Irritable bowel syndrome (IBS) is a common digestive disorder that can cause life-changing symptoms. Common irritable bowel syndrome symptoms include abdominal pain, diarrhea, constipation, fatigue, depression, gas, and bloating. Irritable bowel syndrome symptoms can be the perfect storm that disrupts your overall quality of life.
According to the International Foundation for Gastrointestinal Disorders, irritable bowel syndrome affects between 10% and 15% of adults. Women are more than twice as likely as men to have irritable bowel syndrome.
Risk factors for developing IBS include a family history of the disease, a poor diet, and mental health conditions including depression and anxiety. Estrogen therapy before or after menopause can also increase the risk of women developing irritable bowel syndrome later in life.
Irritable bowel syndrome treatment depends on the severity of IBS symptoms experienced. Some individuals can effectively control the pain and other symptoms by following an IBS diet and making appropriate lifestyle changes. However, individuals with severe irritable bowel syndrome symptoms may find that conventional medications along with dietary and habit change are necessary to find relief.
What Is Irritable Bowel Syndrome?
Also referred to as irritable colon, spastic colon, spastic colitis, and mucous colitis, irritable bowel syndrome is a functional gastrointestinal disorder that affects the digestive tract, including both the large intestine and the small intestine. This condition can be long term, without much relief, or IBS symptoms may come and go.
IBS causes a variety of symptoms unique to each individual. Many of the symptoms are related to disruption or disturbances in the physical motor function of the gut, including muscle contraction. Since motor function is regulated by the brain, many researchers now believe that irritable bowel syndrome is best described as a brain-gut disorder.
There are three recognized types of IBS according to the National Institute of Diabetes and Digestive and Kidney Diseases at the NIH. These types are identified based on bowel movements. Determining which type of IBS you have dictates the proper IBS treatment protocol.
- IBS-C: Irritable bowel syndrome with constipation
- IBS-D: Irritable bowel syndrome with diarrhea
- IBS-M: Irritable bowel syndrome with mixed bowel habits
Irritable Bowel Syndrome Symptoms
Symptoms of irritable bowel syndrome can be mild or severe. This disorder can come and go, or remain over a lifetime. Common symptoms include:
- Abdominal pain
- Mucus in the stool
- Watery or loose stools
- Unexplained weight loss
Cause of IBS
The medical community still doesn’t know what causes IBS. However, researchers have identified possible irritable bowel syndrome causes.
- Abnormal muscle contractions in the intestines: If muscle contractions are stronger than normal, diarrhea, bloating, and gas can occur. Weaker muscle contractions cause the food to move more slowly through the digestive tract, which can lead to pain and constipation.
- Disrupted or poor communication between the brain and the gut: If there are abnormalities in the nerves of your digestive system, your brain may send poor communication signals to the gut. This can cause the digestive system to overreact, or underreact, leading to IBS symptoms.
- Inflammation in the intestines: When there are excess immune-system cells in the intestines, inflammation can occur. This can lead to diarrhea and abdominal pain.
- Severe infection: Post-infectious IBS can occur after a severe bacterial or viral infection that has caused diarrhea (gastroenteritis). IBS is also associated with SIBO or small intestinal bacterial overgrowth.
- Imbalance of friendly bacteria/bad bacteria in the gut: When the gut doesn’t have enough friendly bacteria, IBS can emerge. According to the Mayo Clinic, research now shows that individuals with IBS have a different makeup of bacteria balance than healthy individuals.
Irritable Bowel Syndrome Symptom Triggers
Irritable bowel syndrome is a very personal disorder. This condition doesn’t affect everyone with the same intensity, or in the same way. If you are new to this digestive disease, keeping a food journal with details on how your body reacts may help you identify the foods you should avoid.
Recognized IBS symptom triggers include:
- Eating a low-fiber diet
- Consuming allergens
- Unmanaged stress
- Unaddressed inflammation
- Nutritional deficiencies
- Leaky gut syndrome
- Alcohol use
- Drug use
- Hormonal changes
- Sedentary lifestyle
Conventional Irritable Bowel Syndrome Treatment
Many people diagnosed with irritable bowel syndrome can effectively manage their symptoms through diet and lifestyle changes. However, as the symptoms of IBS can mimic other more serious health conditions, including colon cancer and the most common types of inflammatory bowel disease (IBD) Crohn's disease and ulcerative colitis, it is important to see your doctor whenever there is a change in bowel habits and gut health.
An irritable bowel syndrome diagnosis requires a physical examination and a complete medical history. It is likely that your doctor will order blood tests and a stool test. Also, you will likely be tested for celiac disease, lactose intolerance, bacterial overgrowth, food allergies, autoimmune diseases, and cancer. Your doctor may order a sigmoidoscopy or colonoscopy if colon cancer or a type of inflammatory bowel disease is suspected. A gastroenterologist will provide further guidance to help you manage your IBS.
Conventional irritable bowel syndrome treatment first addresses any underlying causes of this gut-brain disorder before addressing IBS symptom relief with the following medications:
- Over-the-counter laxatives
- Anti-diarrhea drugs
- Anticholinergic and antispasmodic medications for spasms
- Tricyclic antidepressants to reduce pain and depression
- SSRI antidepressants for pain and constipation
- Pain medications
- Alosetron (Lotronex) for diarrhea-predominant IBS to relax the colon
- Eluxadoline (Viberzi) to reduce muscle contractions that cause diarrhea
- Rifaximin (Xifaxan) to decrease bacterial overgrowth and diarrhea
- Lubiprostone (Amitiza) to increase fluid secretion in small intestine IBS with constipation
- Linaclotide (Linzess) for IBS with constipation to increase fluid secretion
In addition to medications, your health care provider will likely recommend avoiding gas-producing foods, alcohol, caffeine, fried foods, spicy foods, sugar, and gluten. Emerging studies show that removing FODMAPs from your diet may help relieve irritable bowel syndrome symptoms.
The Healing Irritable Bowel Syndrome Diet
If you have a new irritable bowel syndrome diagnosis, one of the wisest things you can do is try an elimination diet. This will help you identify the foods that trigger IBS symptoms and the foods that are soothing to your gut.
FODMAPs, or “Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols,” are fermentable short-chain carbohydrates that can cause gastrointestinal distress and irritable bowel syndrome symptoms. In the beginning, following a strict low-FODMAP diet may help to relieve your symptoms. As you progress, you can start to slowly reintroduce foods, one by one, to determine those that are safe for you to eat. We recommend keeping a food diary to track your progress.
On a low-FODMAP diet, it is best to avoid:
|Sugar snap peas||Legumes|
|Onion and garlic||Honey|
|Soft cheeses||Ice cream|
|Artificial sweeteners||Sugar alcohols — sorbitol, mannitol, xylitol, maltitol, erythritol|
One of the long-term risks of irritable bowel syndrome is malnutrition. As you can see above, many of the foods on the “avoid list” are nutrient dense and healthy for the vast majority of people. So, it is imperative that your IBS diet includes foods that are packed with essential vitamins and minerals.
Some healthy irritable bowel syndrome diet options according to Harvard Medical School include:
- Fresh juices made from low-FODMAP fruits and vegetables
- Healthy fats from coconut oil, ghee, nuts, and wild-caught fish
- Beef or chicken bone broth
- Probiotic-rich foods including yogurt, kefir, kimchi, and sauerkraut
- Lean proteins from grass-fed beef and free-range poultry
- Low-FODMAP fruits including bananas, blueberries, cantaloupe, and kiwi
- Low-FODMAP vegetables including carrots, chives, cucumbers, lettuce, potatoes, and turnips
- Gluten-free grains including oats, rice, corn, and quinoa
8 Natural Treatments for Irritable Bowel Syndrome
In addition to dietary changes, natural irritable bowel syndrome treatments can be effective at relieving digestive symptoms as well as depression and anxiety. Here are the top eight natural remedies to try. Remember, IBS is a very personal disorder and not all treatments will be effective for every individual or every symptom of IBS.
1. Peppermint Tea
According to researchers from the USDA Human Nutrition Research Center on Aging at Tufts University, peppermint tea may help to relieve IBS symptoms. The researchers point out that peppermint contains significant antimicrobial and antiviral activities that may help relax gastrointestinal tissue and provide pain relief.
Choose an organic peppermint tea, and use only low-FODMAP sweeteners like brown sugar, coconut sugar, or palm sugar until you know your personal IBS symptom triggers.
2. Peppermint Oil
According to the Mayo Clinic, research shows that for individuals with IBS with diarrhea, enteric-coated peppermint oil tablets may provide short-term relief. These tablets work by slowly releasing peppermint essential oil into the small intestine, thereby easing bloating, abdominal pain, urgency, and the pain associated with passing stool.
In a systematic review and meta-analysis published in the World Journal of Gastroenterology, researchers identify that probiotics reduce pain and the severity of symptoms in people with an irritable bowel syndrome diagnosis.
In addition to adding probiotic-rich foods to your diet like yogurt, kefir, and kombucha, you can take a high-quality probiotic supplement for an extra boost of friendly bacteria. Choose a probiotic supplement with Bifidobacterium infantis, as it has been shown to help specifically with abdominal pain, irregularity, and bloating in those with IBS.
4. Reduce Stress
Chronic stress and unmanaged stress are risk factors for developing irritable bowel syndrome. Once you have an irritable bowel syndrome diagnosis, stress can exacerbate symptoms according to a report on the link between psychological trauma and irritable bowel disease published in Psych Central. Try yoga, meditation, art therapy, music therapy, or cognitive-behavioral therapy to help you manage your stress and prevent the worsening of IBS symptoms.
According to a randomized controlled trial published in the American Journal of Gastroenterology, increasing physical activity and exercise improves gastrointestinal IBS symptoms. The researchers note that physical activity should be a primary irritable bowel syndrome treatment.
If you are inactive or lead a sedentary life, increase your exercise slowly. Start a new exercise program with gentle activities like walking, swimming, dancing, and Pilates. And be sure to incorporate hiking with friends or a rousing game of tennis to keep yourself motivated and exercising regularly.
6. Fiber Supplements
In a recent clinical review published in the International Journal of Molecular Medicine, researchers identified that increasing dietary fiber can relieve irritable bowel syndrome symptoms. The researchers note that some dietary fibers, particularly from high-FODMAP foods can worsen symptoms, so it is imperative to choose low-FODMAP fiber sources like psyllium husk.
Slowly increase dietary fiber, as adding too much too quickly can worsen IBS symptoms.
For over 30 years, hypnosis has been studied as a treatment for a variety of gastrointestinal disorders, including irritable bowel syndrome.
In a comprehensive review published in the American Journal of Clinical Hypnosis, hypnotherapy was shown to significantly improve IBS symptoms in both adults and children. The author of the report notes that hypnosis is highly effective and can provide lasting relief of many symptoms, especially for those who don’t respond well to conventional medical treatment.
In a meta-analysis published in the World Journal of Gastroenterology, acupuncture significantly controlled IBS symptoms without any side effects. The authors of this review note that researchers haven’t yet identified how acupuncture works to relieve symptoms, only that it does, and it can significantly improve overall quality of life in IBS patients.