OVERVIEW

IBS is different for everyone.

With that in mind, GoodPath takes a personalized approach to creating gastrointestinal (GI) care kits. Click below to get a well-rounded care plan in just 3-4 minutes.

What is IBS?

Irritable bowel syndrome may be better known as IBS. A closer look at each of these three words is a helpful way to understand the condition.

Irritable

The bowel can be irritable the same way a person can be. When a person is irritable they may be more sensitive than usual. They may be disagreeable and easily get upset. The same is true for an irritable bowel.

Bowel

Bowel refers to the large and small intestines (also called bowels). The bowels are part of the gastrointestinal (GI) or digestive tract. In the case of IBS, “bowel” refers to the large bowel or large intestine (also called the colon).

Syndrome

Syndrome is a medical term that means a group of symptoms that occur together. The most common symptoms of IBS are:

  • Diarrhea

  • Constipation

  • Both diarrhea and constipation

  • Abdominal (belly) pain


It's a common condition.

About 1 out of 10 people in the world have IBS. While it is not passed genetically, IBS tends to occur more often within families.

Only 1 out of 3 people with symptoms of IBS actually go to see a doctor.

IBS affects more women than men.

It is more common in adults under 50 years old.

This page has been reviewed by the GoodPath medical team. Medical Writer: Beth Holloway, RN, M. Ed; Medical Reviewer: Roukoz Abou-Karam, MD; Updated: February 2020.

What are the types of IBS?

The American College of Gastroenterology (ACG) describes 4 types of irritable bowel syndrome:

IBS with constipation (IBS-C)

On the days when someone has at least one abnormal bowel movement, they have:

  • More than 1 in 4 stools that are hard or lumpy

  • Less than 1 in 4 stools that are loose or watery


IBS with diarrhea (IBS-D)

On the days when someone has at least one abnormal bowel movement, they have:

  • Less than 1 in 4 stools that are hard or lumpy

  • More than 1 in 4 stools that are loose or watery

IBS with mixed symptoms (IBS-M)

On the days when someone has at least one abnormal bowel movement, they have:

  • More than 1 in 4 stools that are hard or lumpy

  • More than 1 in 4 stools that are loose or watery



The fourth type IBS is unclassified (IBS-U). This means a person’s bowel habits don’t fit into one of the other categories.

Doctors don't know the exact cause.

But, most believe that IBS is related to a combination of different factors. Some of these may be early life events, increased bowel sensitivity, and difficulty dealing with stress. 

Functional Gastrointestinal Disorder

IBS is called a functional gastrointestinal (GI) disorder. Since IBS is a functional GI disorder, it interferes with the way the gastrointestinal (GI) system normally works, it’s function. IBS cannot be seen on scans or scoping procedures because there aren’t any changes to the actual tissue of the large intestine.

There is ongoing research to better understand the causes of IBS and similar disorders. For example, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) conducts clinical trials on IBS.

The Gut-Brain Connection

With functional GI disorders, there are problems with the way the brain and intestine work together. This is called the gut-brain connection

It may be that the movement of digested food through the intestine, the way the nerves of the intestine respond, or the way the brain controls these functions isn’t normal. The immune response of the lining of the intestine (part of the body’s response to harm), as well as the normal bacteria in the intestine may also be abnormal.


Each person with IBS has different symptoms.

While one person may have mild symptoms, another person could have severe symptoms that interfere with daily activities. 

In fact, an individual’s symptoms can vary from one day to the next. On some days, a person may have no IBS symptoms at all.

The most common symptoms of IBS are:

CONSTIPATION

Generally, this means a person has fewer than 3 bowel movements a week. And, the stool may be hard and difficult to pass.

DIARRHEA

This means a person has loose, watery bowel movements at least 3 times a day. Cramping commonly occurs, too.

CONSTIPATION AND DIARRHEA

This person will have diarrhea at times and constipation at other times.

ABDOMINAL DISCOMFORT

Also known as belly pain, this can be cramping, discomfort, or pain in the abdomen – often the lower abdomen. The pain typically comes and goes.

Other symptoms include:

BLOATING

This is a feeling of fullness or swelling in the abdomen.

GAS

A person may have more gas than usual. Often, this causes cramping and pain.


INCOMPLETE BOWEL MOVEMENTS

Here, a person may feel as if they still need to have a bowel movement, even though they already did.


MUCUS IN STOOL

The lining of the intestine produces mucus which helps to protect it. Some people with IBS have mucus in their stool.

TREATMENTS

There are many paths to feeling better.

Treating IBS depends on a number of different factors – including a person’s medical history and symptoms. For example, a person with diarrhea may need a different treatment than someone with constipation.

Although prescription medicines may be used to treat IBS symptoms, there are also treatments that don’t require prescriptions. These include over-the-counter medicines; herbals and botanicals; supplements, vitamins, and minerals; dietary changes; and other therapies.

In some cases, a single treatment will relieve symptoms. Yet, some people with IBS may use a combination of treatments to get relief. For instance, someone with constipation, bloating, and gas might need over-the-counter medicines, probiotics, and dietary changes.

There are many different treatments for IBS.

Oral Treatments

Over-The-Counter (OTC) Medicine


Prescription Medicine


Supplements, Vitamins, and Minerals


Herbals and Botanicals

Therapy & Training

Relaxation Training or Yoga


Therapy or Counseling

Lifestyle & Behavior

Diet Changes


Lifestyle Changes

Anatomy of the Digestive Tract

Large Bowel (Intestine)


The bowel refers to the gastrointestinal (GI) or digestive tract. It is part of the gastrointestinal system. It is made up of the small and large intestines or bowels. Bowel in IBS is referring to the large bowel or intestine, also known as the colon. So the focus here is on the lower gastrointestinal (GI) or digestive tract.

The large bowel or colon starts where the small intestine ends (the ileum). It is the ileum that attaches to the first part of the large bowel. The first part of the large bowel is called the cecum. (If you or someone you know has had appendicitis, this is where the appendix is located!).

From the cecum, the large bowel goes up the right side, the ascending colon; across the top, the transverse colon; and then down the left side of the abdomen, the descending colon. It then curves, the sigmoid colon; and becomes the rectum, then the anus.

Structure of Intestinal Wall


The large bowel is about 5 feet long.

It is made up of 4 layers, all with different purposes. The muscle layer helps move digested food through the colon. The moist, inner layer, or the lining of the intestine, is a mucus membrane. It produces mucus, which helps to protect the lining.

PREVENTION

How Does IBS Go Away?

Today, there isn’t a cure to IBS. Treatment is based on individual symptoms – which commonly come and go. These symptoms may also be more or less severe over time.

Some people may have symptoms most of the time, even with treatment. But, treatment usually helps to lessen symptoms. Symptoms may go away in some people without any treatment.




Can IBS Be Prevented?

Unfortunately, the answer is "not at this time". The cause of IBS is complicated and not entirely clear. Ongoing research may help doctors find preventative measures in the future. 

As with most conditions, staying or getting healthy overall is always a good practice. This means a healthy diet, regular exercise, and lowering stress. 



What Are the Risk Factors for IBS?

There are factors that increase a person’s chance of developing irritable bowel syndrome. They include a history of:

A SEVERE DIGESTIVE SYSTEM INFECTION

Following a severe digestive system infection, a person is more likely to develop irritable bowel syndrome – even months or years later.

One example is acute gastroenteritis – which may be from eating or drinking infected food or water. This condition causes severe GI symptoms. Studies have found an increase in IBS following outbreaks of food poisoning.

CERTAIN DISORDERS

IBS often affects people with certain disorders – such as chronic fatigue syndrome or gastrointestinal reflux disease (GERD).

PAIN AND SLEEP DISORDERS

IBS is more common in people that have conditions causing long-term (chronic) pain or sleep problems. Chronic pain conditions include fibromyalgia and arthritis.

MAJOR DEPRESSION AND ANXIETY

A person diagnosed with major depression or anxiety disorder has an increased risk of IBS.

DIFFICULT LIFE EVENTS OR STRESS

Very difficult or stressful life events can increase a person’s risk of IBS.

FAMILY MEMBERS WITH IBS

If a person’s relatives have IBS, they have an increased chance of also having IBS.


How Is IBS Diagnosed?

Not everyone with IBS symptoms goes to their doctor; in fact only about 1 in 3 people do. 

Once at the doctor, diagnosing IBS may be challenging. For one, the symptoms of IBS are similar to other conditions. Furthermore, a person’s symptoms can change over time. Still, doctors can use questions, tests, and more to help rule out other causes of IBS symptoms.

QUESTIONS

In order to diagnose IBS, the doctor will ask questions about a person’s medical history, family history, and gastrointestinal (GI) symptoms. 


They will ask how long the person has had symptoms. That is because the symptoms should have started at least 6 months ago and should be present during the last 3 months, in order to make the diagnosis of IBS.

EXAMS

As with other conditions, the doctor will complete a physical exam. They may feel different areas of the abdomen and ask about pain.

TESTS

There is no test that can determine if a person has IBS. However, there are tests that can help with the diagnosis. For example, the tests may rule out other conditions as the cause of diarrhea.

Doctors might order lab tests, such as checking a person’s blood or stool.  Or imaging tests, such as including scans and scoping procedures.

REFERRALS

Some people may be referred to a gastroenterologist. These doctors specialize in digestive system problems. They will perform an exam and ask about the person’s medical history, family history, and symptoms. They, too, may order diagnostic tests.

Note: Though it’s easy to confuse the terms, IBS (irritable bowel syndrome) and IBD (inflammatory bowel disease) are different. Ulcerative colitis and Crohn’s disease are two inflammatory bowel diseases. IBS and IBD may have similar symptoms but would be treated differently.


When To See A Doctor

In most cases, symptoms of IBS do not mean that a person has a serious problem. However, someone may have other symptoms, a medical history, or a family history that could mean something serious

Individuals should see a doctor when they have a diagnosis or symptoms of IBS and any of the following:

SYMPTOMS

  • Bleeding with bowel movements

  • Blood in the stool. A person with this symptom should call the doctor right away

  • Weight loss

  • Tiredness

  • Fever

  • Trouble sleeping due to IBS symptoms

  • IBS symptoms that started after age 50

MEDICAL HISTORY

  • Anemia (low red blood cell count)

  • Inflammatory bowel disease/IBD (ulcerative colitis or Crohn’s disease)


FAMILY HISTORY

  • Cancer of the rectum or colon

  • Inflammatory bowel disease/IBD (ulcerative colitis or Crohn’s disease)

  • Celiac disease



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