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Irritable bowel syndrome

Show Alternative Names
IBS
Irritable bowel
Spastic colon
Irritable colon
Mucous colitis
Spastic colitis
Abdominal pain - IBS
Diarrhea - IBS
Constipation - IBS
IBS-C
IBS-D

Irritable bowel syndrome (IBS) is a disorder that leads to pain in abdomen and changes in bowel movements.

IBS is not the same as inflammatory bowel disease (IBD).

Irritable bowel syndrome - Animation

Are your off again, on again, bathroom habits affecting your daily life? If so, you may have Irritable Bowel Syndrome, or IBS. IBS is a problem that causes abdominal pain, cramping, and changes in your bowel movements. IBS is known as a functional bowel disorder, and is not considered a disease. What I mean by that, is when a doctor passes a colonoscope into the colon to look around, everything may look perfectly normal - but yet, Your colon may not be not be acting normal at all! Symptoms of IBS can range from mild to severe. The main symptoms are diarrhea, constipation, or both. And you will probably experience abdominal pain, bloating, and gas. These symptoms often will temporarily improve after having a bowel movement, and that instant relief of course feels good. But, the important thing to understand is that the root of the problem often isn't here (abdomen), its here (head). IBS is a classic example of your mind affecting your bowels. It's rarely seen in folks who are not stressed, anxious, or depressed. It's often hard to determine why people get IBS. It has been found that IBS is twice as common in women as it is in men, and can develop at any age, but most get it as teenagers or in early adulthood. Diet can also cause IBS. Foods that often cause IBS symptoms are Fatty foods, such as French fries, or any drink containing caffeine like coffee and tea. One great idea is to keep a Food Diary. Write down what you're eating and when, and include the symptoms you experience after you eat. This information can be helpful to your doctor in identifying if you have IBS. The way most doctors diagnose IBS is by gathering your history and ruling out other things like lactose intolerance, gluten intolerance or some sort of bowel infection. Your doctor might recommend a colonoscopy just to make sure the colon looks okay. But remember, there is no specific test to diagnose IBS. So, how do you manage IBS? For some people, symptoms can reduce their ability to work, travel, and attend social events, and some may have to deal with IBS the rest of their life. There are several ways to manage your IBS. Large meals can make your symptoms worse. Try eating 4 to 5 smaller meals per day. Extra Fiber can bulk up your stools to help with diarrhea or help draw in extra water to help with constipation. Laxatives can help with difficult constipation. Drugs like Hyoscyamine help to calm down an overactive digestive tract. Lastly, since stress, depression and anxiety can fuel IBS, work on ways to relax. Perhaps, try exercise, meditation or yoga - and if that doesn't work, consider trying an antidepressant drug to help improve your mood. Oh, and keep in mind that blood in your stool or significant weight loss are not part of IBS, so be sure to let your doctor know if that ever shows up. Remember that the mind and the body are interconnected. You can't expect to feel good here (head), without feeling good down here (abdomen), and vice versa.

IBS Myths & Facts Quiz

  • A common sign of IBS is frequent:

    Correct Answer
    The correct answer is all of the above. IBS symptoms vary from person to person and can range from mild to severe. Talk to your doctor if you have had IBS symptoms on 3 or more days a month for the past 3 months.

  • Irritable bowel syndrome (IBS) is the same as inflammatory bowel disease (IBD).

    Correct Answer
    The correct answer is myth. IBD includes Crohn disease and ulcerative colitis, conditions that damage the lining of the digestive tract. IBS causes belly pain and abnormal bowel movements but does not harm the intestines.

  • IBS is a common disorder.

    Correct Answer
    The correct answer is fact. About 1 in 6 people in the U.S. have symptoms of IBS. It is the most common intestinal problem that brings patients to a bowel specialist (gastroenterologist).

  • Everyone with IBS has diarrhea.

    Correct Answer
    The correct answer is myth. Some people with IBS have frequent diarrhea, while others tend to have hard stools and be constipated. It's also common to switch between diarrhea and constipation. Bowel problems may get worse for a few weeks and then clear up for awhile. Discuss any changes in your bowel movements with your doctor.

  • Doctors need to run a lot of tests to diagnose IBS.

    Correct Answer
    The correct answer is myth. There is no test to diagnose IBS, although tests may be done to rule out other problems. Most of the time, your doctor can diagnose IBS based on your symptoms, with few or no tests.

  • Stress plays a role in triggering IBS symptoms.

    Correct Answer
    The correct answer is fact. Signals go back and forth between the bowel and brain. These signals affect bowel movements. Stress may cause the intestines to be more sensitive and to squeeze more often. Finding ways to relieve stress can help keep symptoms at bay.

  • There is a special IBS diet that relieves symptoms for most people.

    Correct Answer
    The correct answer is myth. Dietary changes can be helpful. However, no specific diet works for everyone with IBS. This is because the symptoms differ from one person to another. Keeping a food diary can help you figure out which foods make your symptoms worse.

  • Which foods or drinks are most likely to cause IBS symptoms?

    Correct Answer
    The correct answer is any of the above. These are common triggers, although not everyone with IBS will react to all of these foods. Avoiding caffeine is a good idea for most people with IBS. Caffeine can make the intestines more active.

  • What type of medicines can treat IBS?

    Correct Answer
    The correct answer is all of the above. Your doctor will recommend medicines based on your symptoms. Always follow your doctor’s instructions when using medicines for IBS. You should not take a different amount or take the medicine more or less often. Doing so can lead to further problems. Low doses of tricyclic antidepressants can help relieve pain and discomfort even if you are not depressed.

  • It's normal to lose a lot of weight when IBS flares up.

    Correct Answer
    The correct answer is myth. Unexpected weight loss of more than 5 to 10 pounds could be a sign of a more serious problem. Contact your doctor right away if you have weight loss when you are not trying, bloody stools, fever, or severe pain.

Causes

The reasons why IBS develops are not clear. It can occur after a bacterial infection or a parasitic infection (giardiasis) of the intestines. This is called postinfectious IBS. There may also be other triggers, including stress.

The intestine is connected to the brain by hormone and nerve signals that go back and forth between the bowel and the brain. These signals affect bowel function and symptoms. The nerves can become more active during stress. This can cause the intestines to be more sensitive and contract more.

IBS can occur at any age. Often, it begins in the teen years or early adulthood. It is twice as common in women as in men.

 It is less likely to begin in people above 50 years of age.

About 10% to 15% of people in the United States have symptoms of IBS. It is the most common intestinal problem that causes people to be referred to a bowel specialist (gastroenterologist).

Symptoms

IBS symptoms vary from person to person, and range from mild to severe. Most people have mild symptoms. You are said to have IBS when symptoms are present for at least 3 days a month for a period of 3 months or more.

The main symptoms include:

  • Abdominal pain and cramps
  • Gas
  • Fullness
  • Bloating
  • Change in bowel habits. You can have either diarrhea (IBS-D), or constipation (IBS-C).

Pain and other symptoms will often be reduced or go away after a bowel movement. Symptoms may flare up when there is a change in the frequency of your bowel movements.

People with IBS may go back and forth between having constipation and diarrhea or have or mostly have one or the other.

  • If you have IBS with diarrhea, you will have frequent, loose, watery stools. You may have an urgent need to have a bowel movement, which may be hard to control.
  • If you have IBS with constipation, you will have a hard time passing stool, as well as fewer bowel movements. You may need to strain with a bowel movement and have cramps. Often, only a small amount or no stool at all will pass.

The symptoms may get worse for a few weeks or a month, and then decrease for a while. In other cases, symptoms are present most of the time.

You may also lose your appetite if you have IBS. However, blood in stools and unintentional weight loss are not a part of IBS.

Exams and Tests

There is no test to diagnose IBS. Most of the time, your health care provider can diagnose IBS based on your symptoms. Eating a lactose-free diet for 2 weeks may help the provider identify lactase deficiency (or lactose intolerance).

The following tests may be done to rule out other problems:

  • Blood tests to see if you have celiac disease or a low blood count (anemia)
  • Stool exam for occult blood (blood that is not visible)
  • Stool cultures to check for an infection
  • Microscopic exam of a stool sample for parasites
  • Stool exam for a substance called fecal calprotectin

Your provider may recommend a colonoscopy. During this test, a flexible tube is inserted through the anus to examine the colon. You may need this test if:

  • Symptoms began later in life (age 50 or over)
  • You have symptoms such as weight loss or bloody stools
  • You have abnormal blood tests (such as a low blood count)

Other disorders that can cause similar symptoms include:

  • Celiac disease
  • Colon cancer (cancer rarely causes typical IBS symptoms, unless symptoms such as weight loss, blood in the stools, or abnormal blood tests are also present)
  • Crohn disease or ulcerative colitis

Treatment

The goal of treatment is to relieve symptoms.

In some cases of IBS, lifestyle changes can help. For example, regular exercise and improved sleep habits may reduce anxiety and help relieve bowel symptoms.

Dietary changes can be helpful. However, no specific diet can be recommended for IBS because the condition differs from one person to another.

The following changes may help:

  • Avoiding foods and drinks that stimulate the intestines (such as caffeine-containing drinks, tea, or colas)
  • Eating smaller meals
  • Increasing fiber in the diet (this may improve constipation or diarrhea, but make bloating worse)

Talk with your provider before taking over-the-counter medicines.

No one medicine works for everyone. Some that your provider may suggest include:

  • Anticholinergic medicines (dicyclomine, propantheline, belladonna, and hyoscyamine) taken about a half-hour before eating to control intestinal muscle spasms
  • Loperamide to treat IBS-D
  • Alosetron (Lotronex) for IBS-D
  • Eluxadoline (Viberzi) for IBS-D
  • Probiotics
  • Low doses of tricyclic antidepressants to help relieve intestinal pain
  • Lubiprostone (Amitiza) for IBS-C
  • Bisacodyl to treat IBS-C
  • Rifaximin, an antibiotic
  • Linaclotide (Linzess) for IBS-C

Psychological therapy or medicines for anxiety or depression may help with the problem.

Outlook (Prognosis)

IBS may be a life-long condition. For some people, symptoms are disabling and interfere with work, travel, and social activities.

Symptoms often get better with treatment.

IBS does not cause permanent harm to the intestines. Also, it does not lead to a serious disease, such as cancer.

When to Contact a Medical Professional

Contact your provider if you have symptoms of IBS or if you notice changes in your bowel habits that do not go away.

Review Date: 5/2/2023

Reviewed By

Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

References

Aronson JK. Laxatives. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:488-494.

Canavan C, West J, Card T. The epidemiology of irritable bowel syndrome. Clin Epidemiol. 2014;6:71-80. PMID: 24523597 pubmed.ncbi.nlm.nih.gov/24523597/.

Charles MB. Common clinical manifestations of gastrointestinal disease: abdominal pain. In: Wing EJ, Schiffman FJ, eds. Cecil Essentials of Medicine. 10th ed. Philadelphia, PA: Elsevier; 2022:chap 31.

Ferri FF. Irritable bowel syndrome. In: Ferri FF, ed. Ferri's Clinical Advisor 2023. Philadelphia, PA: Elsevier; 2023:875-877.

Ford AC, Talley NJ. Irritable bowel syndrome. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 122.

Mayer EA. Functional gastrointestinal disorders: irritable bowel syndrome, dyspepsia, chest pain of presumed esophageal origin, and heartburn. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 128.

Disclaimer

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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Irritable bowel syndrome - Animation

Are your off again, on again, bathroom habits affecting your daily life?

If so, you may have Irritable Bowel Syndrome, or IBS.

IBS is a problem that causes abdominal pain, cramping, and changes in your bowel movements. IBS is known as a "functional bowel disorder", and is not considered a disease. What I mean by that, is when a doctor passes a colonoscope into the colon to look around, everything may look perfectly normal - but yet, Your colon may not be not be acting normal at all!

Symptoms of IBS can range from mild to severe. The main symptoms are diarrhea, constipation, or both...and you will probably experience abdominal pain, bloating, & gas.

These symptoms often will temporarily improve after having a bowel movement, and that instant relief of course feels good. But, the important thing to understand is that the root of the problem often isn't "here" (abdomen), its "here" (head). IBS is a classic example of your mind affecting your bowels. It's rarely seen in folks who are not stressed, anxious, or depressed.

It's often hard to determine why people get IBS. It has been found that IBS is twice as common in women as it is in men, and can develop at any age, but most get it as teenagers or in early adulthood.

Diet can also cause IBS. Foods that often cause IBS symptoms are Fatty foods, such as French fries, or any drink containing caffeine like coffee and tea.

One great idea is to keep a Food Diary. Write down what you're eating and when, and include the symptoms you experience after you eat. This information can be helpful to your doctor in identifying if you have IBS.

The way most doctors diagnose IBS is by gathering your history and ruling out other things like lactose intolerance, gluten intolerance or some sort of bowel infection. Your doctor might recommend a colonoscopy just to make sure the colon looks okay. But remember, there is no specific test to diagnose IBS.

So, how do you manage IBS?

For some people, symptoms can reduce their ability to work, travel, and attend social events, and some may have to deal with IBS the rest of their life. There are several ways to manage your IBS. Large meals can make your symptoms worse. Try eating 4 to 5 smaller meals per day. Extra Fiber can bulk up your stools to help with diarrhea or help draw in extra water to help with constipation. Laxatives can help with difficult constipation.

Drugs like Hyoscyamine help to calm down an overactive digestive tract. Lastly, since stress, depression and anxiety can fuel IBS, work on ways to relax. Perhaps, try exercise, meditation or yoga - and if that doesn't work, consider trying an antidepressant drug to help improve your mood.

Oh, and keep in mind that blood in your stool or significant weight loss are not part of IBS, so be sure to let your doctor know if that ever shows up. Remember that the mind and the body are interconnected. You can't expect to feel good "here" (head), without feeling good down "here" (abdomen), and vice versa.

 

Irritable bowel syndrome - Animation

Are your off again, on again, bathroom habits affecting your daily life?

If so, you may have Irritable Bowel Syndrome, or IBS.

IBS is a problem that causes abdominal pain, cramping, and changes in your bowel movements. IBS is known as a "functional bowel disorder", and is not considered a disease. What I mean by that, is when a doctor passes a colonoscope into the colon to look around, everything may look perfectly normal - but yet, Your colon may not be not be acting normal at all!

Symptoms of IBS can range from mild to severe. The main symptoms are diarrhea, constipation, or both...and you will probably experience abdominal pain, bloating, & gas.

These symptoms often will temporarily improve after having a bowel movement, and that instant relief of course feels good. But, the important thing to understand is that the root of the problem often isn't "here" (abdomen), its "here" (head). IBS is a classic example of your mind affecting your bowels. It's rarely seen in folks who are not stressed, anxious, or depressed.

It's often hard to determine why people get IBS. It has been found that IBS is twice as common in women as it is in men, and can develop at any age, but most get it as teenagers or in early adulthood.

Diet can also cause IBS. Foods that often cause IBS symptoms are Fatty foods, such as French fries, or any drink containing caffeine like coffee and tea.

One great idea is to keep a Food Diary. Write down what you're eating and when, and include the symptoms you experience after you eat. This information can be helpful to your doctor in identifying if you have IBS.

The way most doctors diagnose IBS is by gathering your history and ruling out other things like lactose intolerance, gluten intolerance or some sort of bowel infection. Your doctor might recommend a colonoscopy just to make sure the colon looks okay. But remember, there is no specific test to diagnose IBS.

So, how do you manage IBS?

For some people, symptoms can reduce their ability to work, travel, and attend social events, and some may have to deal with IBS the rest of their life. There are several ways to manage your IBS. Large meals can make your symptoms worse. Try eating 4 to 5 smaller meals per day. Extra Fiber can bulk up your stools to help with diarrhea or help draw in extra water to help with constipation. Laxatives can help with difficult constipation.

Drugs like Hyoscyamine help to calm down an overactive digestive tract. Lastly, since stress, depression and anxiety can fuel IBS, work on ways to relax. Perhaps, try exercise, meditation or yoga - and if that doesn't work, consider trying an antidepressant drug to help improve your mood.

Oh, and keep in mind that blood in your stool or significant weight loss are not part of IBS, so be sure to let your doctor know if that ever shows up. Remember that the mind and the body are interconnected. You can't expect to feel good "here" (head), without feeling good down "here" (abdomen), and vice versa.

 
 
 
 

 

 
 
 
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