How to Reduce Your IBS Symptoms

Irritable bowel syndrome (IBS) affects 10 to 15% of people in the U.S. and is more common in women than men.

 If every day starts with uncertainty about how your stomach will behave, you should speak to your doctor about irritable bowel syndrome (IBS).

IBS is an uncomfortable condition that causes stomach pain and changes in stool on a weekly basis for at least three months. Stress, diet and even contracting a stomach bug can cause a flare-up. 

How is IBS diagnosed?

While there isn’t a lab test for IBS, your gastroenterologist can make a diagnosis based on the Rome IV criteria. If you experience recurrent abdominal pain on average of at least one day per week in the last three months, you may have IBS as long as you have at least two of the following symptoms:

• Abdominal pain related to defecation or bowel movements
• A change in stool frequency
• A change in stool appearance/consistency at least one day per week for the past three months

IBS is more common in patients who also carry the diagnosis of depression, anxiety and OCD.

Ruling out other diagnoses

Before diagnosing irritable bowel syndrome, your doctor may want to rule out other possible gastrointestinal (GI) conditions. The following symptoms require additional testing:

• Rectal bleeding or black, tarry, stools
• Diarrhea that wakes you up in the middle of the night
• Abdominal pain that gets worse with time
• Unexplained Weight loss 
• Someone in your family has a history of inflammatory bowel disease (like ulcerative colitis or Crohn’s disease)
• A parent or sibling has a history of gastrointestinal cancer (like colon cancer)

Come to your doctor prepared with more information

Because IBS is diagnosed based on your symptoms, your doctor will ask questions about your dietary habits and stool. Pay attention to some of the following before visiting your provider:

• What does your stool look like? 
• How would you describe your pain? 
• How often does it happen? 
• Do any foods trigger your symptoms, such as dairy, caffeine, certain fruits or vegetables 

IBS can be common in those who also have a history of migraines, fibromyalgia, interstitial cystitis (a bladder disorder) and dyspareunia (vaginal pain during intercourse).

If your doctor diagnoses you with IBS, there are four subtypes. 

• IBS D: diarrhea-predominant IBS
• IBS C: constipation-predominant IBS
• IBS-M: mixed 
• IBS-U undifferentiated

You may experience both constipation and diarrhea, but the more predominant symptom indicates the subtype. “Most patients who oscillate between constipation and diarrhea are actually more often constipated, and by treating constipation, we prevent this kind of slamming on the gas and slamming on the brake variation,” says Morgan Allyn Sendzischew Shane, M.D., a gastroenterologist and director of the University of Miami Health System’s Comprehensive Women’s Health Alliance.

The right medication for you will depend on your symptoms. Natural remedies can be helpful, too. “Peppermint oil, which is a smooth muscle relaxant, is clinically proven to be extremely beneficial in IBS for multiple reasons,” says Dr. Shane. Peppermint oil modulates pain, has direct antimicrobial and anti-inflammatory effects and has a stress modulation. 

Identifying and avoiding triggers of IBS

Symptoms of IBS can change so it’s important to know what makes it worse. While some of the triggers that exacerbate IBS are unpreventable, such as the stomach flu, others are. 

Following are some common triggers of IBS symptoms:

• Gastrointestinal (GI) infection, food poisoning and stomach viruses
• Food intolerances, such as lactose
• Foods categorized as FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) are not easily broken down and trap water and bacteria in the gut

Read more about how to eat a low-FODMAP diet here.

Do’s and don’ts to help reduce symptoms of IBS

Some nutritional changes can help manage diarrhea and other symptoms of IBS.

Avoid triggers

You can determine what foods cause an IBS flare-up with the help of your doctor and a registered dietitian.

Eat more soluble fiber

Not all fiber is created equal, and not all types of fiber are well tolerated by everyone. It is important to have a balance of both soluble and insoluble fiber in your diet to help manage stool consistency and promote consistent gut motility

A diet rich in probiotic foods

Probiotics are the live microorganisms that help maintain or improve the good bacteria in your gut. Yogurt, kefir, tempeh, kombucha, sauerkraut and other naturally pickled or fermented foods are all rich in probiotics. This is superior to probiotic supplements. 

Limit liquids during mealtimes

Consuming excessive drinks too high in sugar and sugar substitutes can worsen diarrhea.

Speak to your doctor before taking liquid supplements

Be wary of supplements. Before making any changes to your diet or adding other remedies, consult your doctor who can work with you to identify triggers and work toward solutions.

Most importantly, says Dr. Shane, know that IBS is a real diagnosis with real criteria. “You don’t need to figure this out on your own. See a specialist who can help you identify your symptoms and most importantly, help you feel better,” she says.

UHealth’s Comprehensive Women’s Health Alliance provides specialized care for women’s health at all ages. Call 855-3-4-WOMEN (96636) or request an appointment online.

Wendy Margolin is a contributor for UHealth’s news service.

Tags: Dr. Morgan Allyn Sendzischew Shane, IBS, irritable bowel syndrome, upset stomach