Irritable bowel syndrome (IBS) is a prevalent gastrointestinal condition that affects the large intestine. People with IBS experience a range of symptoms that can include abdominal pain, and changes in bowel movements. The severity of these symptoms can vary from person to person, and some people may experience all of them, while others may only experience one or two.
Some of the symptoms that are often associated with IBS may also occur in other gastrointestinal (GI) conditions. Given the similarities in symptoms between IBS and other GI conditions, it can be challenging to diagnose IBS accurately. However, there are specific diagnostic criteria that healthcare professionals can use to distinguish IBS from other conditions.
Getting an accurate diagnosis for your stomach and bowel problems is key to getting the right treatment. Despite similar symptoms, GI conditions have different causes and require different treatments. Being misdiagnosed may lead to receiving ineffective treatments or unnecessary medical procedures which can be frustrating. This is why it's important to work with a healthcare professional, like a Registered Dietitian, to get an accurate diagnosis and develop a treatment plan that's right for you.
Symptoms of IBS and Other GI Conditions
Common symptoms of irritable bowel syndrome (IBS) include abdominal pain or discomfort, bloating, gas, diarrhea or constipation, or alternating between the two. Other, less common, symptoms of IBS include, nausea, reflux and heartburn. Many of these symptoms are often associated with other gastrointestinal (GI) conditions, such as diverticulitis, celiac disease, and inflammatory bowel disease (IBD). It is important to remember that people may experience different combinations of symptoms.
You may have noticed that not everyone with IBS experiences the same triggers, or symptoms during flare-ups. In fact, most people with IBS have different triggers and “IBS-safe foods”. One of the reasons for this is that there are different types of IBS.
Differences between IBS and Other GI Conditions
Although IBS and other GI conditions share some symptoms like abdominal pain, bloating and changes in bowel habits. However, they have different underlying causes and require different treatment plans. It is important to work with a healthcare professional to obtain an accurate diagnosis and personalized treatment plan that addresses your specific needs.
Diagnostic Testing for IBS
Diagnostic testing for GI conditions may vary depending on the specific condition, as well as your symptoms. It typically involves a combination of medical history, physical examination, and diagnostic tests. For IBS, there is no specific diagnostic test, but your doctor may perform tests to rule out other conditions with similar symptoms, such as inflammatory bowel disease (IBD). These tests may include,
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- Blood tests
- Stool tests
- Imaging (such as x-rays, CT scans)
- Scopes (such as colonoscopy or endoscopy)
Although there is no specific diagnostic test for IBS, there are diagnostic criteria. This criteria includes:
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- Stomach pain or discomfort for at least 12 weeks in the past year
- AND at least two of the following:
- Changes in your bowel movements
- Bloating
- New symptoms related to a change in frequency and consistency of bowel movement
What Is IBS?
First off, what is IBS? IBS is short for irritable bowel syndrome. It is a chronic condition that is characterized by symptoms of diarrhea, constipation, flatulence, bloating, and abdominal pain.
It is currently estimated that 10 to 20% of the world’s population experience IBS. Studies report that women and people under the age of 50 are experiencing higher rates of IBS, with Canada reporting one of the highest rates of IBS across the globe. Additionally, research has shown that women with IBS are more likely to experience symptoms during their periods.
Types of IBS
IBS is can be categorized based on the dominant symptoms. In IBS-C, the main symptom is constipation, while in IBS-D the main symptom is diarrhea. Some people may experience a combination of both diarrhea and constipation which is referred to as IBS-mixed. Other individuals may have a variety of dominant symptoms, which is referred to as undefined IBS or IBS-U.
Causes of IBS
IBS can develop at any point in our lives. However, we do not fully know why some people develop IBS in the first place. However, there are many possible causes including,
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- Small Intestinal Bacterial Overgrowth (SIBO)
- Oversensitive nerves in your gut
- Physical, mental or emotional stress
- Infection
- Food moving too quickly or too slowly through your gut
- Family history of IBS
What Happens to Your Body with IBS
Aside from unpleasant GI symptoms, irritable bowel syndrome can impact many aspects of your health and can cause some of the following,
Stomach Pain and Cramping
Many people with IBS experience strong pain and cramping in their stomach area after eating meals. This may be the result of changes in pressure in the stomach, such as bloating.
Change in the Movement of Food Through Your Gut
Change in the Bacteria Living in Your Gut
Increased Communication Along the Gut-Brain Axis
Current Treatment for IBS
Currently, there are a few approaches that are used to treat irritable bowel syndrome. These include,
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- Medications
- There are some medications which are used in the treatment of IBS. However, these medications temporarily treat your symptoms, rather than the cause of your IBS.
- Therapy
- Probiotics
- Probiotic supplements are a newer approach but may be beneficial for some people
- Diet
- Medications
Dietary Changes for IBS
As you may already know, your diet can play a role in the management of IBS. Nutrients in your diet can influence the types, and amounts of bacteria that live in your digestive tract, and can limit the amount of fermented. Some changes you can make to your diet to help alleviate symptoms include,
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- Reduce your alcohol intake
- Eating smaller meals throughout the day
- Limit your caffeine intake
- Reduce the amount of high-fat foods in your diet
- Include more soluble fibre in your diet
- Avoid spicy foods
Although these changes may help to reduce the severity of your IBS symptoms, they do not guarantee they will eliminate them. On the other hand, the low-FODMAP diet can help you identify which foods trigger your symptoms.
Find more tips for eating with IBS from my articles, Building an IBS-Friendly Breakfast and IBS-Friendly Snacks.
The Low-FODMAP Diet
FODMAP stands for:
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- Fermentable
- Oligosaccharides
- Disaccharides
- Monosaccharides and
- Polyols
These are all different forms of carbohydrates that are, normally, easily digested. However, in IBS, these carbohydrates are not digested as normal and instead are fermented by bacteria found in your gut.
How the Low-FODMAP Diet Works
The low-FODMAP diet is not a long-term diet. In fact, it is a temporary, multi-stage diet which includes eliminating all high-FODMAP foods for 4 to 8 weeks to stop symptoms, before slowly re-introducing high-FODMAPs.
This process should be done under the supervision and guidance of a healthcare procession such as a Registered Dietitian (RD) to ensure you continue to meet your nutritional needs while on the low FODMAP diet.
Check out my article for everything you need to know about the low-FODMAP diet, including when to use it!
Why Should You Know Your Type of IBS
Knowing and understanding your dominant type of IBS can help you identify ways to manage the symptoms. It can also make it easier for you to spot on-coming flare ups.
Symptom tracking is can help you identify what is your dominant type of IBS, and the indicators of a flare up.
Types of IBS
IBS is categorized into different subtypes based on the dominant symptoms that you experience during flare-ups. In addition to the common symptoms of IBS such as stomach cramping and bloating, people also experience changes in the movement of food through the gut during flare-ups, which contribute to the dominant symptoms they experience.
Currently, there are 4 different types of IBS. Understanding the type of IBS you have can help identify dietary and lifestyle changes you can make to support IBS management. It can also help determine what types of medications can be used to alleviate symptoms of your IBS.
IBS-C
People experiencing constipation as a primary symptom of their IBS flare-ups are said to have IBS-C (constipation). With IBS-C, you may also experience less frequent trips to the bathroom, along with more bloating.
Including additional fibre and gentle exercises such as yoga or walking can help promote the movement of food through your gut and reduce your constipation.
Another way to support bowel movements during IBS-C is by using the Squatty Potty. The Squatty Potty is a stool designed to fit around the toilet. It helps to support bowel movements by elevating your feet while you're on the toilet, helps to relax a muscle (your puborectalis muscle) below your rectum.
IBS-D
Diarrhea is the primary symptom during IBS-D flare-ups. People with IBS-D experience watery, loose bowel movements during their flare-ups rather than constipation.
According to research, excessive caffeine, indigestible carbohydrates and high lactose intakes can contribute to this type of IBS. If you have this type of IBS, it may be helpful to lay off the coffee (or caffeinated tea), high lactose foods and high-fibre foods during flare ups.
IBS-M
IBS-M refers to IBS with mixed bowel symptoms. In other words, people with this type of IBS experience a combination of both constipation and diarrhea during flare-ups.
Managing this type of IBS can be overwhelming due to the alternating symptoms. Making sure you are getting enough fluid, limiting your caffeine intake, getting enough fibre and incorporating gentle exercise into your routine can help with managing your symptoms.
IBS-U
IBS-U refers to unclassified IBS. People with unclassified IBS don’t necessarily experience constipation or diarrhea, but may continue to experience regular bowel movements throughout their flare-up. During IBS-U flare ups, it is still important to consume enough fluid and eat balanced meals while managing your symptoms.
Tracking Your Symptoms
If you’re not sure what type of IBS you’re experiencing, you may consider tracking your symptoms during flare-ups. Keeping a symptom journal can help you and your healthcare team identify changes in your symptoms as well as any your personal triggers IBS triggers.