9 Signs and symptoms of irritable bowel syndrome (IBS)

Irritable bowel syndrome (IBS) affects between 6 and 18% of people around the world.

This condition involves changes in the frequency or shape of bowel movements and lower abdominal pain (1).

Diet, stress, lack of sleep and changes in intestinal bacteria can trigger symptoms.

However, the triggers are different for each person, which makes it difficult to name certain foods or stressors that all people with the disorder should avoid (2).

This article will discuss the most common symptoms of IBS and what to do if you suspect you have it.

1. Pain and cramps

Abdominal pain is the most common symptom and a key factor in the diagnosis.

Normally, your gut and brain work together to control digestion. This happens through the hormones, nerves and signals released by the good bacteria that live in the intestine.

In IBS, these signs of cooperation are distorted, which causes an uncoordinated and painful tension in the muscles of the digestive tract (3).

This pain usually occurs in the lower abdomen or throughout the abdomen, but is less likely to be found only in the upper abdomen. The pain usually decreases after a bowel movement (4).

Modifications to the diet, such as a diet low in FODMAP, can improve pain and other symptoms (5).

Other treatments include intestinal relaxants such as peppermint oil, cognitive behavioral therapy and hypnotherapy (6).

For pain that does not respond to these changes, a gastroenterologist can help you find a drug specifically tested to relieve IBS pain.

Summary: The most common symptom of IBS is lower abdominal pain that is less severe after a bowel movement. Dietary modifications, therapies to reduce stress and certain medications can help reduce pain.

2. diarrhea

IBS with predominance of diarrhea is one of the three main types of disorder. It affects approximately one third of patients with IBS (7).

A study of 200 adults found that those with IBS with predominant diarrhea had, on average, 12 weekly evacuations, more than double the number of adults without IBS (8).

Accelerated bowel transit in IBS can also result in a sudden and immediate need to have a bowel movement. Some patients describe this as a major source of stress, even avoiding some social situations for fear of sudden diarrhea (9).

In addition, faeces in the predominant type of diarrhea tend to be loose and watery and may contain mucus (10).

Summary: Frequent and loose stools are common in IBS and are a symptom of the predominant type of diarrhea. Stools may also contain mucus.

3. constipation

Although it may seem counterintuitive, IBS can cause constipation and diarrhea.

IBS with predominance of constipation is the most common type and affects almost 50% of people with IBS (11).

The altered communication between the brain and the intestine can accelerate or slow down the normal stool transit time. When the transit time decreases, the intestine absorbs more water from the stool and becomes more difficult to pass (10).

Constipation is defined as having less than three bowel movements per week (12).

"Functional" constipation describes chronic constipation not explained by another disease. It is not related to IBS and it is very common. Functional constipation differs from IBS in that it is usually not painful.

In contrast, constipation in IBS includes abdominal pain that is relieved by bowel movements.

Constipation in IBS often also causes the sensation of incomplete bowel movement. This leads to unnecessary tension (13).

Along with the usual treatments for IBS, exercise, drinking more water, eating soluble fiber, taking probiotics and using limited laxatives can help.

Summary: Constipation is very common. However, abdominal pain that improves after a bowel movement and a feeling of incomplete bowel movements after passing stools are signs of IBS.

4. Alternation of constipation and diarrhea.

Mixed or alternating constipation and diarrhea affect approximately 20% of patients with IBS (11).

Diarrhea and constipation in IBS involve chronic and recurrent abdominal pain. Pain is the most important sign that changes in bowel movements are not related to diet or common mild infections (4).

This type of IBS tends to be more severe than the others with more frequent and intense symptoms (14).

The symptoms of mixed IBS also vary more from one person to another. Therefore, this condition requires an individualized treatment approach instead of the "one size fits all" recommendations (15).

Summary: About 20% of patients with IBS experience alternate periods of diarrhea and constipation. Throughout each phase, they continue to experience pain relieved by bowel movements.

5. Changes in bowel movements

Slow-moving stools in the bowel often dehydrate as the bowel absorbs water. In turn, this creates hard stools, which can exacerbate the symptoms of constipation (16).

Rapid movement of stool through the intestine leaves little time for water absorption and produces loose stools characteristic of diarrhea (10).

IBS can also cause mucus to accumulate in the stool, which is not usually associated with other causes of constipation (17).

The blood in the stool can be a sign of another potentially serious medical condition and deserves a visit to your doctor. The blood in the stool may appear red, but often appears very dark or black with a tarry consistency (12).

Summary: IBS changes the length of time stools remain in your intestines. This changes the amount of water in the stool, giving it a range of loose and watery to hard and dry.

6. Gas and swelling

Altered digestion in IBS leads to increased gas production in the intestine. This can cause swelling, which is uncomfortable (18).

Many with IBS identify swelling as one of the most persistent and persistent symptoms of the disorder (19).

In a study of 337 patients with IBS, 83% reported swelling and colic. Both symptoms were more common in women and in IBS with constipation or mixed types of IBS (20, 21).

Avoiding lactose and other FODMAP can help reduce swelling (22).

Summary: Gas and bloating are some of the most common and frustrating symptoms of IBS. Following a diet low in FODMAP can help reduce swelling.

7. Food intolerance

Up to 70% of people with IBS report that certain foods trigger symptoms (23).

Two thirds of people with IBS actively avoid certain foods. Sometimes these people exclude multiple foods from the diet.

It is not clear why these foods cause symptoms. These food intolerances are not allergies and the trigger foods do not cause measurable differences in digestion.

While the trigger foods are different for each person, some of the most common include foods that produce gases, such as FODMAP, as well as lactose and gluten (24, 25, 26).

Summary: Many people with IBS report specific trigger foods. Some common triggers include FODMAP and stimulants, such as caffeine.

8. Fatigue and difficulty sleeping

More than half of people with IBS report fatigue (27).

In one study, 160 adults diagnosed with IBS described a low resistance that limited physical effort at work, leisure and social interactions (28).

Another study of 85 adults found that the intensity of their symptoms predicted the severity of fatigue (29).

IBS is also related to insomnia, which includes difficulty falling asleep, waking up frequently and feeling restless in the morning (30).

In a study of 112 adults with IBS, 13% reported poor sleep quality (31).

Another study of 50 men and women found that people with IBS slept approximately one hour more, but felt less rested in the morning than those without IBS (32).

Interestingly, lack of sleep predicts more severe gastrointestinal symptoms the next day (33).

Summary: Those with IBS are more fatigued and report a less refreshing sleep compared to those who do not. Fatigue and poor sleep quality are also associated with more severe gastrointestinal symptoms.

9. Anxiety and depression

IBS is linked to anxiety and depression, too.

It is not clear if the symptoms of IBS are an expression of mental stress or if the stress of living with IBS makes people more prone to psychological difficulties.

Whatever happens first, the anxiety and digestive symptoms of IBS reinforce each other in a vicious circle.

In a large study of 94,000 men and women, people with IBS were more than 50% likely to have an anxiety disorder and more than 70% were likely to have a mood disorder, such as depression (34) .

Another study compared the levels of the stress hormone cortisol in patients with and without IBS. Given a public speaking task, people with IBS experienced greater changes in cortisol, suggesting higher levels of stress (35).

In addition, another study found that anxiety reduction therapy reduced the stress and symptoms of IBS (36).

Summary: IBS can produce a vicious circle of digestive symptoms that increase anxiety and anxiety that increases digestive symptoms. Addressing anxiety can help reduce other symptoms.

What to do if you think you have IBS

If you have symptoms of IBS that interfere with your quality of life, visit your doctor, who can help you diagnose IBS and rule out other diseases that mimic IBS.

IBS is diagnosed with recurrent abdominal pain for at least 6 months, combined with weekly pain for 3 months, as well as a combination of pain relieved by bowel movements and changes in the frequency or shape of bowel movements.

Your doctor can refer you to a gastroenterologist, a specialist in digestive diseases, who can help you identify the triggers and discuss ways to control your symptoms.

Changes in lifestyle, such as low FODMAP diet, stress relief, exercise, drinking lots of water and over-the-counter laxatives can also help. Interestingly, a low FODMAP diet is one of the most promising lifestyle changes to relieve symptoms (37).

Identifying other trigger foods can be difficult, as they are different for each person. Keeping a diary of foods and ingredients can help identify triggers (38, 39, 40).

Probiotic supplements can also reduce symptoms (37).

In addition, avoiding digestive stimulants, such as caffeine, alcohol and sugary drinks, may reduce symptoms in some people (41).

If your symptoms do not respond to changes in lifestyle or over-the-counter treatments, there are several drugs tested to help in difficult cases.

If you think you have IBS, consider keeping a diary of food and symptoms. Then, take this information to your doctor to help diagnose and control the condition.

Reference: https: //www.healthline.com/nutrition/9-signs-and-symptoms-of-ibs


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