All you need to know about: Irritable Bowel Syndrome

IBS is a chronic, generally lifelong, gastrointestinal disorder that is believed to arise from a problem with the gut-brain connection

April is marked as IBS awareness month, to build awareness around one of the most common, yet somewhat uncomfortable-to-discuss gastrointestinal disorders, irritable bowel syndrome. Awareness of what it is, what its symptoms are and what can be done to manage it, can help with early diagnosis and care. In India, the prevalence of IBS from 0.4% to 4.2% as per a 2023 consensus statement on IBS in adults by the Indian Neurogastroenterology and Motility Association. However, the statement notes that this may be an under-estimate of the disease burden.

What is IBS?

IBS is a chronic, generally lifelong, gastrointestinal disorder. It is characterised as a functional gastrointestinal disorder, which means that it is a disorder of the gut-brain connection, to do with how you gut and your brain work together. A problem with the gut-brain coordination can cause the nerves in your gut to be more sensitive, or change how the muscles in the bowel move. However, there are no changes to the bowel tissue or damage in the digestive tract.

What causes IBS?

It is unclear what causes IBS exactly. Apart from interaction problems between the gut and the brain in coordinating how your digestive system works, some other causes are believed to be: having had a severe gastrointestinal infection, a history of a stressful childhood, or changes in the gut microbes -- research indicates the gut bacteria in people with IBS may be different that in those without IBS. Those with a family history of IBS may also be at increased risk.

What are the signs and symptoms of IBS?

Common signs of IBS are: stomach pain and cramps and bloating, feeling uncomfortably swollen, usually to do with passing stool; changes in the appearance of, and frequency of passing stool; constipation and diarrhoea; a feeling of incomplete evacuation.

IBS mostly occurs in young people -- those in their late teens to early 40s. While in the West it is thought to affect more women than men, in India, it is believed to be as prevalent in the male as the female population, .

What can trigger the symptoms?

While an IBS flare-up can occur for no reason, food and stress are believed to be two major triggers.

Food triggers vary from person to person. Some common foods that can cause flare-ups include dairy products, foods containing gluten, gassy foods, carbonated drinks, caffeine and alcohol.

Many people with IBS also experience worse symptoms of flare-ups during periods of extreme stress.

Also Read | Don’t ignore abdominal symptoms

What are the types of IBS?

There are several types of IBS:

In IBS with constipation (IBS-C), people mostly have constipation (hard stools) with abdominal discomfort.

In IBS with diarrhoea (IBS-D), people mostly have diarrhoea (loose, watery stools) with abdominal discomfort.

In IBS with mixed bowel habits (IBS-M), people have alternating diarrhoea and constipation with abdominal discomfort.

There is also undefined IBS, (IBS-U), where symptoms may vary.

How is IBS diagnosed?

While there is no definitive test for diagnosis, healthcare providers will usually start with a complete medical history and may also conduct a physical exam as well as other tests including blood tests, stool tests and breath tests (to look for bacterial overgrowth). Other imaging tests may include a colonoscopy, an upper endoscopy, or scans to help with the diagnosis.

Do people with IBS have other diseases?

Many people with IBS may have other chronic conditions that involve pain such as fibromyalgia (a condition causing musculoskeletal pain and fatigue), chronic pelvic pain or chronic fatigue syndrome or may have anxiety or depression or problems with sleeping.

How is IBS treated?

Treatment for IBS is focused on managing and relieving symptoms. Lifestyle modifications and diet changes may be recommended.

Diet recommendations may include staying away from foods that can trigger symptoms, eating well-balanced meals, slowly and on time, with plenty of high-fibre food, drinking plenty of water and fluids and avoiding/limiting gassy or hard-to-digest foods or gluten or dairy.

Lifestyle modifications that may be recommended include getting adequate, regular exercise, sleeping well (7 to 9 hours per night) and trying relaxation techniques to keep stress at bay.

Medication such as fibre supplements or laxatives may also be recommended depending on symptoms. Other medications that may be recommended include those for pain, spasms, probiotics or antidepressants.

IBS does not put you at greater risk of colon cancer. It should not be confused with Inflammatory Bowel Disease (IBD), which is different. If you have symptoms, it is important to consult your healthcare provider for an accurate diagnosis and for treatment.

Published - April 03, 2025 03:45 pm IST