Being diagnosed with Irritable Bowel Syndrome can be a confusing experience. So, I've put together a series of posts to answer some frequently asked questions about IBS. In this article, you'll find answers to 10 frequently asked questions about what it means to have Irritable Bowel Syndrome. Ready? Let's go!
What is IBS?
Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal disorder or FGID. People who are diagnosed with IBS need to experience chronic abdominal pain and problematic bowel movements for three months or more. But, unlike Inflammatory Bowel Disease (IBD) or colon cancer, there aren't any physical or chemical issues that might explain a person's symptoms.
Check out my full What Is Irritable Bowel Syndrome article for an in-depth look at IBS.
What Are the Symptoms of IBS?
IBS looks different in everyone, but to be diagnosed with IBS, each person must experience abdominal pain at least once a week for three months along with at least two of the following symptoms:
- Pain related to bowel movements;
- Changes in the frequency of stool; and/or
- Changes in the appearance of stool (based on the Bristol Stool Scale)
In addition to the symptoms above, people with IBS might also experience abdominal pain or cramping, feeling like you still need to poop after a bowel movement, gas, abdominal bloating and/or distension, and mucus in the stool.
Are There Different Kinds of IBS?
If you've spent any time in the online IBS community, you may have noticed some people identify themselves as IBS-C, IBS-D, or IBS-M/A. Each of these “codes” represents a different type of IBS. There are four official categories of IBS.
IBS-C: People with IBS-C suffer mainly from constipation. To be placed in this subgroup, 1/4 (25%) of a patient's problematic bowel movements need to fall between 1 and 2 on the Bristol Stool Scale.
IBS-D: People with IBS-D suffer mainly from diarrhea. To be placed in this subgroup, 1/4 (25%) of a patient's problematic bowel movements need to fall between 6 and 7 on the Bristol Stool Scale.
IBS-M: People with IBS-M suffer consistently from both constipation and diarrhea. These patients are considered “mixed.” To be placed in this subgroup, 1/4 (25%) of their problematic bowel movements need to fall between 1 and 2 and 1/4 (25%) of their problematic bowel movements need to fall between 6 and 7 on the Bristol Stool Scale.
*IBS-M is sometimes called IBS-A for alternating.
IBS-U: People who have less than 1/4 (25%) of their bowel movements clearly in the diarrhea or constipation camp fall into the “unspecified” subgroup. This is where most IBS patients fall.
Just so we're clear, IBS subcategories are based on the number of bowel movements that fall into the constipation or diarrhea category in the Bristol Stool Chart. Not the severity of your symptoms.
How Is IBS Diagnosed?
Because IBS is a functional disorder, there currently aren't any tests to diagnose IBS*. This means that people with Irritable Bowel Syndrome are diagnosed based on the symptoms they report to their doctor.
If someone mentions a “red flag” symptom for another illness or disease that may have similar symptoms, their doctor may request additional tests like blood tests, a stool sample, a colonoscopy, or an abdominal ultrasound to check for other issues. Some doctors order these as part of their screening routine, so don't panic if you're sent for additional testing.
Heads up! Because IBS is an issue with the way the intestine functions, not because of a structural issue (like inflammation, impaction, or a tumour) or a biochemical issue (like an acid or hormone imbalance), these tests will come back normal if a person has IBS.
Just so you know, you won't be diagnosed with IBS just because you don't show signs of another illness. IBS is a specific disorder with clear diagnostic criteria and a clear path to diagnosis. There are no specific tests required for an “official” IBS diagnosis at this time.
Is There a Cure for IBS?
Currently, there is no cure for IBS. This is likely because there are many different ways a person might develop IBS. In all likelihood, each of these “root causes” may require a different type of treatment to be “cured.”
Don't despair, though! Science has made some significant leaps forward for the IBS community (like discovering FODMAPs). Researchers have also identified and separated specific disorders like lactose-intolerance, fructose malabsorption, and Bile Acid Malabsorption from under the IBS umbrella. This has made diagnosing and treating these specific disorders much easier.
How to Treat IBS Symptoms?
Because IBS sits differently in everyone's body, the tools each person needs to manage their IBS symptoms will be different. Symptom management plans should cater to a person's specific symptoms so they can get back to living a normal life. Common symptom management tools include:
- Improving sleep
- Adding physical activity
- Reviewing your intake of soluble and insoluble fibre
- Managing your hydration
- Finding ways to cope with stress (through hobbies, a meditation practice, psychotherapy, cognitive behavioural therapy (CBT), or dialectical behaviour therapy (DBT), among other things
- Finding your personal dietary triggers (using programs like the Low FODMAP Diet)
- Taking a probiotic supplement
- Using doctor-recommended medications to manage flares or unruly long-term symptoms
What Causes IBS?
Currently, researchers don't know what causes IBS. In fact, they think there may be several reasons people develop IBS or are prone to it in the first place.
Some of these theories include genetics, immune system activation, changes in intestinal permeability (how well your gut can control what passes through the intestinal lining), and complications in the brain-gut-axis (how your brain and gut communicate with one another).
Recently, there has been a lot of focus on the microbiome (the community of bugs that naturally live in your gut). Researchers suspect the microbiome plays an important role in the development and function of your gut. As research on the microbiome continues, we will likely learn more about how some people develop IBS and how to treat it.
How Common Is IBS?
Researchers believe 20% of the population has IBS. Based on this estimate, up to 30 million North Americans (1 in 5) would likely meet the criteria for an IBS diagnosis.
Are Women or Men More Likely to Have IBS?
Women are diagnosed with IBS twice as often as men. Researchers aren't entirely clear on why this gender gap has occurred. Though some studies have suggested biologically, women may handle stress differently, the nerves in their internal organs may process pain differently, and that hormones like estrogen may play a significant roll in IBS.
Do People with IBS Suffer from Anxiety or Depression?
Researchers believe up to 70% of IBS patients meet the criteria for anxiety or depression. However, this does not mean IBS is a symptom of a psychological disorder. This research also doesn't indicate how many people suffered from anxiety and/or depression prior to developing IBS and how many people developed anxiety and/or depression due to IBS's impact on their overall quality of life.
I hope you found the answers to these frequently asked questions helpful! In the next post of this series, I'll discuss common questions about IBS triggers. Don't want to miss it? Sign up for my mailing list below and you'll get a roundup of my monthly posts along with exclusive access to bonus content, VIP discounts, and some fabulous freebies! Together we'll get the Low FODMAP Diet down to a science!
© 2019 Amy Agur – The FODMAP Formula
- Anbardan, S. J., Daryani, N. E., Fereshtehnejad, S., Vakili, S. T., Keramati, M. R., & Ajdarkosh, H. (2012). Gender Role in Irritable Bowel Syndrome: A Comparison of Irritable Bowel Syndrome Module (ROME III) Between Male and Female Patients. J Neurogastroenterol Motil,(18), 1st ser., 70-77. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3271257/.
- Arebi, N., Bullas, D., Hobson, A., Stagg, A., & Kamm, M. (2008, July 10). Review article: The psychoneuroimmunology of irritable bowel syndrome – an exploration of interactions between psychological, neurological and immunological observations. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2036.2008.03801.x
- Fichna, J., & Storr, M. A. (2012). Brain-Gut Interactions in IBS. Frontiers In Pharmacology,3(127), 1-12. Retrieved from https://www.researchgate.net/publication/229065770_Brain-gut_interactions_in_IBS.
- Gynecological Aspects of Irritable Bowel Syndrome. (n.d.). Retrieved from https://www.aboutibs.org/gynecological-aspects-of-irritable-bowel-syndrome.html
- Irritable bowel syndrome. (2018, March 17). Retrieved from https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/diagnosis-treatment/drc-20360064
- Kim, Y. S., & Kim, N. (2018). Sex-Gender Differences in Irritable Bowel Syndrome. J Neurogastroenterol Motil,(24), 4th ser., 544-558. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175559/.
- Lacy, B. E., Ph.D. MD, Chey, W. D., MD, & Lembo, A. J. (2015). New and Emerging Treatment Options for Irritable Bowel Syndrome. Gastroenterology and Hepatology,2(11), 4th ser., 1-19. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4612133/.
- Park, J., Choi, M., & Cho, Y. (2012). Irritable Bowel Syndrome: A Malfunction of the Endocannabinoid System? Gastroenterology Journal,142(2). Retrieved from https://www.gastrojournal.org/article/S0016-5085(11)01710-0/pdf.
- Taylor, S. E., Klein, L. C., Lewis, B. P., Gruenwald, T. L., Gurung, R. A., & Updegraff, J. A. (2000). Biobehavioral Responses to Stress in Females: Tend-and-Befriend, Not Fight-or-Fight. American Psychological Association,107(3), 412-429. Retrieved from https://scholar.harvard.edu/files/marianabockarova/files/tend-and-befriend.pdf.
You might also like one of these:
What is Referred Pain? You already know IBS can be a pain in the butt! But, did you know it can also be a pain in the back? Check out this article for everything you need to know about why and how referred pain happens.
How to Relieve Trapped Gas Need some help letting it go? These practical tips will help you prevent trapped gas when you can and relieve it when it strikes.
The Truth About IBS and Exercise Think you can't work out with IBS? Here's everything you need to know from managing your symptoms to crushing your fitness goals. Ready, set, go!