Your digestive system does its job under the radar, and you might not give it much thought—unless symptoms such as abdominal pain, constipation or diarrhea occur. If those symptoms happen each week for several months, IBS may be to blame. This gastrointestinal disorder can turn life upside down, but IBS treatment can get things back on track.
Gastroenterologists and other health care providers can recommend different methods to treat IBS that don’t require surgery. Finding a treatment or combination of treatments that control IBS symptoms can restore your quality of life and allow you to think about your digestive system a little less often.
IBS 101
To understand IBS treatment, it helps to learn about the disorder itself. A group of symptoms rather than a disease, IBS affects both the large and small intestines. According to the American College of Gastroenterology, up to 15 percent of people in the U.S. may have IBS. Women are much more likely to develop this disorder than men.
What causes IBS is unclear, but a breakdown in communication between the brain and gut plays a role. Several factors can increase your risk for IBS, including a family history of the disorder, stress or trauma, and gastrointestinal tract infection.
People with IBS experience abnormal bowel movements that come and go. Factors that can contribute to IBS flare-ups include stress, food sensitivities, and anxiety or depression.
Many people have IBS with constipation, or IBS-C, in which constipation is their primary abnormal bowel movement. Other people have IBS with diarrhea (IBS-D), with loose bowel movements occurring more often than normal. Still, other people have both constipation and diarrhea, which is known as IBS with mixed bowel habits (IBS-M).
In addition to abnormal bowel movements, such as constipation and diarrhea, IBS can also cause:
- Abdominal pain
- Bloating
- Gas
- More frequent urges to have a bowel movement, even if you’ve just had one
- Mucus in the stool
IBS is a long-term condition, and it doesn’t have a cure. This disorder does, however, come with several silver linings. First, IBS doesn’t damage your intestines. Second, you won’t need surgery to treat it. Finally, and perhaps most importantly, IBS treatment often reduces symptoms. Finding a solution starts with getting a diagnosis.
Diagnosis: The First Step Toward IBS Treatment
Before diagnosing IBS, your gastroenterologist or primary care provider has to rule out conditions that cause some of the same symptoms as IBS, such as inflammatory bowel disease.
The diagnostic process then starts with discussing your symptoms and medical history. Your health care provider will perform a physical exam to look for signs of IBS, such as bloating or tenderness in your abdomen.
In many cases, assessing symptoms, reviewing medical history and performing a physical exam are enough to diagnose IBS. Sometimes, however, health care providers order tests to help ensure other medical conditions aren’t responsible for the symptoms. These tests may include blood and stool tests, X-rays of the gastrointestinal tract or a colonoscopy to rule out colon cancer.
Changing for the Better: Getting Started with IBS Treatment
There’s no such thing as the best treatment for IBS. A strategy that improves symptoms for a friend or family member may not produce successful results for you. The key is to partner with your health care provider to find what works best for you.
For many people, treating IBS starts with making healthy lifestyle changes to address triggers. For example, setting aside time each day to do something relaxing or joyful can reduce stress, a potential driver of IBS. Exercising regularly and getting at least seven hours of sleep each night may also help improve symptoms.
Some of the most important changes you may need to make are dietary. If, for example, you have IBS with constipation, gradually adding more fiber-rich foods to your diet may make bowel movements easier.
Your health care provider may recommend avoiding foods with Fermentable, Oligo-, Di-, Mono-saccharides And Polyols (FODMAPs), which are types of carbohydrates the small intestine can struggle to break down. Foods containing FODMAPs include foods such as apples, asparagus, beans, blackberries, cauliflower, cherries, garlic, ice cream, onions, milk, watermelons and yogurt. Doing an elimination diet under the supervision of a dietitian can help you determine which, if any, of the FODMAPs you are sensitive to. Most people are sensitive to only some of these foods, and those are the only foods that need to be avoided.
Treating IBS with Medications
Lifestyle changes may not be enough on their own to control IBS symptoms. That’s when medicines can help. Many medicines are available to treat different symptoms of IBS. Anti-diarrheal medicines, for example, can help reduce diarrhea, and laxatives can alleviate constipation.
Abdominal pain is one of the most uncomfortable symptoms of IBS. Fortunately, a variety of medications can help soothe discomfort. These include peppermint oil capsules and antidepressants.
Antidepressants don’t just help treat depression. They can also relieve some forms of pain, including abdominal pain. Antidepressants that can treat IBS-related abdominal pain include tricyclic antidepressants and selective serotonin reuptake inhibitors. These medications can cause side effects, such as dry mouth, so weigh the pros and cons with your health care provider. Talk to your provider before starting any supplements, like peppermint oil capsules or other remedies, as well.
The Mental Health Side of IBS Treatment
Your mental health can affect how your gut behaves, and that, in turn, can influence IBS symptoms. Consequently, behavioral health treatment may help improve IBS.
One of these types of treatment is cognitive behavioral therapy. This form of talk therapy can help you build better awareness of your thoughts and learn how to change negative behaviors. Cognitive behavioral therapy can equip you to manage stress better, thereby giving your gut some relief from IBS.
Medically reviewed by Joseph Murphy, MD, gastroenterologist, UM Charles Regional Medical Group – Gastroenterology.
