourirritablebowelsyndromeconstipation,causedbyatearinyouranus.Thebleedingalsomightbecausedbyahemorrhoid.Butifyouhavealargeamountofbloodinyourstool,orifthebleedingjustwon’tgoaway,youshouldgetmedicalattentionassoonaspossible.Weightloss:Ifyoufindyou’relosingweightfornoreason,it’stimetogetitcheckedout.Fever,vomiting,andanemia:Ifyouhaveoneormore,orthinkyoudo,youshouldcallyourdoctor.IBSCausesandRiskFactorsWhileseveralthingsareknowntotriggerIBSsymptoms,expertsdon'tknowwhatcausesthecondition.Studiessuggestthatthecolongetshypersensitive,overreactingtomildstimulation.Insteadofslow,rhythmicmusclemovements,thebowelmusclesspasm.Thatcancausediarrheaorconstipation.Anothertheorysuggestsitmayinvolvechemicalsmadebythebody,suchasserotoninandgastrin,thatcontrolnervesignalsbetweenthebrainanddigestivetract.Otherresearchersarestudyingtoseeifcertainbacteriainthebowelscanleadtothecondition.IBSaffectsbetween25millionand45millionAmericans.Somethingsseemtomakepeoplemorelikelytohaveitthanothers:Beingawoman.Abouttwiceasmanywomenasmenhavethecondition.It’snotclearwhy,butsomeresearchersthinkthechanginghormonesinthemenstrualcyclemayhavesomethingtodowithit.Sofar,studieshaven’tbornethisout.Age.IBScanaffectpeopleofallages,butit'smorelikelyforpeopleintheirteensthroughtheir40s.Familyhistory.Theconditionseemstoruninfamilies.Somestudieshaveshownthatyourgenesmayplayarole.Emotionaltrouble.SomepeoplewithIBSseemtohavetroublewithstress,haveamentaldisorder,orhavebeenthroughatraumaticeventintheirlives,suchassexualabuseordomesticviolence.It'snotclearwhatcomesfirst--thestressortheIBS.Butthere'sevidencethatstressmanagementandbehavioraltherapycanhelprelievesymptomsinsomepeoplewiththecondition.Foodsensitivities.Somepeoplemayhavedigestivesystemsthatrumbleangrilywhentheyeatdairy,wheat,asugarinfruitscalledfructose,orthesugarsubstitutesorbitol.Fattyfoods,carbonateddrinks,andalcoholcanalsoupsetdigestion.There'snoproofanyofthesefoodscauseIBS,buttheymaytriggersymptoms.Medications.StudieshaveshownalinkbetweenIBSsymptomsandantibiotics,antidepressants,anddrugsmadewithsorbitol.Otherdigestiveproblems,likestomachflu,traveler'sdiarrhea,orfoodpoisoning.AsmallstudypublishedinJanuary2021suggeststhataGItractinfectioncanchangetheimmunesystemsothatitrespondstocertainfoodsasifthey'reathreat,likegermsorviruses.Researchersarelookingintotheseearlyfindings.IBSDiagnosisTherearenospecificlabteststhatcandiagnoseIBS.YourdoctorwillseeifyoursymptomsmatchwiththedefinitionofIBS,andtheymayrunteststoruleoutconditionssuchas:Foodallergiesorintolerances,suchaslactoseintoleranceandpoordietaryhabitsMedicationssuchashighbloodpressuredrugs,iron,andcertainantacidsInfectionEnzymedeficiencieswherethepancreasisn'treleasingenoughenzymestoproperlydigestorbreakdownfoodInflammatoryboweldiseaseslikeulcerativecolitisorCrohn'sdiseaseYourdoctormaydosomeofthefollowingteststodecideifyouhaveIBS:FlexiblesigmoidoscopyorcolonoscopytolookforsignsofblockageorinflammationinyourintestinesUpperendoscopyifyouhaveheartburnorindigestionX-raysBloodteststolookforanemia(toofewredbloodcells),thyroidproblems,andsignsofinfectionStooltestsforbloodorinfectionsTestsforlactoseintolerance,glutenallergy,orceliacdiseaseTeststolookforproblemswithyourbowelmusclesIBSTreatmentandHomeCareNearlyallpeoplewithIBScangethelp,butnosingletreatmentworksforeveryone.Youandyourdoctorwillneedtoworktogethertofindtherighttreatmentplantomanageyoursymptoms.ManythingscantriggerIBSsymptoms,includingcertainfoods,medicines,thepresenceofgasorstool,andemotionalstress.You’llneedtolearnwhatyourtriggersare.Youmayneedtomakesomelifestylechangesandtakemedication.DietandlifestylechangesUsually,withafewbasicchangesindietandactivities,IBSwillimproveovertime.Herearesometipstohelpeasesymptoms:Avoidcaffeine(incoffee,tea,andsoda).Addfibertoyourdietwithfoodslikefruits,vegetables,wholegrains,andnuts.Drinkatleastthreetofourglassesofwaterperday.Don'tsmoke.Learntorelax,eitherbygettingmoreexerciseorbyreducingstressinyourlife.Limithowmuchmilkorcheeseyoueat.Eatsmallermealsmoreofteninsteadofbigmeals.KeeparecordofthefoodsyoueatsoyoucanfigureoutwhichfoodsbringonboutsofIBS.Commonfood"triggers"areredpeppers,greenonions,redwine,wheat,andcow'smilk.Ifyou'reconcernedaboutgettingenoughcalcium,youcantrytogetitfromotherfoods,likebroccoli,spinach,turnipgreens,tofu,yogurt,sardines,salmonwithbones,calcium-fortifiedorangejuiceandbreads,orcalciumsupplements.YourdoctormaysuggestyoutrysomethingcalledalowFODMAPdietthatcutsdownonhard-to-digestcarbssuchaswheat,beans,andcertainfruitsandvegetables. MedicationsThefollowingtypesofdrugsareusedtotreatIBS:Bulkingagents,suchaspsyllium,wheatbran,andcornfiber,helpslowthemovementoffoodthroughthedigestivesystemandmayalsohelprelievesymptoms.Antibiotics,suchasrifaximin(Xifaxan),canchangetheamountofbacteriainyourintestines.Youtakepillsfor2weeks.Itcancontrolsymptomsforaslongas6months.Iftheycomeback,youcanbetreatedagain.OthertreatmentscanhelpwithsymptomsofIBS:BellypainandbloatingAntispasmodicscancontrolcolonmusclespasms,butexpertsareunsurethatthesedrugshelp.Theyalsohavesideeffects,suchasmakingyoudrowsyandconstipated,thatmakethemabadchoiceforsomepeople.Antidepressantsmayalsohelprelievesymptomsinsomepeople.Probiotics,whicharelivebacteriaandyeaststhataregoodforyourhealth,especiallyyourdigestivesystem;doctorsoftensuggestthemtohelpwithdigestiveproblems.ConstipationLinaclotide(Linzess)isacapsuleyoutakeoncedailyonanemptystomach,atleast30minutesbeforeyourfirstmealoftheday.Ithelpstorelieveconstipationbyhelpingbowelmovementshappenmoreoften.It’snotforanyone17yearsoldoryounger.Thedrug'smostcommonsideeffectisdiarrhea.Lubiprostone(Amitiza)cantreatIBSwithconstipationinwomenwhenothertreatmentshavenothelped.Studieshaven’tfullyshownthatitworkswellinmen.Commonsideeffectsincludenausea,diarrhea,andbellypain.Moreserioussideeffectsmayincludefainting,swellingofthearmsandlegs,breathingproblems,andheartpalpitations.Plecanatide(Trulance)hasbeenshowntotreatconstipationwithouttheusualsideeffectsofcrampingandbellypain.Theonce-a-daypillcanbetakenwithorwithoutfood.Itworkstoincreasegastrointestinalfluidinyourgutandencourageregularbowelmovements.Polyethyleneglycol(PEG)isanosmoticlaxativeandcauseswatertoremaininthestool,whichresultsinsofterstools.Thismedicationmayworkbestforthosewhocan'ttoleratedietaryfibersupplements.Tegaserodisadrugforwomen.Itworksbyspeedingupthemotioninyourgut.Thiseffectshortensthetimestoolremainsinthebowel,andhelpslessensymptomssuchasbellypainandconstipation.Tenapanor(IBSRELA)increasesbowelmovementsanddecreasesbellypain.DiarrheaAlosetron(Lotronex)canhelprelievestomachpainandslowyourbowelstorelievediarrhea,buttherecanbeserioussideeffects,soit’sonlytobeusedbywomenwithsevereIBS-Dwhosesymptomsaren’thelpedbyothertreatments.Bileacidsequestrantsarecholesterol-loweringmedications.Takenorally,theyworkintheintestinesbybindingbileacidsandreducingstoolproduction.Eluxadoline(Viberzi)isprescribedtohelpreducebowelcontractions,bellycramps,anddiarrhea.Loperamide(Imodium)worksbyslowingdownthemovementofthegut.Thisdecreasesthenumberofbowelmovementsandmakesthestoollesswatery.Makesuretofollowyourdoctor'sinstructionswhentakingIBSmedications,includinglaxatives,whichcanbehabit-formingifyoudon’tusethemcarefully.10questionstoaskyourdoctorGoingtothedoctorcanbeintimidating.Youmightfeelrushedandforgettoaskquestionsthatareimportant.It'salwaysagoodideatoknowwhattoaskbeforehandandtotakenoteswhile withthedoctor.Someofthequestionsbelowmaybeworthasking.Printoutthesequestionsandtakethemwithyoutoyournextappointment:1.CouldsomeotherconditionbecausingmyIBSsymptoms?CouldIhaveinflammatoryboweldiseaseorcoloncancer?2.ShouldIkeepadiaryofmyIBSsymptoms,and,ifso,whatshouldIwritedown?3.ShouldItakelaxativesorotherover-the-countermedications?Ifso,whattype,andhowoftenisitsafetotakethem?4.WouldithelpmyIBSsymptomstoaddmorefibertomydiet?Ifso,howmuchandwhatkind?5.ArethereotherdietarychangesyouwouldrecommendforIBS,andshouldIconsultadietitian?6.Couldrelaxationtherapy,counseling,orexercisehelpmyIBS?7.ShouldItakeprescriptionmedicationsformyIBSsymptoms?Ifso,whatsideeffectsshouldIexpect?8.Arethereanytestsyouwouldrecommendnoworinthefuture?9.ArethereanyotherapproachesortreatmentsIshouldknowabout?10.HowsoonshouldIhaveafollow-upappointment?IBSComplicationsBecausefindinganIBStreatmentthatworkscantaketime,otherhealthproblemscancropupinthemeantime.Noneofthecomplicationsarelife-threatening,though.IBSdoesn'tleadtocancerorothermoreseriousbowel-relatedconditions.Herearesomeofthehealthissuesitcancause:Impactedbowel:Ifyou'reconstipatedforalongtime,stoolcangetblockedinyourcolon.Sometimesitcangetsohardthatyoucan'tpushitout.Thisisknownasafecalimpaction.Itcanhurtandcausethingslikeheadache,nausea,andvomiting.Ithappensmostoftenwitholderadults.Seeyourdoctorrightawayifyouhavesignsthismaybehappening.Foodintolerance:CertainfoodscanmakeyourIBSsymptomsworse.Whattheyarecanbedifferentforeveryone.Butsomepeoplefeelbetterwhentheycutoutwheat,dairy,coffee,eggs,yeast,potatoes,andcitrusfruits.Andfatsandsugarscanmakediarrheaworse.YourdoctormaysuggestyoutryaFODMAPdiettocutoutsomecarbohydratesthatarehardtodigest.Malnourishment:CuttingbackonsometypesoffoodscaneaseyourIBSsymptoms.Butyourbodymaynotgetallthenutrientsitneeds.Adietitiancanhelpyoufindadietthatworksforyou.Hemorrhoids:Swollenbloodvesselsaroundyouranus,theopeningwherestoolcomesout,canhurtandbleed.Veryhardorveryloosestoolscanmakethesituationworse.Iftheswollenvesselsareinsideyouranus,theymayfallfarenoughtostickout.Youcanoftentreathemorrhoidsathomewithanover-the-countercream.Youalsomighttrysittingonacoldicepack.Andbesuretokeeptheareaclean.Pregnancycomplications:Hormonechangesandthephysicalpressureababyputsonthebowelwallcancausedigestiveissues.ManywomenalsochoosetostopanyIBSdrugsthey'retaking.Thiscanbebetterforthebaby.Butitcanmakemoms-to-bemorelikelytohavethingslikeheartburnandindigestion.Qualityoflife:Flare-upscanhappenwithoutwarning.Also,youmayhavediarrheaforatimeandthenbeconstipated.Notbeingabletopredicthowyou'llfeelcanmakeithardtogoaboutyourdailylife.Youalsoprobablyneedtoseeyourdoctoroftenandarelikelytomissmoreworkthanotherpeople.Itmaybehardertofocuswhenyou'reatyourjob.Managingstress,forexamplethroughexerciseormeditation,canhelp.Depressionandanxiety:It'scommonforpeoplewhohaveIBStofeellikethey'relosingcontrolovertheirlives.Ifyoursymptomsarebad,youmayfindyourselfalwaystryingtomapoutthenearestbathroom.Becausethere'salinkbetweenyourbrainandgut,thiskindofstresscanmakeyourIBSworse.Thepainandtheawkwardsymptomsyou'redealingwithcanaffectyourmood.Itmayhelptotalktoacounseloraboutwhat'sgoingonwithyou.NextArticleWhatCausesIBS?IrritableBowelSyndrome(IBS)GuideOverviewSymptoms&TypesDiagnosis&TreatmentLiving&ManagingStressandDigestiveProblemsQuiz:AssessYourIBSSymptomsTreatingIBSWithDiarrheaTreatingIBSWithConstipationAvoidingIBDFlares[ss_icon]ConstipationMythsandFactsIBSTriggersPreventionstrategiestotry.AllAboutIBSFromsymptomstotreatments.IBSandDiarrheaCauses,symptoms,andtreatments.StressandIBSAretheyrelated?VideoIBSTriggerFoodsArticleSupplementsforIBS:WhatWorks?QuizCheckIBSSymptomsSlideshow16TipsforBetterDigestionSlideshowTipsforaGluten-FreeDietSlideshow7YearstoDigestGum&OtherMythsVideoWhatCausesDiarrhea?ArticleIBSorLactoseIntolerance?Low-ResidueDietsIBSandDepressionDiarrhea:FoodstoAvoidTreatingIBSandDiarrheaHealthSolutionsPenisCurvedWhenErect?CouldIhaveCAD?TreatBentFingersTreatHR+,HER2-MBCTiredofDandruff?BenefitsofCBDRethinkMSTreatmentAFib-RelatedStrokesRiskofaFutureDVT/PEIsMyPenisNormal?RelapsingMSOptionsLiverTransplantsSaveLivesFinancePlasticSurgeryBentFingerCausesLivingWithPsoriasis?MissingTeeth?MorefromWebMD5TipstoHelpWithRelapsingMSHowtoThriveWithNarcolepsyReliefforBlockedHairFolliclesPsoriaticArthritisandYourSleepWhatPsoriasisFeelsLikeFirstPsoriaticArthritisFlareTalkingtoYourDoctorAboutRACrohn's:A'Full-Body'DiseaseAvoidingCrohn’sFlaresHealthBenefitsofHempSeedOilLiveBetterWithPsoriaticDiseaseTypesofB-CellTherapyforMS5HealthBenefitsofHempWhyProstateCancerSpreadsLivingwithAdvancedBreastCancerWhereBreastCancerSpreads