One week you're feeling fine and the next you're bloated, not comfortable and dealing with diarrhea. Other times, you have constipation and passing stool is painful. Sound familiar?
If you feel like you're always trying to guess what your bowels might do next, it might be time to talk with your healthcare team about irritable bowel syndrome, also called IBS.
IBS is a common disorder that affects the stomach and intestines. Symptoms can include cramping, abdominal pain, bloating, gas, and diarrhea, constipation or both. Symptoms can come and go, making IBS hard to predict.
Here's what Mayo Clinic experts want you to know about IBS.
IBS is common — but lots of people never get diagnosed
It's estimated that IBS affects between 10% and 15% of all Americans — but only about 15% of people with IBS seek treatment. This may be because some people are too embarrassed to seek help.
The exact cause of IBS isn't known
The reason IBS happens isn't completely understood. But researchers have determined that it's a gut-brain interaction disorder. This means there's a problem with how the gut and the brain talk to each other, which can affect the muscles and the nerves in the intestines.
For some people with IBS, this miscommunication can cause muscle contractions in the intestines that are stronger and last longer, which can lead to gas, bloating and diarrhea. For others, it can cause weaker contractions that slowly move food and lead to hard, dry stools.
Problems with how the brain and the gut communicate also can cause the nerves in the intestines to be overactive and extra sensitive. This means that a process like gas moving through the intestines might be more painful for someone with IBS.
Some people are more likely than others to develop IBS
Many people have occasional symptoms of IBS. But some risk factors that can increase your chances of developing IBS include:
- Age. IBS occurs more often in people under age 50.
- Sex assigned at birth. In the United States, IBS is more common among women. Estrogen therapy before or after menopause also is a risk factor for IBS.
- Family history. You might be more likely to develop IBS if a family member, like a parent or sibling, also has it.
- Early life stress. People who have had stressful events, especially in childhood, tend to have more symptoms of IBS.
- Mental health. People who have mental health disorders, like depression and anxiety, are more at risk.
- Severe infection. IBS can develop after getting sick with a bacteria or virus that causes severe diarrhea.
There are different types of IBS
There are 3 types of IBS, based on their symptoms. The types are:
- IBS with constipation (IBS-C). On flare-up days, most stools are hard and lumpy.
- IBS with diarrhea (IBS-D). On flare-up days, most stools are loose and watery.
- IBS with mixed bowel habits (IBS-M). On flare-up days, there are both hard and lumpy stools and soft and watery stools.
You should know these common triggers
There are some things that can make IBS symptoms worse. These are called triggers. Although triggers are different for everyone, 2 common ones include:
- Food. Many people notice that their IBS symptoms get worse when they eat or drink certain foods or beverages. These may include wheat, dairy products, citrus fruits, beans, broccoli, cabbage, milk and bubbly drinks.
- Stress. Symptoms of IBS can get worse or increase when people are under more stress. But while stress may make symptoms worse, it doesn't cause them.
Small changes can make a big difference
For many people, simple changes to diet and day-to-day activities can provide relief from IBS. These changes take time to make a difference — and your body needs time to adapt.
Here are some changes you might try:
- Limit gluten and dairy. People who have IBS may be more sensitive to these.
- Try the low FODMAP diet. This is a special diet that cuts out certain carbs that are hard to digest. Your healthcare team can help you get started.
- Add more fiber. Slowly increase the amount of fiber in your diet over weeks with foods like whole grains, fruits, vegetables and beans.
- Stay hydrated. Aim for at least 8 glasses of fluids during the day. All types of drinks count, including water, juice, milk, tea and coffee.
- Exercise regularly. Being physically active has been shown to reduce how bad IBS symptoms are.
- Eat at regular times. Don't skip meals, and try to eat at about the same time each day to help keep your bowel function regular.
- Look for ways to manage stress. There are several coping strategies to help lower stress, including yoga, meditation and breathing exercises.
Hypnosis may provide long-term benefits
Research suggests that hypnosis may reduce abdominal pain and bloating. During hypnosis, a trained professional helps you get into a state of deep relaxation. Then you're led through a series of soothing images and sounds to help you relax your abdominal muscles.
Peppermint may help calm your gut
For people who have IBS with diarrhea, coated peppermint oil tablets may provide short-term relief. Research has found that some people see improvements in bloating, pain and the urgent need to pass stool.
Snacking on some good bacteria may help
Probiotics are helpful bacteria that live in the intestines. They're found in certain foods, like yogurt, and in dietary supplements. Research suggests that certain probiotics may relieve symptoms like abdominal pain, bloating and diarrhea.
Medicine is an option for more-severe symptoms
If diet and lifestyle changes aren't enough to manage your symptoms, there are medicines that can help. Some of these include:
- Medicines that help with constipation.
- Medicines that control diarrhea.
- Medicines that lessen bowel spasms.
- Medicines that treat depression.
- Some pain medicines.
There are also prescription medicines that are specifically for some people who have IBS. Talk with your care team about whether these medicines would be a good option for you.
Don't be afraid to ask for help
If you feel like IBS is impacting your quality of life, talk with your care team. Be honest and specific when talking about your symptoms. For example, say "I haven't pooped in 5 days" instead of "I've been having some trouble going to the bathroom." It's OK to use words that are comfortable for you.