Irritable bowel syndrome (IBS) is common, affecting roughly 10 to 15 percent of US adults, including twice as many women as men.
Whether or not your healthcare team has provided a diagnosis (over 90 percent of cases have not yet been diagnosed), you may suffer from abdominal cramps, bloating, constipation, diarrhea, or excessive gas.
What Is IBS?
Formerly known as colitis, nervous colon, or spastic bowel or colon, this group of symptoms occurs in a bowel that shows no obvious signs of disease.
Doctors now classify IBS as a functional gastrointestinal disorder, or problem with the way the brain and gut work together.
The syndrome is more likely if a family member suffers from it; there has been a severe digestive tract infection; or stressful life events (such as child sexual abuse) have occurred.
Forms of IBS
IBS comes in four types according to a person's predominant bowel habits:
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IBS-D
IBS-D, or IBS with diarrhea, is the most common subtype. Its symptoms include abdominal discomfort, pain or cramps in the stomach, gas, and diarrhea: regular loose stools and urgency to move the bowels.
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IBS-C
IBS-C, or IBS with constipation, produces abdominal discomfort, pain and bloating, and constipation: straining and difficulty in moving the bowels, infrequent bowel movements, and hard stools.
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IBS-M
IBS-M, or IBS with mixed symptoms—sometimes referred to as IBS-A, for alternating—produces symptoms of both IBS-D and IBS-C.
People with IBS-M swing back and forth from diarrhea to constipation.
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IBS-U
IBS-U, or undefined IBS, produces variable symptoms. Stool consistency does not meet the criteria for the other types of IBS.
Managing IBS Symptoms
IBS has no cure, but the condition is not life-threatening. Symptom management can involve lifestyle changes, stress reduction, and diet adjustments.
Know Your Trigger Foods
There's no list of foods that everyone with IBS needs to avoid. Triggers can vary from person to person. Pay attention to foods that consistently seem to bring on symptoms such as bloating, abdominal pain, diarrhea, or constipation.
Some common potential triggers include:
- High-FODMAP foods: Certain poorly absorbed carbohydrates can be rapidly fermented by gut bacteria, contributing to gas, bloating, pain, and changes in bowel habits. Examples include onions and garlic; apples, pears, and some other fruits; beans and lentils; wheat- and rye-based foods; and high-fructose corn syrup.
- Milk and other lactose-containing foods.
- Sugar alcohols such as sorbitol, mannitol, xylitol, and maltitol are frequently used in sugar-free gum and candy, protein bars, and reduced-sugar foods.
- Carbonated drinks
- Caffeine
- Beans
- Cruciferous vegetables like broccoli and Brussels sprouts
- Wheat
- Red peppers and green onions
- Red wine
- Nutritional and weight-loss supplements
Some people find relief through the low-FODMAP diet. FODMAPs are fermentable sugars and fiber found in some dairy products, fruit, grains, legumes, and veggies, that are difficult for some people to digest.
If you decide to follow a low-FODMAP diet, you can still eat foods like rice, potatoes, quinoa, wheat-free bread, lactose-free dairy products, fish, eggs, chicken, beef, and certain fruits and veggies. You will want to avoid garlic, onions, beans, lentils, sausage, battered fish, breaded meats, gluten-based breads, certain fruits (including blackberries, watermelon, pears, and peaches), and certain nuts (including cashews, almonds, and pistachios).
One recent study found that 71 percent of people with IBS who followed a low-carbohydrate, high-fat diet experienced significant reductions in IBS symptoms.
Working with a gastroenterologist and a dietitian with IBS experience can help you sort through all this.
Lifestyle
Emotional stress can set off IBS as well. Exercise, deep breathing, biofeedback, acupuncture, yoga, a soothing cup of tea—cultivate relaxation methods to keep anxiety at bay.
Supplements
Some supplements have been shown to be helpful. Here’s what the research shows:
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Probiotics
Scientists are studying probiotics as a treatment for IBS and other GI disorders with similar symptoms, as an imbalance in the gut microbiota could be a cause of symptoms brought on by IBS.
For instance, one study of patients with celiac disease who had IBS-type symptoms despite following a gluten-free diet found that those given probiotics for six weeks had a significant decrease in symptoms compared to the placebo group.
A scientific review suggested that combining probiotic and prebiotic supplementation with the low FODMAP diet could have promise for management of IBS.
While both treatments have been effective for some people with the condition, the probiotics and prebiotics would serve to counter the drop in Bifidobacteria caused by the FODMAP diet.
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Boswellia Extract
Several people with IBS but no other conditions were assigned to treatment groups for four weeks.
- People in one group were given hyoscine butylbromide, a medication used to treat cramps.
- Those in the second group were given papaverine hydrochloride, which is a vasodilator, plus belladonna extract.
- Those in the third group were given supplements of boswellia extract (250 milligrams per day).
Symptoms improved in all groups. The number of people who needed medical attention for IBS decreased significantly in the boswellia group only.
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Peppermint Oil
Scientists analyzed 12 randomized studies including 835 patients to determine the effect of peppermint oil as a treatment of IBS. They found that peppermint oil is safe and effective in treating pain and other symptoms in adults with IBS.
Exercise
Aerobic exercise, such as moderate-intensity walking three times a week, can contribute to less anxiety and depression related to GI issues.
Talk to Your Doctor
If you don’t have a diagnosis but think you may have IBS, talk with your healthcare practitioner. Other conditions can create similar symptoms, so you’ll want to rule them out.
Also, medication is available for people who need additional help managing the symptoms. Your healthcare provider will help you determine which of the four types of IBS you have, as the medication prescribed varies depending on type.