Irritable bowel syndrome (IBS) is a chronic, lifelong condition characterized by a fluctuation of symptoms primarily affecting the gut. Symptoms like stomach discomfort and alterations in bowel patterns are typical for anyone dealing with IBS. Most people suffering from IBS don’t even know it’s an actual medical diagnosis or that there are ways to help manage uncomfortable symptoms. The majority of my patients report suffering from debilitating symptoms for years before seeking treatment. So, I know this is a shitty subject- pun intended, but it’s so prevalent in healthcare that we need to start talking more about bowel health.
IBS is more common than you think. In fact, it’s one of the most commonly diagnosed gut disorders. It’s estimated that 25-45 million people in the U.S. suffer from IBS, women more than men, between the ages of 18-40. Certain triggers like food sensitivities or anxiety can cause flare-ups of abdominal symptoms that can be a big inconvenience in your life if not managed properly. Managing symptoms is often done with diet changes and medications, but I’ve also got some of my own tips to share with you so let’s dive in.
What Causes IBS?
Stress, either emotional or physical, can trigger an IBS flare, but stress isn’t the cause of IBS. The actual cause of IBS is yet to be determined. Since IBS has an unknown cause, treatment is largely based on symptom management. However, IBS is likely related to the interactions between the gut, brain, and nervous system. Your gut is lined with more than 100 million nerves and communicates with your brain all day long, acting like a 2nd brain. Most of your serotonin is also made in your gut, which means your gut health can heavily influence your mood. Therefore, your mood could significantly affect the gut as well.
Sudden changes in mood like stress, anxiety, excitement, and sadness can cause abrupt changes in your gut, altering function, and increasing sensation, and motility. It can speed up digestion causing the immediate need to empty its contents, or it could stop completely, causing a backup.
Symptoms and triggers can change so it can be hard to pinpoint the problem. Think of your gut as an irritable two-year-old that’s happy, then crying in the same minute. Throw in a random temper tantrum for absolutely no reason at all. A gut suffering from IBS is going through the “terrible twos”, as it’s unpredictable. Having IBS can really mess up your day. One day you’re constantly visiting the bathroom and the next you might be considering a laxative.
Symptoms of IBS can range from being very mild to a major inconvenience in your life. IBS can affect your social, dating, and work-life. Abdominal pain/discomfort and cramping are among the most common symptoms but also bloating, and changes in the bowels between diarrhea and constipation. Diagnosis is typically based on symptoms, but it’s important to first rule out other GI disorders like inflammatory bowel disease (IBD).
Treatment for IBS
When considering treatment, you should narrow down your symptoms. Treatment for IBS is based on symptom management. Determining your triggers will drastically help with treatment. If you’re triggered by certain foods, avoiding them is part of the treatment plan. However, if it’s stress or social anxiety, you may benefit from a low-dose antidepressant. Therefore, you should discuss all of your symptoms with your primary care provider (PCP).
IBS can be more diarrhea dominant or constipation, which makes a big difference in how you manage symptoms. IBS-D (diarrhea), IBS-C (constipation), or IBS-M (mixed, both constipation & diarrhea) have different variations in treatment, with fiber being the most controversial. Fiber can either improve or worsen symptoms of IBS, so you could try slowly adjusting your intake with a fiber supplement and see how your gut responds.
Certain foods can trigger IBS symptoms and gluten is a common one. Adhering to a gluten-free diet may help with symptoms if you’re sensitive to gluten. Dairy, caffeine, alcohol, fatty and spicy foods can also irritate the gut.
The FODMAP diet (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) outlines certain types of carbs that should be avoided with IBS to help manage symptoms. Common examples are fructose, lactose, wheat, sugar alcohols, cabbage, onions, and broccoli.
Probiotics & prebiotics can improve gut health by balancing healthy bacteria. A probiotic supplement is an easy way to help restore gut balance, but eating a diet rich in probiotics and prebiotic foods is optimal. Check out my tips on shopping for a probiotic supplement and ways to get in more probiotics in your diet.
Medications such as antispasmodics can help relax the smooth muscle of the GI tract and help with cramping pains. Anti-diarrheals and stimulant laxatives can help manage bowel movement frequency.
IBS is a complex condition with no one-size-fits-all treatment plan. Treating IBS must be individualized and requires some investigation of underlying factors. Be sure to stay hydrated by boosting your water intake and engaging in routine physical activity. Often mental health treatment for anxiety can help ease the frequency and intensity of flares since the gut is lined with nerves and is sensitive to changes in mood. Although there is no cure for IBS, with these interventions and my tips below you can better manage your life.
- Determine & avoid triggers- Use a food sensitivity diary to identify food triggers. Gluten often triggers IBS flares for those with gluten sensitivity. Learn more about gluten and the gluten-free diet to see if this relates to your symptoms. Reduce intake of alcohol, caffeine, spicy and fatty foods as these are irritating to the gut. Journal events that triggered a flare like a first date, graduation party, or your wedding day to see how your emotions play a role in your IBS symptoms.
- Identify symptoms- Keep an IBS journal with dates of flares along with foods you ate and external stressors. If social events trigger symptoms record details so you can discuss this with your PCP.
- Manage stress and anxiety- Mental health can affect bowel patterns so calming anxiety can help manage symptoms. Meditation, yoga, and other exercises may help. Consider cognitive & behavioral therapy and possible low-dose antidepressants to be discussed with your PCP.
- Improve gut health- Avoid processed foods and added sugars that can be damaging to your gut health. Make adjustments in your diet like gluten-free, dairy-free, and/or FODMAP. Talk to a dietician about your diet plan (may need a referral from your PCP). Probiotics and prebiotics can restore healthy bacteria to reduce inflammation. Consider the Whole 30 Diet, as it focuses on eliminating common foods that can often trigger an IBS flare.
- Use OTC medications for bowel symptoms- fiber supplements, stool softeners, laxatives, antidiarrheals, and antispasmodics may help with symptoms as needed. Taking a collagen supplement can also help repair and heal the gut lining.
- Improve sleep- Lack of or poor quality sleep can increase stress on the body and increase IBS flares. Click here for my top tips for a good night’s sleep!
- Talk to your PCP about your symptoms- Bring your food/symptom journal to your appointment to review with your PCP to come up with your individual treatment plan. IBS is a real condition that’s lifelong. Managing symptoms can make a huge difference in the quality of your life so don’t be afraid to seek medical help.
Disclaimer: The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health conditions without consulting your healthcare provider. Information used is based on experience and opinion, not 100% evidence. Always consult with a health care practitioner before relying on any information in this article or on this website. Some links in this article may contain affiliate links.