IBS diarrhea
People who experience diarrhea symptoms as part of their IBS have loose, watery stools or a frequent need to have a bowel movement. IBS with Diarrhea (IBS-D) is the second most common type of IBS, accounting for approximately 30% of IBS cases.
While it may seem obvious that diarrhea is the opposite experience to constipation, it’s interesting to note that this symptom happens when the gut sends stools through your digestive tract faster than usual. Less water is absorbed from the stool into the intestines and this in a sense of urgency to use the toilet, and loose, watery stools.
IBS gas and bloating
Bloating is the buildup of gas in the stomach and intestines, producing an uncomfortable feeling. Bloating is a common IBS symptom, with over 80% of people with IBS experiencing it.
Research has suggested that bloating may occur as a result of hydrogen gas produced by bacteria in the gut. Avoiding certain foods, such as those high in FODMAPs, is thought to reduce bloating and gas.
Other IBS symptoms
Besides those symptoms required for a diagnosis, other symptoms of IBS include:
Fatigue
One study reported over half of people with IBS report fatigue. IBS has been shown to lower perceived energy levels and limit physical capacities at work, and in social settings.
Difficulty sleeping
Approximately 15% of people with IBS reported reduced sleeping quality, according to one study. IBS can also result in feeling less refreshed upon awakening.
Mucus in stools
IBS can cause mucus to accumulate in stools. If you’re seeing mucus, it isn’t a cause for concern. Mucus is a normal secretion of the bowel, but may simply happen more for people with IBS.
Gender differences in IBS symptoms
Women more commonly experience IBS than men. During menstruation, women may have more symptoms than usual, while rates of IBS are lower after menopause. Men experience the same symptoms of IBS as women, but research shows that they are less likely to see a doctor.
IBS and psychological symptoms
Research has shown that there is a relationship between anxiety, depression, and IBS. In fact, one study showed that people with IBS are 80% more likely to have depression than those without IBS.
However, it is not clear which way the influence lies. Is it possible that IBS is caused by anxiety and depression, or is the IBS affecting mental health?
Either way, a vicious cycle can occur in which IBS symptoms can trigger feelings of anxiety or distress, and they, in turn, create more intense IBS symptoms.
Several mind-body therapies have been shown to improve the physical symptoms of IBS. These include psychotherapy and hypnotherapy. It is thought that these therapies may help to reduce feelings of anxiety and restore the connection between the brain and the gut, eventually reducing the physical symptoms of IBS.
When should you seek help?
If you are experiencing abdominal pain, constipation, diarrhea, or any other gut symptoms regularly, then talk to your doctor. They will be able to take you through the criteria for an IBS diagnosis and suggest management options. They can also investigate whether your symptoms are related to other conditions such as Crohn’s disease or lactose intolerance.
Symptoms that may suggest another condition that is not IBS, are:
Managing IBS Symptoms
Once you have an IBS diagnosis, there are several options available to help you manage your symptoms. These include:
Low FODMAP diet: this involves eliminating or reducing foods high in short-chain carbohydrates called FODMAPs that are common triggers for IBS.
Probiotic supplements: which have been shown to improve IBS symptoms by altering the composition of bacteria in the gut.
Gut-directed hypnotherapy: which involves guided relaxation and suggestions targeting symptoms of IBS. Several studies have shown this to be among the most effective therapies for relieving symptoms of IBS.
Over-the-counter medications: such as laxatives for IBS with constipation, or pain medications to manage abdominal pain.
Antidepressant medications: most commonly prescribed for IBS are tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs).
The Wrap Up
The most common symptoms of IBS are abdominal pain, constipation, and/or diarrhea. Other common IBS symptoms include gas and bloating, fatigue, mucus in stools, and trouble sleeping. IBS commonly occurs in people dealing with anxiety and depression. Fortunately, a range of evidence-based treatment options are available to manage IBS symptoms, including gut-directed hypnotherapy, the low FODMAP diet, and antidepressant medications.
References
Choung, R.S. and Locke 3rd, G.R., 2011. Epidemiology of IBS. Gastroenterology Clinics of North America, 40(1), pp.1-10. https://europepmc.org/article/med/21333897
Azpiroz, F., Bouin, M., Camilleri, M., Mayer, E.A., Poitras, P., Serra, J. and Spiller, R.C., 2007. Mechanisms of hypersensitivity in IBS and functional disorders. Neurogastroenterology & Motility, 19, pp.62-88. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2982.2006.00875.x
Schmulson, M., Vargas, J.A., López-Colombo, A., Remes-Troche, J.M. and López-Alvarenga, J.C., 2010. Prevalence and clinical characteristics of the IBS subtypes according to the Rome III criteria in patients from a clinical, multicentric trial. A report from the Mexican IBS Working Group. Revista de gastroenterologia de Mexico, 75(4), pp.427-438. https://europepmc.org/article/med/21169110=
Lacy, B.E. and Patel, N.K., 2017. Rome criteria and a diagnostic approach to irritable bowel syndrome. Journal of clinical medicine, 6(11), p.99. https://www.mdpi.com/2077-0383/6/11/99
Quigley, E.M., 2018. The gut-brain axis and the microbiome: clues to pathophysiology and opportunities for novel management strategies in irritable bowel syndrome (IBS). Journal of clinical medicine, 7(1), p.6.
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