Things to know about irritable bowel syndrome (IBS)

Irritable Bowel Syndrome (IBS): Causes, Symptoms, Diagnosis & Treatment

Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder that affects the large intestine. It is a chronic condition characterized by abdominal pain, altered bowel habits, and digestive discomfort. Although IBS does not damage the intestines permanently or increase cancer risk, it can significantly affect daily life and mental well-being.

What Happens in IBS? (Pathophysiology)

IBS is believed to occur due to a combination of:

• Abnormal gut motility – intestines contract too fast or too slow.

• Visceral hypersensitivity – increased sensitivity to pain in the gut.

• Brain–gut axis dysfunction – communication issues between the nervous system & digestive tract.

• Altered gut microbiota – imbalance of healthy gut bacteria.

• Post-infectious inflammation – IBS may develop after gastroenteritis.

 Main Causes & Triggers

IBS has no single cause, but several factors contribute:

Trigger

How It Affects

1.Stress & anxiety

Worsens symptoms due to brain–gut axis involvement

2.Certain foods

Spicy, fatty foods, caffeine, alcohol may trigger flares

3.Hormonal changes

Symptoms commonly worsen during menstruation

4.Prior GI infections

Food poisoning or gut infections increase risk

5.FODMAP-rich foods

Fermentable carbs causing gas & bloating

 Types of IBS

IBS is classified based on predominant bowel pattern: IBS-D (diarrhea predominant), IBS-C (constipation predominant), IBS-M (mixed type), and IBS-U (unclassified). Identifying the type helps guide appropriate management.

1.IBS-C

Constipation-dominant

2.IBS-D

Diarrhea-dominant

3.IBS-M

Mixed (alternating constipation & diarrhea)

4.IBS-U

Unclassified, symptoms vary

 Common Symptoms

IBS typically presents with recurrent abdominal pain associated with changes in bowel habits, including diarrhea, constipation, or a mix of both. Other symptoms include bloating, excessive gas, mucus in stools, and a feeling of incomplete evacuation. Symptoms often fluctuate and may worsen during stress.

• Recurrent abdominal pain or cramps

• Bloating and gas

• Mucus in stools

• Constipation, diarrhea, or both

• Feeling of incomplete evacuation

• Pain relief after bowel movement (often)

Red flag symptoms which need urgent evaluation :

• Unexplained weight loss

• Rectal bleeding

• Persistent fever

• Anemia

• Symptoms after age 50 with no prior history

 Diagnosis

IBS is diagnosed clinically with criteria like the Rome IV Criteria:

Abdominal pain at least 1 day per week in the last 3 months, associated with change in stool frequency or form.

Tests may be done to rule out other conditions:

• Stool tests, blood tests

• Colonoscopy (if red flags present)

• Imaging if required

• Screening for celiac disease or lactose intolerance

 Treatment & Management

Management focuses on symptom relief and includes dietary modifications (such as low-FODMAP diet), stress management, regular physical activity, and medications tailored to symptoms (antispasmodics, laxatives, or antidiarrheal agents). Psychological therapies may also be beneficial.

There is no single cure, but symptoms can be controlled.

 Diet

• Low FODMAP diet (under supervision)

• Increase soluble fiber (psyllium)

• Avoid trigger foods:
  caffeine, artificial sweeteners, fried foods

• Keep a food diary to identify triggers

 Medications

Symptom

Medication Examples

1.Constipation

Fiber supplements, PEG (laxatives), Lubiprostone

2.Diarrhea

Loperamide, bile acid binders

3.Pain/cramps

Antispasmodics (Dicyclomine, Mebeverine)

4.Gut sensitivity

Low-dose antidepressants (TCAs/SSRIs)

(Note: Treatment should be guided by a doctor.)

Lifestyle

• Stress reduction: yoga, meditation, counseling

• Regular exercise

• Adequate sleep

• Slow, mindful eating

 Prognosis

IBS is a long-term condition but manageable. With proper lifestyle changes and treatment, most people experience significant improvement. Early recognition and personalized care improve outcomes and quality of life.

Disclaimer:

The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified physician or other licensed healthcare provider with any questions you may have regarding a medical condition.