Irritable bowel syndrome (IBS)

Overview

Irritable bowel syndrome (IBS) is a group of symptoms that happen together, including repeated pain in the belly and changes in bowel movements. With IBS, there's no visible damage or disease in the digestive tract.

Experts think IBS comes from problems with how the brain and gut work together. Food may move too fast or too slow, and the gut may be extra sensitive, so a normal amount of gas or stool can hurt. There are different types: IBS with diarrhea, with constipation, or mixed.

Symptoms

Symptoms often come and go, and may be worse during stress or, for women, during periods.

• Belly pain or cramping, often related to bowel movements
• Bloating or gas
• Diarrhea, constipation, or both
• Feeling that you haven't finished a bowel movement

Less common

• Whitish mucus in the stool
• Pelvic or lower belly pain
• Symptoms worse after meals

How it usually goes

• Flare: Symptoms can last days to weeks, then ease.
• Months: IBS is diagnosed when symptoms happen regularly over months.
• Years: IBS is long-term, but symptoms often get better with treatment.

When to get medical care

Causes

Doctors aren't sure exactly what causes IBS. It's thought to be a problem with how the brain and gut work together, which can change how fast food moves and how much the gut senses pain.

Things that may play a role include stress, a past gut infection, changes in gut bacteria, and food sensitivities. IBS can run in families.

Does it spread or run in families?

• It isn't contagious. You can't catch it from someone else.
• It can run in families. Tell your doctor if a parent, brother, or sister has it.

Who is more likely to get it

• Women
• People under 50
• Stress, anxiety, or depression
• A past stomach infection
• Family history of IBS

Possible complications

• Lower quality of life: Symptoms can affect work, sleep, and mood
• Hemorrhoids: From straining or frequent diarrhea

Diagnosis

A healthcare professional diagnoses IBS by looking for a pattern in your symptoms over time, along with your medical and family history and a physical exam. Tests are sometimes used to rule out other problems.

Questions you may be asked

• How often you have belly pain, and whether it's related to bowel movements
• Whether you have diarrhea, constipation, or both
• How long you've had symptoms
• Whether you've seen blood, lost weight, or wake at night with diarrhea
• Your family history of celiac disease, IBD, or colon cancer

The exam

They'll press on your belly to check for tenderness or swelling and listen with a stethoscope.

Tests

Tests may be done to rule out other conditions:

• Blood tests: To check for anemia, infection, or celiac disease.
• Stool tests: To check for blood, infection, or inflammation.
• Colonoscopy: If you have warning signs or are due for colon cancer screening.

Treatment

Treatment focuses on easing symptoms. Different things help different people, so you may need to try a few.

Self-care

• Add fiber slowly, about 2 to 3 grams more a day; soluble fiber (beans, fruit, oats) helps most
• Ask about a low FODMAP diet: cutting back on certain hard-to-digest foods for a few weeks
• Try avoiding gluten for a few weeks to see if it helps
• Be active, get enough sleep, and lower stress
• Keep a food and symptom diary to find your triggers

Medicines

Medicines depend on your main symptoms. Ask your healthcare professional which are right for you.

Medicine names link to drug information from the U.S. National Library of Medicine (MedlinePlus). OwieClear doesn't give doses: follow the label or your healthcare professional.

Your healthcare professional may suggest medicines for your type of IBS, peppermint oil capsules, or therapies like cognitive behavioral therapy or gut-directed hypnotherapy, which can help a lot.

How it compares

Prevention

You can't prevent IBS, but you can lower flares:

• Learn your food triggers, and eat regular meals
• Add fiber slowly and drink enough water
• Manage stress with exercise, relaxation, or therapy
• Get enough sleep

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to a gastroenterologist (stomach and gut doctor).

Living with it

• Keep a food and symptom diary.
• Plan ahead for bathroom access when out.
• Ask about a dietitian who knows this condition.
• Long-term illness can affect mood. Tell your doctor if you feel down or anxious.

Back to school, work, or sports

• Most people can keep working or going to school.
• Ask about changes that help, like extra breaks or a flexible schedule. Workers may be covered by the ADA. Students may get a 504 plan.

Children, pregnancy, and older adults

• Children: IBS happens in children too. Talk with your child's doctor or a dietitian before changing their diet, since good nutrition matters for growth.
• Women: Symptoms are often worse during periods.
• Over 50: New bowel changes after age 50 should be checked, since colon problems are more common.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

For caregivers

• Go to visits when you can and take notes.
• Keep a list of medicines, allergies, and doctors in one place.
• Learn the warning signs that need fast care.
• Take breaks and ask for help. Caregivers need care too.

Outlook

IBS is long-term, but it doesn't damage your gut or raise your risk of cancer. Most people find a mix of diet, lifestyle, and treatments that makes symptoms much better.

Myths and facts

Getting ready for your visit

A food and symptom diary is the most helpful thing to bring.

What to bring

• A diary of your symptoms, bowel movements, and what you ate
• All medicines and supplements you take
• Your family history of digestive diseases

Questions to ask

• Could this be something other than IBS?
• Should I try a low FODMAP diet, and can I see a dietitian?
• Which medicine fits my type of IBS?
• Would therapy or hypnotherapy help me?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Irritable bowel syndrome (IBS)