​​Irritable Bowel Syndrome (IBS): Symptoms, Causes & Treatments

When you deal with problems in the bathroom for months or even years, you start to think it’s just part of your life forever. But digestive disorders are often curable — and nothing to be embarrassed about.

Irritable bowel syndrome (IBS) is a very common disorder, but it doesn’t have to be.

How many people in the United States have IBS? According to the International Foundation of Functional Gastrointestinal Disorders, between 25 and 45 million people in the United States have IBS. That is almost a quarter of American adults.

It is almost sad to see IBS patients “treated” with pharmaceuticals that temporarily mask some symptoms and bring about all sorts of adverse side effects.

At PrimeHealth, we identify and treat the root cause of your IBS symptoms. In our practice, we’ve witnessed astounding success when diagnosing and addressing underlying causes, instead of superficial symptoms.

Done letting your gut issues rule your life? Join PrimeHealth’s Gut Health Group Visits and find lasting relief with a community of others who understand.
Sign up today — only a few spots remain for the next group beginning on Sept 20!

What is irritable bowel syndrome (IBS)?

Irritable bowel syndrome (sometimes called spastic colon) is a large intestine disorder. IBS causes recurrent abdominal pain and diarrhea or constipation over at least 6 months. 

While conventional medicine claims this condition is chronic, it is possible to reverse IBS in many cases.

How long does IBS last? IBS symptoms must last for at least 6 months to officially be considered IBS, but this condition can last your whole life if you don’t do anything about it.

If you are experiencing changing bowel habits, it’s wise to see a healthcare provider sooner rather than later.

There are 4 types of IBS:

• Diarrhea-predominant (IBS-D)
• Constipation-predominant (IBS-C)
• Mixed, or mixed pattern (IBS-M)
• Unspecified (IBS-U)

Symptoms of IBS (in Men & Women)

What are the symptoms of irritable bowel syndrome?

• Bloating
• Abdominal pain
• Cramping
• Stomach growling
• Constipation
• Diarrhea, loose stool
• Undesired weight loss
• Urgency to go

Menstrual cramps may be confused with abdominal cramping for women during their cycles. Most women are good at deciphering which is which, but younger women who have only recently started menstruating may not have the same experience distinguishing between the two.

Telling the difference between IBS and IBD (inflammatory bowel disease) can be tricky. IBS and IBD are separate classifications. Crohn’s disease and ulcerative colitis are examples of IBD, and both are considered more severe disorders than IBS.

Extra-gastrointestinal IBD symptoms (outside the gut) include eye inflammation, joint pain, and extreme fatigue. A doctor can confirm the diagnosis of IBD with a colonoscopy and biopsies from the digestive tract.

How do you feel when you have irritable bowel syndrome? You feel bloated when you have irritable bowel syndrome. You seldom feel comfortable more than a minute from a bathroom. IBS symptoms make you feel as if you’re frequently sick to your stomach.

What are the worst symptoms of IBS? The worst symptoms of IBS include constant abdominal discomfort and the fear of not getting to the bathroom soon enough, which may lead to anxiety and stress.

Diagnosing Irritable Bowel Syndrome

To diagnose IBS, doctors use the Rome criteria. A proper diagnosis of IBS is when you have experienced recurring abdominal pain for 6 or more months or any two of the following three in the past 3 months:

1. Pain or relief related to bowel movements
2. Change in frequency of bowel movements
3. Change in consistency of bowel movements

IBS is considered a “diagnosis of exclusion,” meaning that once all known causes for gastrointestinal distress are ruled out before you get an IBS diagnosis.

Right off the bat, your doctor should ask about your personal medical history and family history. They should rule out IBD, anemia, Celiac disease, colon cancer, carcinoid syndrome, and chronic inflammation. A colonoscopy may be required to rule out some conditions.

For instance, the American College of Gastroenterology recommends all people with IBS symptoms get tested for celiac disease. 

To identify the underlying cause of your IBS, your provider should discuss and test for specific IBS triggers, like:

• Food allergies
• Leaky gut
• Stress
• Parasites
• Yeast overgrowth
• Antibiotics
• Hormone imbalance

Keeping an up-to-date food diary may help nail down your individual IBS triggers.

SIBO tests

At PrimeHealth, we run SIBO tests for all our patients with IBS since SIBO is a common cause of its symptoms. SIBO stands for “small intestinal bacterial overgrowth.”

The majority of the time, the test will come back positive.

Glucose and lactulose breath tests are less invasive than blood tests and effectively test for SIBO. A methane-positive test usually indicates a constipation-dominant IBS, and a hydrogen-positive test usually indicates diarrhea-dominant IBS.

This breath test gives doctors a better idea of how to treat your IBS by focusing on the underlying causes.

Causes of IBS

What are the causes of IBS? The primary causes of IBS are unknown. However, there are several known triggers, each of which causes IBS — such as leaky gut syndrome and SIBO.

Risk Factors for IBS

What are the risk factors for IBS?

• Stress
• Younger age
• Stomach flu (gastroenteritis)
• Smoking
• Excessive alcohol use
• Diabetes

Common IBS Triggers

IBS symptoms (during flare-ups) may be triggered by:

• Food allergens are probably the most common trigger for IBS. For instance, if you have lactose intolerance, dairy can trigger IBS. Allergic to gluten? Wheat products can trigger IBS, too.
• Small intestine bacterial overgrowth (SIBO) is when bacteria populate in your small intestine instead of your large intestine, where they should populate. SIBO leads to IBS symptoms, such as gas and bloating. SIBO causes include food allergens and complications after abdominal surgery.
• Antibiotics are often connected to bowel diseases because antibiotics kill good and bad bacteria (which may lead to a leaky gut). The balance of good bacteria in your gut determines your gut and immune health.
• Leaky gut syndrome is when an imbalance of harmful bacteria in your gut leads to weakened tight junction proteins in your intestinal lining, which let nutrients pass from the gastrointestinal tract into the bloodstream. Leaky gut may trigger immune dysfunction, digestive issues, and inflammation throughout the body.
• Hormone imbalances can result in IBS. There is a direct interplay between your hormones and your gut. An imbalance in hormones can cause an imbalance in gut bacteria. In particular, thyroid disorders can be associated with digestive distress.
• Candida or yeast overgrowth is a particularly frustrating IBS trigger. Though not recognized as a diagnosis in conventional medicine, candida/yeast infection cases are increasing due to antibiotic overuse and excess dietary sugar.
• Parasites can also trigger IBS. We can test for parasites in a stool sample. While stool samples conducted in conventional medical centers may not pick up parasites, PrimeHealth uses specific testing companies that detect parasites through PCR DNA analysis and advanced microscopic techniques.
• Excessive alcohol use has been linked with IBS symptoms.
• Low vagal tone has been observed in IBS and other bowel diseases. The vagus nerve is the biggest cranial nerve, which connects your brain to the rest of your body. Stimulation can cause a sudden drop in blood pressure and heart rate, resulting in fainting. Low vagal tone means low vagus nerve activity and a sluggish digestive system.
• Thyroid dysfunction is another potential IBS trigger. Since thyroid hormones regulate your metabolism, thyroid disorders may cause digestive system problems that lead to IBS.
• Histamine intolerance can contribute to IBS. Histamine regulates allergic responses and gut function. Your body’s primary mode of breaking down histamine in your gut is through an enzyme called diamine oxidase or DAO. Some people have an unbalanced ratio of histamine to DAO, and they cannot handle histamine in their diet without experiencing IBS symptoms and other discomforts.
• Poor hydration may also trigger IBS.
• Fructose malabsorption can lead to excessive fructose in the GI tract, leading to SIBO and IBS. The prevalence of high-fructose corn syrup has brought this IBS trigger to the forefront.
• Food poisoning can also damage the migratory motor complex and lead to a prolonged bowel disorder such as IBS.
• Simple sugar and carbohydrates can promote a yeast infection and therefore IBS.
• Excessive caffeine may contribute to yeast infection, cortisol excess, and IBS.
• Eating too frequently, in general, can lead to IBS symptoms. The migratory motor complex is not activated when you do not give your body enough time to digest.

Alcohol & Caffeine Alternative: A favorite alternative of ours is Feel Free, a plant-based tonic that provides improved mood, sustained energy, and decreased anxiety, without the many negatives of alcohol or caffeine. For 40% off your first order use code primehealth40. Subscribe to receive an additional discount and order as many boxes in your 1st order as you’d like to capitalize on this considerable discount and cancel your subscription at any time!

Post-infectious IBS refers to irritable bowel syndrome that occurs after a bacterial infection in your digestive tract. Bacterial infections are a common cause of IBS.

IBS Treatments

The most common and effective treatment options for irritable bowel syndrome may surprise you.

We have found that IBS can be cured in most cases. Yes, that is a controversial claim to make. But our patients prove it to be true.

IBS Medications

IBS medications can support the recovery and reversal of this condition.

Since there is no official cause for IBS identified in the conventional medical world, people with IBS are generally treated with palliative medications to suppress their symptoms.

Conventional doctors may prescribe the following medicines for IBS:

• Antispasmodics like Bentyl (dicyclomine) for cramping
• Loperamide or eluxadoline for diarrhea
• Lubiprostone or linaclotide for constipation
• Tricyclic antidepressants to improve mental health and ease physical pain

But we believe the side effects are not worth the superficial treatment of symptoms. We think it is wiser to identify and treat the root cause of IBS instead of just the symptoms.

Here are 5 alternative IBS treatments to discuss with your healthcare provider:

1. Rifaximin is the generic of Xifaxan, an FDA-approved antibiotic to treat IBS-D. Rifaximin is the only medication we prescribe for hydrogen-dominant IBS. While many insurance companies will not pay its high price tag, we use pharmacies in Canada to obtain the generic form at a reasonable price.
2. For methane-dominant IBS, there are more options. Rifaximin, in conjunction with another antibiotic, has been shown to yield even better results. Neomycin is a potential antibiotic we may use. However, if a patient tests positive for parasites, we will prescribe an antiparasitic antibiotic — either metronidazole or tinidazole.
3. Biofilm disruptors are a way to weaken harmful bacteria. Often, bacteria will form a biofilm to adapt to their environment. Biofilms are very resistant to antibiotics, so a biofilm disruptor is sometimes needed to neutralize bacteria’s defenses.
4. Fecal transplant is a procedure that transfers healthy stool into a patient with a digestive disorder. This procedure restores a lot of beneficial bacteria to the patient. There is surprisingly convincing science to back up this procedure.
5. Prokinetics (AKA promotility agents) are benign medications useful in resilient IBS cases. Prokinetics aid in digestion when your digestive tract does not work as effectively as it needs to. Prokinetics alleviate bloating. Some examples are ginger, low-dose naltrexone, and prucalopride.

A 2014 study revealed that specific herbal blends were as effective as Rifaximin in treating SIBO. For many patients, the all-natural route is the best one.

IBS Diet

What is a typical IBS diet? The low-FODMAP diet is typically beneficial for most IBS patients. Even the National Institute of Diabetes and Digestive and Kidney Diseases talks about the efficacy of the low-FODMAP diet.

We recommend a temporary low-FODMAP diet as part of nearly every treatment plan for PrimeHealth patients.

FODMAPs are fermentable carbs. They are notorious for triggering bloating and other digestive issues. Low-FODMAP is not meant to be followed for more than a few months.

What foods usually trigger IBS? Avoid these IBS-triggering foods on the low-FODMAP diet:

• Wheat
• Rye
• Dairy
• Beans
• Garlic (contain fructans)
• Onions (contain fructans)
• Fruit (because of fructose)
• Asparagus
• Brussels sprouts
• Cauliflower
• Mushrooms
• Snow peas
• Agave nectar, sugar alcohols

The low-FODMAP diet is meant to be an elimination diet. If symptoms subside while on the diet, you can slowly reintroduce foods. Figure out which foods you can tolerate, and determine the amount you can handle.

The low-FODMAP diet is not recommended while being treated for SIBO with antibiotics. These antibiotics are more effective when you eat high-FODMAP foods, so your doctor should consider this.

While low-FODMAP is often the right way to go for IBS, it’s not the only diet that can relieve your IBS symptoms. Hint: avoid honey.

Lifestyle Changes

Stress relief is a surefire way to lower your risk of irritable bowel syndrome. Meditation, a full night’s sleep, yoga, and spending time outside are all great ways to relieve stress.

Exercise may help treat IBS. A clinical trial revealed that physically active people are significantly less likely to suffer from IBS than inactive people.

Intermittent fasting (bowel rest) may help relieve IBS symptoms. If you’re eating too much, too quickly, your digestive tract doesn’t have enough time to process the food properly. Fasting in the mornings or evenings can help correct this issue. Aim for a 12-hour fasting window, then work your way to 14-16 hours between dinner and breakfast.

Cognitive-behavioral therapy helps IBS patients train their bowels, small intestine, and rectum to move waste when the patient wants to — not when the body decides to.

Probiotics

Probiotics restore the good bacteria that many people lose throughout their lives. Whether through diet, lifestyle, antibiotic overuse, or medical conditions, your gut often needs a helping hand. Probiotics treat leaky gut syndrome (an imbalance of good bacteria), and leaky gut is a potential trigger for IBS.

You can get probiotics both in supplement form and through bacteria-rich foods and drinks, such as kombucha, kefir, and sauerkraut.

CBD

Cannabidiol, commonly known as CBD, has been shown by study after study to help treat bowel diseases.

A study published in Biochemical Pharmacology confirmed that CBD offers relief for bowel inflammation.

A 2016 study talks about how CBD affects many organ systems. Despite the social controversy, CBD may truly address serious digestive tract issues.

Vitamin D

Vitamin D, the only vitamin that is also a hormone, may help treat IBS.

Research indicates that vitamin D deficiency is significantly more prevalent in those with IBS than those without IBS.

A 2018 study observed that vitamin D effectively treated IBS in adolescents.

Dietary Supplements

Various over-the-counter dietary supplements calm irritable bowel syndrome:

• Digestive enzymes aid in the digestive process.
• Berberine addresses yeast infections.
• Artemisia treats parasites.
• Chasteberry balances hormones.
• Iodine helps correct thyroid problems.
• Allicin treats SIBO.
• Glutathione fights toxins.
• Oil of oregano treats SIBO, yeast infections, and leaky gut.
• Peppermint oil addresses constipation.
• Certain herbal blends, like Dysbiocide or FC-cidal, treat SIBO.

Complications of Untreated IBS

Several possible complications can arise when you live with irritable bowel syndrome.

Good bacteria in your gut are usually out of whack when you suffer from IBS. An imbalance in healthy gut bacteria can lead to leaky gut syndrome. Because a large portion of your immune system lives in your gut, a leaky gut often leads to an autoimmune condition or other immune dysfunction.

If you’re constipated, this can mean you are not detoxing properly. A healthy digestive system detoxes your body of:

• Heavy metals
• Pesticides
• Excess estrogen

Without detoxing these and other toxins, you may face hormone or immune disorders.

As with other digestive issues, you may be experiencing malabsorption, meaning your digestive tract is not absorbing all the nutrients it needs whenever you eat. The food is hurrying through your digestive system too quickly.

Malabsorption can increase the risk of osteoporosis (due to calcium malabsorption), cognitive decline (due to vitamin B12 malabsorption), infection, and immune dysfunction (due to zinc and vitamin A malabsorption).

Also, acid-blocking meds and laxatives (two potential IBS medications) can both lead to malabsorption.

Long-Term Outlook for IBS

You can reverse irritable bowel syndrome by treating the root cause of your IBS.

Patients have come through our doors who have had IBS for 10 years. IBS affects your quality of life in many negative ways, and a decade of suffering can wear a person down. 

Nothing worked for them until we identified and addressed the root cause. Suddenly, we saw massive improvements in a couple months!

Stop Googling and finally get to the root of your gut issues.
Our gut health group visits begin Sept 20, 2022. Don’t miss out — sign up today!

Sources

1. Won, E., & Kim, Y. K. (2016). Stress, the autonomic nervous system, and the immune-kynurenine pathway in the etiology of depression. Current neuropharmacology, 14(7), 665-673.
2. Jadallah, K. A., Nimri, L. F., & Ghanem, R. A. (2017). Protozoan parasites in irritable bowel syndrome: a case-control study. World journal of gastrointestinal pharmacology and therapeutics, 8(4), 201.
3. Reding, K. W., Cain, K. C., Jarrett, M. E., Eugenio, M. D., & Heitkemper, M. M. (2013). Relationship between patterns of alcohol consumption and gastrointestinal symptoms among patients with irritable bowel syndrome. The American journal of gastroenterology, 108(2), 270.
4. Bonaz, B., Bazin, T., & Pellissier, S. (2018). The vagus nerve at the interface of the microbiota-gut-brain axis. Frontiers in neuroscience, 12, 49.
5. Nam, S. Y., Kim, B. C., Ryu, K. H., & Park, B. J. (2010). Prevalence and risk factors of irritable bowel syndrome in healthy screenee undergoing colonoscopy and laboratory tests. Journal of neurogastroenterology and motility, 16(1), 47.
6. Filip, M., Tzaneva, V., & Dumitrascu, D. L. (2018). Fecal transplantation: digestive and extradigestive clinical applications. Clujul Medical, 91(3), 259.
7. Chedid, V., Dhalla, S., Clarke, J. O., Roland, B. C., Dunbar, K. B., Koh, J., … & Mullin, G. E. (2014). Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth. Global advances in health and medicine, 3(3), 16-24.
8. Gibson, P. R., & Shepherd, S. J. (2005). Personal view: food for thought–western lifestyle and susceptibility to Crohn’s disease. The FODMAP hypothesis. Alimentary pharmacology & therapeutics, 21(12), 1399-1409.
9. Hirotsu, C., Tufik, S., & Andersen, M. L. (2015). Interactions between sleep, stress, and metabolism: From physiological to pathological conditions. Sleep Science, 8(3), 143-152.
10. Thompson, C. W., Roe, J., Aspinall, P., Mitchell, R., Clow, A., & Miller, D. (2012). More green space is linked to less stress in deprived communities: Evidence from salivary cortisol patterns. Landscape and urban planning, 105(3), 221-229.
11. Johannesson, E., Simrén, M., Strid, H., Bajor, A., & Sadik, R. (2011). Physical activity improves symptoms in irritable bowel syndrome: a randomized controlled trial. American Journal of Gastroenterology, 106(5), 915-922.
12. Mu, Q., Kirby, J., Reilly, C. M., & Luo, X. M. (2017). Leaky gut as a danger signal for autoimmune diseases. Frontiers in immunology, 8, 598.
13. Esposito, G., Filippis, D. D., Cirillo, C., Iuvone, T., Capoccia, E., Scuderi, C., … & Steardo, L. (2013). Cannabidiol in inflammatory bowel diseases: a brief overview. Phytotherapy Research, 27(5), 633-636.
14. Sharkey, K. A., & Wiley, J. W. (2016). The role of the endocannabinoid system in the brain–gut axis. Gastroenterology, 151(2), 252-266.
15. Borrelli, F., Fasolino, I., Romano, B., Capasso, R., Maiello, F., Coppola, D., … & Izzo, A. A. (2013). Beneficial effect of the non-psychotropic plant cannabinoid cannabigerol on experimental inflammatory bowel disease. Biochemical pharmacology, 85(9), 1306-1316.
16. Reichenbach, Z. W., & Schey, R. (2016). Cannabinoids and GI disorders: endogenous and exogenous. Current treatment options in gastroenterology, 14(4), 461-477.
17. Williams, C. E., Williams, E. A., & Corfe, B. M. (2018). Vitamin D status in irritable bowel syndrome and the impact of supplementation on symptoms: what do we know and what do we need to know?. European journal of clinical nutrition, 72(10), 1358-1363.
18. El Amrousy, D., Hassan, S., El Ashry, H., Yousef, M., & Hodeib, H. (2018). Vitamin D supplementation in adolescents with irritable bowel syndrome: Is it useful? A randomized controlled trial. Saudi journal of gastroenterology: official journal of the Saudi Gastroenterology Association, 24(2), 109.
19. Liu, X., Ma, Z., Zhang, J., & Yang, L. (2017). Antifungal compounds against candida infections from traditional Chinese medicine. BioMed research international, 2017.
20. Duntas, L. H. (2015). The role of iodine and selenium in autoimmune thyroiditis. Hormone and Metabolic Research, 47(10), 721-726.
21. Zou, Y., Xiang, Q., Wang, J., Peng, J., & Wei, H. (2016). Oregano essential oil improves intestinal morphology and expression of tight junction proteins associated with modulation of selected intestinal bacteria and immune status in a pig model. BioMed research international, 2016.