woman laying on the couch, holding her abdomen

IBS Symptoms: What You Need to Know

How to Improve Your Quality of Life

Irritable bowel syndrome (IBS) is one of the most commonly diagnosed gastrointestinal (GI) disorders. Living with the ongoing symptoms of IBS can take its toll — physically, socially and emotionally. In fact, one study revealed that some patients with IBS with diarrhea even have suicidal thoughts when their symptoms are bad.

Although IBS can certainly be challenging to live with, there are many things you can do to improve your quality of life while managing your symptoms.

If you have digestive problems and can't figure out why, start by learning the most common symptoms of IBS, so you can be proactive in seeking care.

Know the Symptoms

Each person with IBS has a unique set of symptoms, and they can mimic symptoms of other diseases. There can also be periods of remission where symptoms disappear completely. The major symptom of IBS is pain or discomfort in the abdomen. Other symptoms include:

  • Bloating and/or abdominal distention (swelling of the belly as determined by a physician)
  • Increased gas production
  • Increased intestinal gurgling, rumbling or other sounds
  • Mucus-covered stool
  • Diarrhea, constipation, or switching between the two
  • Changes in bowel habits, including increased or decreased frequency and urgency, straining, and feelings of incomplete bowel movements
  • Non-GI symptoms (and conditions), such as migraines, anxiety, brain fog, chronic fatigue and depression

IBS is not the same as inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis. IBS does not cause inflammation in bowel tissue or increase your chances of developing colorectal cancer. People may have symptoms of both IBS and IBD at the same time.

Get a Diagnosis

Between 10% and 15% of adults worldwide are affected by IBS, but the majority do not seek medical care, so they remain undiagnosed or unaware they have a real condition. “We estimate that approximately 75% of people in the U.S. with IBS have yet to be definitively or accurately diagnosed,” states Darren M. Brenner, MD, director of the Neurogastroenterology and Motility Program at the Digestive Health Center at Northwestern Memorial Hospital.

If you think you might have IBS, do not try to self-diagnose — talk with your healthcare provider. This is the best way to find out the cause of your symptoms and start a treatment plan to improve your quality of life.

The effective management of IBS begins with an accurate diagnosis. Dr. Brenner explains that this involves using an established set of criteria called the ROME criteria. These criteria make sure patients have symptoms consistent with IBS. It is also important to rule out signs or symptoms that indicate another diagnosis.

Generally, eight questions can be used to determine whether a patient has IBS with a high level of accuracy:

  1. Do you have pain or discomfort?
  2. Is the pain made better or worse when you have a bowel movement?
  3. Is this pain associated with a change in the frequency or form of your stools?
  4. Are you older than 50?
  5. Is this pain a recent change?
  6. Do you have unexplained, unintentional weight loss?
  7. Are you anemic (low number of red blood cells) or have repeated GI bleeding?
  8. Do you have a family history of colon cancer, IBD or celiac disease?

“For many patients, these criteria allow us to make a definitive IBS diagnosis with an accuracy that approaches 97% to 98%,” says Dr. Brenner. "This is important because a quick and accurate diagnosis can minimize the amount of unnecessary diagnostic testing performed and allow for more efficient treatment. I cannot emphasize enough that IBS is not a diagnosis of exclusion, which is a diagnosis reached by a process of elimination."

Manage the Symptoms

If you are diagnosed with IBS, lifestyle changes can help manage symptoms and prevent flare-ups. “You should work together with your healthcare provider to identify whether different foods exacerbate your IBS symptoms,” states Dr. Brenner. "If you determine there are specific food triggers, your diet can be personalized to reduce these symptoms. Regular exercise has been shown to be beneficial as well.”

Although the frequency, duration and severity of IBS symptoms vary from person to person, these lifestyle factors are the typical culprits of IBS flare-ups:

  • Stress
  • Lack of sleep
  • Menstruation
  • Eating foods with gluten
  • Eating foods high in insoluble fiber (such as whole grains and cereals)
  • Eating foods with lactose (found in milk and other dairy products)
  • Eating FODMAPs (high-carbohydrate foods that are fermentable, or broken down by gut bacteria to produce gas)

If you have IBS, there is always a possibility of a flare-up. However, knowing how to manage your symptoms can empower you and give you back some degree of control.

In addition to lifestyle modifications, there are other treatment options that can help. These range from prescription medications to evidence-based therapies like cognitive behavioral therapy, which has been shown to significantly lower the impact IBS has on a patient’s life.

If you have digestive issues, talk with your healthcare provider — even if you've already been diagnosed with IBS. In the event something has changed, your treatment plan must change as well.