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It's critical to understand that irritable bowel syndrome (IBS) is a collection of symptoms and not a disease. Constipation and diarrhea regularly can be warning symptoms of IBS.

• A doctor will most likely diagnose you with IBS if you have had diarrhea or constipation for more than six weeks.
• Many people with IBS experience crampy abdominal discomfort or pain that comes and goes and fluctuates with bowel function (typically easing after a bowel movement).
• If you experience constipation, indigestion, or diarrhea when you are stressed and your symptoms (while still present) are milder when you are calm, then you may have IBS.

However, because there is no single, definitive way to diagnose IBS, you may receive a diagnosis from one doctor but not from another.

IBS symptoms can be extremely uncomfortable, even painful, and have a significant effect on your quality of life.

People with IBS may experience one or more of these 11 symptoms:

1. Abdominal pain
2. Cramping
3. Excess gas
4. Bloating (or swelling) of the abdomen
5. Change in bowel movement (diarrhea or constipation)
6. Straining feeling during a bowel movement
7. Change in frequency or a sense that the bowel movement is incomplete
8. Mucus in stools
9. Fecal urgency (especially after meals)
10. Feeling that you have not fully emptied your bowels after going to the toilet
11. Increased intestinal gurgling or rumbling sound

Six severe signs and symptoms of IBS include:

• Weight loss
• Rectal bleeding
• Iron deficiency anemia
• Continuous pain that isn’t relieved by passing gas or a bowel movement
• Nausea and vomiting
• Difficulty swallowing

Although the severity of symptoms varies, only a small percentage of people with IBS will experience severe symptoms. Because IBS is not considered a serious disease, there are no official “alarm symptoms” or warning signs.

Fortunately, IBS does not harm the digestive tract. However, if you experience IBS symptoms that interfere with your quality of life, you should consult your doctor.

How is IBS diagnosed?

To ensure that you do not have any other disease, your doctor may recommend lab and imaging tests that may include:

• Blood tests
• Urinalysis and urine culture
• Stool culture
• Stool testing for blood (fecal occult blood test)
• Upper endoscopy also called esophagogastroduodenoscopy
• Abdominal X-rays
• Abdominal ultrasound (sonogram)
• Colonoscopy
• Breath test (may diagnose bacterial overgrowth in the intestines that some belief can lead to IBS)

IBS is diagnosed when you have had abdominal pain and discomfort at least one time a week for the past three months and at least two of the following factors are true:

• Pain and discomfort with the passage of stools
• Altered frequency of bowel movement
• Altered appearance of stools

According to the latest updated criteria, the clinical diagnosis of IBS can be divided into the following four subtypes:

1. IBS with constipation (IBS-C)
2. IBS with diarrhea (IBS-D)
3. Mixed IBS where you have both constipation and diarrhea (IBS-M)
4. Unsubtyped IBS

Doctors frequently categorize IBS into one of the four types based on the consistency of usual stool. These distinctions are significant because they influence the types of treatment that are most likely to alleviate your symptoms.

The four types of IBS are described as follows:

1. IBS with constipation (IBS-C):
   • Hard or lumpy stools at least 25 percent of the time
   • Loose or watery stools less than 25 percent of the time
2. IBS with diarrhea (IBS-D):
   • Loose or watery stools at least 25 percent of the time
   • Hard or lumpy stools less than 25 percent of the time
3. Mixed IBS (IBS-M):
   • Hard or lumpy stools at least 25 percent of the time
   • Loose or watery stools at least 25 percent of the time
4. Unsubtyped IBS (IBS-U):
   • Hard or lumpy stools less than 25 percent of the time
   • Loose or watery stools less than 25 percent of the time

Knowing which subtype of IBS you have is important for you and your doctor because it will influence your treatment and dietary recommendations.

What is IBS?

Irritable bowel syndrome (IBS) is a common digestive disorder. It only involves symptoms of the colon and can present as either diarrhea or constipation.

IBS is a digestive disorder that affects how the bowel works. The nerves and muscles in the bowel are much more sensitive than normal in people with IBS.

The exact cause of IBS is unknown; however, there appear to be five outside factors at work, which include:

1. Muscle contractions in the intestine:
   • Muscle layers line the intestines that contract as food passes through your digestive tract.
   • Stronger than usual contractions can cause gas, bloating, and diarrhea.
   • Weak intestinal contractions can cause hard and dry stools that lead to constipation.
2. Nervous system:
   • When the abdomen stretches due to gas or stool, hypersensitivity in the digestive nerves may cause people to feel more discomfort than usual.
   • Poorly coordinated signals between the brain and intestines can cause the body to overreact to normal digestive process changes, resulting in pain, diarrhea, or constipation.
3. Severe infection:
   • IBS can arise due to a severe bout of diarrhea caused by a bacterium or virus.
   • IBS may be linked to an overabundance of bacteria in the upper gastrointestinal tract.
4. Changes in gut microbes:
   • Changes in bacteria, fungi, and viruses that typically reside in the intestines and play an important role in health may lead to IBS.
   • According to research, microbes in people with IBS may differ from those in healthy people.
5. Early life stress:
   • People who have been exposed to stressful events, particularly as children, are more likely to develop IBS symptoms.

Two triggers of IBS include:

1. Food:
   • Food allergies or intolerance play an unknown role in IBS. IBS is rarely caused by a true food allergy.
   • However, many people experience worse IBS symptoms when they consume certain foods or beverages such as wheat, dairy products, citrus fruits, beans, cabbage, milk, and carbonated beverages.
2. Stress:
   • During times of increased stress, the majority of people with IBS experience severe or more frequent signs and symptoms.
   • However, although stress can aggravate symptoms, it does not always cause them.

Four risk factors for IBS include

1. Age: IBS is more common in people younger than 50 years.
2. Female gender: Women are more likely than men to have IBS.
3. Family history: Individuals with a family history of IBS are more likely to develop the condition.
4. Mental health: People with anxiety, depression, or other types of mental health issues may be at a higher risk of IBS.

According to studies, IBS affects 10 to 15 percent of adults in the United States. However, only about five to seven percent of adults in the United States have been diagnosed with IBS.

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What are the treatment options for IBS?

There is currently no cure for irritable bowel syndrome (IBS) in modern science.

The condition is not entirely treatable, but with the right lifestyle and dietary choices, a person can manage it. As a result, one should see a doctor as soon as possible to make the necessary adjustments and maintain their quality of life.

The most effective IBS treatments that have been recommended include:

• Dietary changes (to find the diet that works for your body by following a six-week elimination diet)
• Lifestyle changes
• Certain medications

Dietary and lifestyle changes

• Following a low-FODMAP diet:
  • According to research, following a low-FODMAP diet can help three out of four people with IBS get symptom relief, usually within one to four weeks, and the benefits can last for a long time.
  • It's best if you can see a dietitian who is familiar with this diet to help you make the necessary changes.
• Reducing stress:
  • Researchers have discovered that reducing stress can help alleviate your symptoms.
• Increasing physical activity:
  • There is evidence that increasing your physical activity can help reduce your IBS symptoms.
  • This could be because it aids in the passage of digested food through your digestive tract, thereby reducing gas and bloating.
• Medications:
  • Medications are sometimes prescribed to help treat the symptoms of IBS, such as:
    • Laxatives for relief of constipation
    • Anti-diarrheal medications to relieve chronic diarrhea
    • Antispasmodic medications to assist in relieving abdominal pain and cramps
    • Antidepressant medication to help with pain
• Cognitive-behavioral therapy (CBT):
  • Because of the connection between the brain and gut (the gut-brain axis), talking therapy, such as CBT, is beneficial in the management of IBS symptoms.

IBS is unpredictable. You may go months without experiencing any symptoms before experiencing a sudden flare-up.

The condition can be painful and debilitating, lowering your quality of life and negatively affecting your emotional state. If you're experiencing symptoms of depression or anxiety that are interfering with your daily life, talk to your doctor.

You should be able to live a normal, full, and active life with IBS if you receive medical and psychological treatment. IBS does not pose a serious threat to your physical health and does not increase your risk of cancer or other bowel-related illnesses.