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Irritable Bowel Syndrome (IBS)


Most of us like to keep our bathroom habits as private as possible, but that can sometimes be difficult for people with irritable bowel syndrome (IBS). IBS is a gastrointestinal condition that brings on frequent (and unpredictable) episodes of diarrhea and/or constipation, along with abdominal cramping.  

Thought to affect between 10 and 20% of American adults, IBS is the most commonly diagnosed digestive disorder in the country. Although it can affect anyone, it is usually diagnosed in people during their 20s through their 40s, and woman are twice as likely to be diagnosed with IBS than men.  

There are several treatments that offer relief for people with IBS. Lifestyle changes may be effective, as well as a variety of medications, which can minimize symptoms. Although people with IBS may experience flare-ups periodically, it’s possible to lead a normal life.

What is irritable bowel syndrome?

Irritable bowel syndrome is a chronic condition that causes abdominal pain and changes in bowel habits, affecting the frequency of bathroom visits and the consistency of stool.  

People with IBS typically have episodes of diarrhea and/or constipation, along with gas, bloating, abdominal cramping and frequent, strong urges to use the bathroom.

IBS affects how quickly or slowly food moves through the digestive system, resulting in diarrhea or constipation. Those who experience diarrhea often feel an urge to use the bathroom soon after meals.  

People with IBS often have anxiety, depression, or strong reactions to stress. These emotional responses may make IBS symptoms feel worse, but they aren’t the cause of gastrointestinal symptoms.

What causes irritable bowel syndrome?

Doctors aren’t sure exactly what causes IBS, but there are several factors that make people more likely to develop the condition:  

  • Movement of food through the system. Optimal digestion depends upon the speed at which food goes through the digestive system. In people with IBS, food may travel more quickly or slowly, resulting in discomfort and altering bowel patterns. When food passes through too quickly, the intestines may spasm more powerfully, causing cramping and discomfort and leading to diarrhea. When food moves through the system more slowly, stool may become hardened and dry, making it more difficult to pass, leading to constipation.
  • Altered gut flora. Some people with IBS have different proportions of gut bacteria than those with healthy digestive systems.
  • Food sensitivity. Foods that make people more prone to gas may aggravate IBS symptoms. Examples include beans, as well as certain vegetables like cabbage and broccoli. For people who are lactose intolerant, most dairy products will also cause painful gas and bloating.
  • Genetic predisposition. Some people with IBS have a family history of the condition.

What are the symptoms of irritable bowel syndrome?

The diagnostic criteria for IBS includes having abdominal pain at least once a week for a period of 3 months or more, and symptoms that have persisted for at least 6 months. An inexplicable change in bowel patterns is one of the most common signs of IBS.  

Other symptoms include:

  • Abdominal pain or cramping
  • A change in consistency of bowel movements—either harder or softer than usual
  • A change in the frequency of bowel movements—more or less often than usual
  • Periods of diarrhea or constipation, or alternating periods of diarrhea and constipation
  • Gas and/or bloating
  • A feeling of urgency to have bowel movements
  • Feeling unable to completely empty the bowel when using the bathroom
  • Mucus that accompanies bowel movements

What are the risk factors for irritable bowel syndrome?

Although anyone may be diagnosed with IBS, including children and older adults, it’s more likely to occur in:

  • Women
  • Younger adults
  • People with a family history of IBS
  • People who have a history of depression or anxiety

How is irritable bowel syndrome diagnosed?

There is no single test doctors can use to confirm a diagnosis of irritable bowel syndrome. Instead, doctors ask about symptoms, as well as personal and family medical history. They can also use tests to rule out other conditions.  

If your doctor suspects you have IBS, he or she may ask about your abdominal pain, the frequency of your trips to the bathroom, and how often you experience diarrhea and/or constipation. What’s notable is that doctors don’t usually find pain or other concerning symptoms in people with IBS during a physical exam, although some people may have slight sensitivity in the lower abdomen.  

Since IBS symptoms are similar to those caused by other digestive disorders, doctors may order blood tests for the following conditions, which would require different treatments:  

  • Inflammatory Bowel Disease (IBD), which includes Crohn’s disease or ulcerative colitis
  • Celiac disease
  • Anemia

Doctors may also order other tests to diagnose different conditions that may also be related, including:

  • A hydrogen breath test, to check for lactose intolerance
  • A colonoscopy, to investigate the cause of rectal bleeding and check for colon cancer
  • A stool sample analysis, to check for malabsorption (in someone with diarrhea)  

How is irritable bowel syndrome treated?

There is no cure for IBS; instead, doctors work with patients to help them learn how to manage their symptoms. Strategies include dietary and lifestyle changes and, in some cases, medication.  

The following lifestyle changes may help reduce IBS symptoms:

  • Avoid foods that trigger IBS symptoms, such as high-fat foods, foods that produce gas (like beans or broccoli), dairy products, artificial sweeteners like sorbitol, coffee, and alcoholic beverages
  • Add more fiber to your diet, which may help to improve the quality of stool
  • Take steps to lower stress levels, including exercising regularly, practicing good sleep hygiene, and avoiding high-stress situations

Your doctor may also suggest or prescribe medication for your symptoms.

What is the outlook for people with irritable bowel syndrome?

People with IBS can live normal lives. Symptoms may flare up periodically, but the condition doesn’t typically worsen over time or lead to other health problems. About half of people with IBS only have intermittent symptoms. Those who have periods of cramping, diarrhea, and constipation may be able to manage the condition with a doctor’s help, which may include medication and lifestyle changes.