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What are the Symptoms and Causes of IBS?

by Kirsten Jackson Specialist Dietitian Leave a Comment

In this article I will explain what are the symptoms of IBS and also what are the causes of IBS. These are two confusing topics which you will need to understand in order to control your condition.

If you have IBS you will be experiencing a range of digestive symptoms and these may differ from someone else you know with the condition.

Similarly, you may be looking for answers about why you have this problem in the first place. Causes are not yet fully understood but we have managed to link several possible suspects in the research.

what are the symptoms of IBS

HOW TO GET AN IBS DIAGNOSIS

The symptoms and causes of IBS may sound wooly but there is  a specific criteria for an IBS diagnosis.

The IBS Criteria;

You must be experiencing abdominal pain at least 1 day a week for the past 3 months (1). In addition, this abdominal pain will be related to at least 2 of the following;

  • Opening your bowels
  • A change in stool frequency
  • A change in stool appearance

To make a diagnosis, you must also have a set of specific tests carried out. These tests will rule out other possible health conditions. You can find out about these tests here.

WHAT ARE THE SYMPTOMS OF IBS?

1. BLOATING SYMPTOMS IN IBS

It wont surprise you to find that bloating is a common symptom of IBS. Bloating is caused by trapped or excess gas that leads to more pressure in your digestive tract.

You can read more about the causes of bloating here.

2. STOMACH PAIN AND CRAMPING SYMPTOMS IN IBS

IBS causes abdominal pain at least 1 day / week (2).

This symptom is thought to be caused by hypersensitivity in the gut. Therefore, your gut may be communicating to your brain that you are in pain in response to just normal digestion.

3. EXCESS GAS

Gas production is a normal part of digestion. However, if you are suffering with excess gas then this is more of an IBS symptom.  It is caused by changes in gut bacteria and food intolerances.

3. DIARRHOEA IS A SYMPTOM OF IBS

Diarrhoea in IBS is caused by food intolerances and a hypersensitivity. Things like FODMAPs, caffeine, nicotine, alcohol and stress can cause diarrhoea.

The definition of diarrhoea: “Diarrhoea is defined as the passage of three or more loose or liquid stools per day (or more frequent passage than is normal for the individual)” (3).

4. LOOSE STOOLS

You may not fit the strict definition for diarrhoea, but still have IBS predominant diarrhoea (IBS-D). You would fit this criteria if your IBS symptoms included mostly stool types 5-6 (see below chart).

what are the causes of IBS

5. CONSTIPATION

Constipation is considered a sign of IBS. There is no real accurate definition of constipation unfortunately. For this one you need to look at your stool type and movement.

A stool type of 1-3 indicates constipation.

6. FATIGUE

If you feel exhausted then this may be a symptom of your IBS (4).

When you feel tired with IBS, the causes are likely due to a combination of factors. Regular pain, bloating, constipation and diarrhoea will all make you feel fatigued.

You may also feel quite stressed and low in mood about your symptoms. Stress and a low mood have also been linked to fatigue.

7. LOW MOOD AND ANXIETY

Through the gut-brain axis, we know that mental health is linked to IBS.

So, it is not surprising that you may feel lower in mood or suffer with anxiety. In one paper, it was even suggested that people with anxiety and depression are twice as likely to suffer with IBS.

WHAT CAUSES IBS?

You will be frustrated to find that the exact cause of IBS is currently unknown. Research does show that IBS causes could be multifactorial.

Have you ever been told ‘it is all in your head’? As nasty as this comment is, there may actually be some truth in it. Because, when we look at IBS pain symptoms, research suggests that it could be due to a sensitive nervous system.

Having a hypersensitive nervous system would cause pain signalling to your brain when nothing out of the norm is going on in your gut (5, 6).

The following issues are thought to be potential other causes of IBS;

  • Stress (7)
  • Infection (7)
  • Being female (8)
  • Food intolerances

PSYCHOLOGICAL FACTORS

When your body is under stress, it releases hormones, such as cortisol, which can lead to digestive symptoms (8).

Stress is thought to play a large role in IBS pain symptoms. It is known that chronic stress can increase gut permeability and modify how the pain signalling in the body works (9).

Take the time to consider what caused your IBS may help you to manage it going forward.

HOW IS IBS TREATED?

As much as I want to tell you about the ‘treatments of IBS’ there are none. In fact, IBS is a chronic condition with no cure, so the term ‘treatment’ is misleading. Although you may be disappointed at this, there are multiple management options available.

Below I have listed out different, scientifically proven IBS management methods. Although each one is proven by science to improve symptoms, I would suggest using them all. IBS is a multifactorial condition and requires this approach.

THE LOW FODMAP DIET

‘FODMAPs’ stands for fermentable oligosaccharides disaccharides monosaccharides and polyols. It has been shown to have up to a 70% effective rate at managing IBS symptoms (10).

FODMAPs are different types of carbohydrates which can be found in various foods.

FODMAPs make their way through the gut, to the large bowel, where they are broken down by gut bacteria.

This process is known as fermentation and produces gas and draws water into your large bowel.

In those with IBS, FODMAPs can cause stomach distension and bloating, resulting in  pain, loose stools and excess gas (11, 12).

You firstly follow a diet low in fermentable carbohydrates for 4-6 weeks. This controls your symptoms by avoiding fermentable carbohydrates.

PROBIOTICS

After the initial reduction phase, you go on to the reintroduction process. This is a structured process which allows you to pinpoint your triggers and tolerance levels

Probiotics have been shown to help manage IBS symptoms in multiple studies.

If you take a probiotic regularly you may find you have a reduction in IBS pain, flatulence and bloating. Probiotics can also help normalise stool patterns (13, 14, 15).

Exactly how probiotics help IBS symptoms of pain is unclear at present. But, research is starting to suggest a role for gut bacteria in the the gut – brain axis (3).

For recommendations on which probiotics to try, see my previous article on probiotics in IBS.

PSYCHOLOGICAL TREATMENTS

Given that there is a psychological element in IBS, it comes as no surprise that psychological therapies can help.

Cognitive behavioural therapy (CBT), hypnotherapy and mindfulness are all shown to have some benefit for those with IBS symptoms (16).

YOGA

Doing yoga twice a week has been shown to improve your symptoms as much as the low FODMAP diet (17).

FIBRE

If you have IBS-C then taking a fibre supplement can help to relieve symptoms.

But, be careful that you take the correct type of fibre supplement, only Psyllium, methylcelluose, calcium polycarbophil and wheat dextrin have been shown to reduce symptoms (18).

MEDICATIONS

There are a range of medications that can help with IBS pain symptoms, to get advice on these, speak to your doctor or pharmacist.

PEPPERMINT OIL

You will likely have heard that peppermint is good for digestion and may even have tried peppermint tea in the past.

But, you should be taking peppermint oil to get the full benefit. This oil is an extract from the mentha plant. Interestingly, it has been used for many years as a digestive aid and in more recent times, studies looking at its effectiveness in IBS have been carried out.

In one study, individuals with mild symptoms of IBS were given 180mg of peppermint oil 3 times a day for 4 weeks. This resulted in a reduction in IBS related pain (19).

When you take peppermint oil for your IBS pain, it works by blocking calcium channels in your body (20).

Studies on peppermint oil capsules range from 225mg twice a day to 187mg four times a day (21). So it may be worthwhile starting with a lower dose and working your way up.

BOTTOM LINE

Irritable bowel syndrome is a condition which has multifactorial causes. Symptoms can vary in type and intensity between people and testing is required for diagnosis. 

IBS is a chronic condition with no cure but you can manage symptoms by pin-pointing triggers through the low FODMAP diet, targeting gut microbiota and changing lifestyle habits.

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Filed Under: Medical advice for IBS Tagged With: IBS causes, IBS symptoms

About Kirsten Jackson Specialist Dietitian

Kirsten Jackson is a UK registered Consultant Gastroenterology Dietitian and founder of The Food Treatment Clinic. She has undergone many qualifications to get where she is today, including a UK BSc Honours Degree in Dietetics and Post-Graduate Certificate in Advanced Dietetics. In addition to this, she has FODMAP Training from Kings College London University. Kirsten set up The Food Treatment Clinic in 2015 after first experiencing digestive problems herself. She felt that the NHS was unable to provide the support individuals needed and went on to specialise in this area before opening a bespoke IBS service. Kirsten also participates in charity work as an Expert Advisor for the IBS Network. In addition, she can be seen in publications such as Cosmopolitan and The Telegraph discussing IBS as an Official Media Spokesperson to the IBS Network.

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🙋‍♀️ Coffee contains the active ingredient caffeine. Although we think of caffeine as an everyday thing, it is a drug and does have an impact on our body. In IBS, this impact may be negative in the form of over stimulating bowels. It can also worsen anxiety and prevent good quality sleep, both of these aspects then have a knock on impact on your IBS. 

🤔Instead of blindly avoiding all coffee (which may not be needed). Here are some top tips from the Take Control Membership:
1️⃣ Never exceed 400mg caffeine a day (this is the general guidelines for a healthy intake and is lower for those pregnant and breast feeding) 
2️⃣ Reduce intake gradually to avoid headaches. 
3️⃣ Avoid coffee after mid-day (it's long 1/2 life means it may still be in your system when trying to sleep otherwise). 
4️⃣ Track your bowel habits and mood against intake to see if it is causing an issue.
5️⃣ Coffee isn't all bad for IBS - if you have IBS-C,  you may find that it helps you go! 

‼️ Have you downloaded my free 'morning guide' yet? (the link is in my bio).⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀⠀
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🤷‍♀️Have you heard of SIBO before? Comment below ⬇️

🙋‍♀️SIBO (small intestinal bacterial overgrowth) is a condition caused by..you guessed it...an overgrowth of bacteria in the small bowel. It is unclear what causes SIBO but it does seem to be linked with PPI medications, low immunity and poor gut motility.

🤓The management of SIBO is difficult. Because the best diagnostic tools we currently have are not very accurate and the current treatments for SIBO are mostly antibiotics. We often see in practise that SIBO tends to return after antibiotic treatment, likely due the underlying cause not being treated.
 
🤓SIBO management;
✅Antibiotics
✅Addressing motility (avoiding constipation)
✅Optimising good gut bacteria (so it can thrive and compete with bad bacteria)
✅Elemental diet - some limited research to support this use as a treatment.
❓Low FODMAP diet - no evidence but the theory is that these FODMAPs will feed the bad bacteria so avoidance of them whilst taking antibiotics may allow the antibiotics to work better. 
❌Herbs - no placebo controlled trials to support this or any logical theory.

🤓Ultimately we have very limited research in this area. I tend to work with gastroenterologists on this one to first have the condition diagnosed and then get the individuals gut in a place where the antibiotics are mostly likely to work.

‼️ If you haven't already, do not forget to sign up to my free Veganuary IBS Guide (the link is in my bio).⠀⠀⠀⠀⠀⠀ 

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🙋‍♀️when you have IBS, it is a whirlwind of emotion. One minute, everything is going well and then suddenly you have a flare up of symptoms. Or perhaps you are anxious about what your bowels may do. This whirlwind is due to having a limited understanding of your triggers and so you simply can not avoid them. Instead of this, opt for the low FODMAP process which will guide you step by step to pinpointing your trigger foods.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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🤓Research shows that IBS is directly linked to poor gut health, so it is not surprising that this was the main outcome for this client.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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🙋‍♀️I always advise my clients that they MUST get an accurate IBS diagnosis, this includes ruling out IBD.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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🤓IBD stands for inflammatory bowel disease. Although many symptoms are similar, the condition is not. IBD is an autoimmune disease which causes inflammation in the GI tract. So, make sure you have the correct testing done (a fecal calprotectin test).⠀⠀⠀⠀⠀⠀⠀⠀⠀
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ARE YOU GUILTY OF STAYING UP Late? ⠀⠀⠀⠀⠀ ARE YOU GUILTY OF STAYING UP Late?
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🙋‍♀️ Sleep is such an important factor in our general health as well as gut health.. Yet we seem to put it at the bottom of the list after fitness and nutrition.. Why? Whilst chatting to @drsalihaafridi recently she summed it up.. We evented electricity! .⠀⠀⠀⠀⠀⠀⠀⠀⠀
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🤓Poor quality and or quantity of sleep will reduce your mental wellbeing and negatively impact your gut. It also impacts your food choices. 

👍We cover sleep hygiene in my Take Control Programme (available for joining at the end of this month). In the meantime, here are some easy tips. 
✳️ Use @off_the_grid_app (to block your phone overnight!) 
✳️ Read before bed
✳️ Have a hot shower before bed to relax your muscles
✳️ Go to bed and get up at the same time each day
✳️ Use an eye mask⠀⠀⠀⠀⠀⠀⠀⠀⠀
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⏩⏩ If you would like to know more about my Take Control Programme then please DM me so I see if you are suitable and also give you some details 😊. 
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This website uses cookies to improve your experience while you navigate through the website. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may affect your browsing experience.
Necessary
Always Enabled

Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.

Non-necessary

Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. It is mandatory to procure user consent prior to running these cookies on your website.