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Irritable Bowel Syndrome (IBS) – Causes and Management

Medically reviewed by Dr. Irfan Ullah Yasir, MBBS, FCPS—Written by Dr. Hamza Waheed, MBBS on August 12, 2021.

Irritable bowel syndrome (IBS) is a collection of intestinal symptoms characterized by abdominal pain, discomfort, bloating, and gas. This is a chronic gastrointestinal disorder that tends to change its symptoms over the course of time but can be easily managed by making some lifestyle modifications

Symptoms of IBS

IBS affects the large intestine and varies in intensity of signs and symptoms from person to person. Some of these are:

  • Abdominal pain and cramping
  • Gas and bloating
  • Recurrent constipation and diarrhea
  • Food intolerance
  • Change in bowel movement and habits
  • Pain relief after passing stool
  • Hard, lumpy, or mucus containing stool
  • Rectal bleeding
  • Nausea
  • Fatigue
  • Joint or muscle pain
  • Halitosis
  • Frequent urination
  • Loss of appetite
  • Weight loss

Symptoms of IBS in women

Females tend to have more symptoms around menstruation. Their regular symptoms are accompanied by

Symptoms of IBS in men

  • Fewer men report symptoms of IBS than women but those who do have similar symptoms as women
  • These symptoms should occur 3 times a month, lasting for six months at stretch to be classified as IBS

Causes of IBS

The exact cause of irritable bowel syndrome is unknown but some probable causes are:

  • Changes in gut bacteria
  • Contractions in the intestine or any change in bowel movements
  • Bacterial overgrowth in the intestine
  • Gastroenteritis
  • Malfunction of the enteric system
  • Failure of the nervous system to control gut movements

Types of IBS

There are three main types of IBS, every individual experiences different types of IBS, over time:

  • IBS with constipation (IBS-C): Symptoms are accompanied by hard, lumpy stool which may also contain blood
  • IBS with diarrhea (IBS-D): Frequent bowel movements are accompanied by loose, watery stool
  • IBS with alternating stool pattern (IBS-A): Individual experiences both diarrhea and constipation

IBS triggers

IBS is a lifelong condition that comes and goes throughout your life, each episode can be triggered by some factors which are:

  • Foods that increase gas and cause flatulence such as cabbage, Brussel sprouts, broccoli, and beans
  • Carbonated drinks
  • Alcohol
  • Dairy products
  • Constant stress
  • Fatty foods
  • Foods with high sugar content

Risk factors

Certain people are more likely to develop irritable bowel syndrome than others, some of those are:

  • People with anxiety or depression disorders
  • People with food allergies and sensitivities
  • Those under the 50s
  • Individuals with a family history of IBS
  • People with a history of physical or emotional abuse
  • Female gender
  • Females who undergo hormone replacement therapy

IBS diet

Foods that you can eat in IBS

  • Fresh fruit juices
  • Lean meat
  • Eggs
  • Nuts and other Omega-3 Fatty acid containing foods
  • Seeds
  • Rice, gluten-free oats
  • Food with low-FODMAP

Food that you cannot eat in IBS

  • High in sugar content
  • High in fiber content
  • Gass producing vegetables like legumes, broccoli, cabbage etc.
  • Dairy products
  • Gluten
  • Caffeine
  • Alcohol
  • Fatty foods
  • Spices

Complications of IBS

Irritable bowel syndrome is a long term condition that gives rise to a number of complications that are:

  • Anemia due to blood loss
  • Nutritional deficiencies
  • Rectal bleeding
  • Inflammatory bowel diseases like Crohn’s disease and ulcerative colitis
  • Colon cancer

Management of IBS

There is no definitive cure for IBS but proper diagnosis and systemic treatment can help relieve the symptoms.

Diagnosis

IBS resembles other gastrointestinal disorders in its symptoms. Thus, it should be carefully diagnosed. Your doctor will begin with a detailed history of your symptoms. This is followed by a number of investigations:

  • Blood test
  • Stool culture
  • X-rays
  • Upper GI endoscopy
  • Colonoscopy
  • CT-Scan

Blood tests for anti-CdtB and anti vinculin antibodies can detect IBS with diarrhea but not IBS with constipation

Treatment

There is no cure for irritable bowel syndrome but can be managed by a conservative and symptomatic approach to get through the painful episode.

  • Antidepressants for stress
  • Antispasmodics to relax gut muscles
  • Laxatives for IBS-C
  • Antimotility medications for IBS-D
  • Antibiotics for bacterial infection

Lifestyle changes and home remedies

  • Quit smoking, caffeine, alcohol
  • Out on a regular basis
  • Add probiotics to your routine
  • Try stress management techniques like acupuncture, yoga, and meditation
  • Pain management techniques are also helpful
  • Include foods to your diet that aid in digestion such as ginger
  • For stress and depression, psychotherapy should be considered

When to consult a doctor?

Every individual may experience different symptoms in every episode of IBS, but should regularly go for follow-up visits. Other than that, if an episode is marked by severe symptoms you should consult your doctor. Some of these may be rectal bleeding, increased intensity of pain, weight loss, or loss of appetite.

FAQ

Can IBS be caused by stress?

Stress and anxiety result in overactivity of GIT, the increase in gut motility leads to diarrhea which can trigger an episode of IBS.

Can IBS go away?

Irritable bowel syndrome is a chronic condition that may never go away completely but some lifestyle modifications and medications can reduce the severity and frequency of attacks.

Can exercise make IBS worse?

Intense and vigorous exercise can trigger an episode of IBS but regular mild to moderate exercise can relieve stress, promote relaxation, and help in managing your symptoms.

Last medically reviewed on August 12, 2021.