Irritable Bowel Syndrome, or IBS, is a common digestive disorder that affects millions of people around the world. People with IBS may struggle with symptoms like stomach pain, bloating, and changes in how often they go to the bathroom, causing a lot of discomfort.
In this blog, we’ll break down what IBS is, how it’s diagnosed, what triggers it, and how to manage it through diet, lifestyle, and exercise.
What Is IBS
Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder, which means the digestive system looks normal but doesn’t work as it should. IBS is mainly identified by chronic abdominal pain, which is often linked to changes in the frequency and form of stools (constipation or diarrhea).
It’s important to understand that IBS is not the same as IBD (Inflammatory Bowel Disease). Unlike IBD, IBS does not cause inflammation or damage to the intestines. Because of this, imaging scans like X-rays or endoscopy usually don’t show anything abnormal in IBS cases.
Types of IBS
Doctors often use guidelines from the Rome Foundation, an international group that collects data to understand and treat digestive disorders, to classify IBS.
- IBS-C (Constipation-predominant) – Hard or lumpy stools are more common.
- IBS-D (Diarrhea-predominant) – Loose or watery stools are more frequent.
- IBS-M (Mixed-type) – Alternating between diarrhea and constipation.
- IBS-U (Unclassified) – Symptoms don’t fall into the other three types.
How Is IBS Diagnosed?
Diagnosing IBS can be tricky because no single test or biomarker can confirm it. Instead, doctors focus on symptoms and medical history and rule out other conditions before making a diagnosis.
To help rule out other serious digestive problems, doctors may recommend some basic tests such as:
- Blood tests – to check for infections, anemia, or celiac disease.
- Stool tests – to look for signs of infection or inflammation.
- Abdominal ultrasound – to check if your organs look normal.
- Upper endoscopy or colonoscopy – to view the inside of your stomach or colon, especially if bleeding, weight loss, or symptoms started after age 50.
When Should You Suspect IBS?
Certain signs and risk factors help doctors suspect and diagnose IBS. These include:
- Unintentional weight loss
- Iron-deficiency anemia
- Rectal bleeding (without known causes like hemorrhoids)
- Change in bowel habits lasting more than 6 weeks in patients over 60 years
- A history of antibiotic use
- Family history of gut disorders
Research shows that women are more commonly affected by IBS than men. The exact reason isn’t apparent, but hormonal changes may play a role.
The most common symptoms of IBS include:
- Abdominal pain or cramping
- Gas and flatulence
- Bloating
- Dyspepsia (discomfort in the upper stomach)
- Alternating diarrhoea and constipation
If you or someone you know experiences any of these, speaking with a healthcare provider is essential..
What Triggers IBS?
Many different foods and lifestyle factors can trigger IBS symptoms. Foods rich in carbohydrates and fats, like cabbage, onion, peas/beans, hot spices, deep-fried foods, pizza, coffee, smoked/processed food, etc., are common triggers.
However, the triggers can vary from person to person. Not everyone with IBS reacts to the same foods, so it’s important to observe and track your own symptoms.
The Role of Stress in IBS
One major but often overlooked trigger for IBS is stress. The gut and brain are closely connected through what’s called the gut-brain axis. That means stress, anxiety, or emotional upset can directly affect how your gut behaves.
When stressed, your body releases hormones like cortisol, CRH (Corticotropin-Releasing Hormone), and serotonin that can speed up or slow down your digestive process, leading to bloating, pain, or irregular bowel movements. Studies show that people with IBS often have higher levels of anxiety or depression compared to others.
Tips for Managing Stress With IBS:
- Practice mindfulness or meditation
- Try deep breathing exercises
- Get 8 hours of sleep every night
- Engage in relaxing activities like reading, gardening, or listening to music
- Speak to a therapist or counselor if stress feels overwhelming
Managing IBS Through Diet and Lifestyle
While IBS can’t be cured, symptoms can be managed well with diet and lifestyle changes.
1. Try a Low FODMAP Diet
Many doctors and dietitians recommend following a low FODMAP diet. FODMAP stands for:
- Fermentable
- Oligosaccharides (e.g., wheat, rye, onions, garlic)
- Disaccharides (e.g., lactose in milk, yogurt, soft cheese)
- Monosaccharides (e.g., excess fructose in apples, mangoes, and honey)
- And
- Polyols (e.g., sorbitol and mannitol in some fruits and artificial sweeteners)
FODMAPs are certain types of carbohydrates that are poorly absorbed in the intestine. These can cause gas, bloating, and diarrhea in some people.
Research (Altobelli et al., 2017) shows that reducing high-FODMAP foods may help improve stool consistency and reduce the frequency of bowel movements in IBS patients.
After avoiding FODMAP-rich foods for a few weeks, these foods should be gradually reintroduced to identify which ones trigger symptoms.
High FODMAP Foods to Limit (during elimination phase):
- Fruits: Apples, pears, watermelon, mangoes
- Vegetables: Onion, garlic, cauliflower, mushrooms
- Dairy: Milk, yogurt, soft cheeses (high in lactose)
- Legumes: Beans, lentils, chickpeas
- Grains: Wheat, rye, barley (especially in large amounts)
- Sweeteners: Sorbitol, mannitol, xylitol (found in sugar-free gum/candies)
Low FODMAP Foods You Can Eat:
- Fruits: Bananas, blueberries, grapes, oranges, kiwi
- Vegetables: Carrots, spinach, zucchini, cucumber, bell peppers
- Dairy alternatives: Lactose-free milk, almond milk, hard cheeses
- Protein: Eggs, tofu, chicken, fish
- Grains: Rice, oats, quinoa, gluten-free bread
- Sweeteners: Maple syrup, stevia
- Choose Soluble Over Insoluble Fiber
NOTE: Always try this diet under the guidance of a certified nutritionist or doctor to avoid unnecessary restrictions.
2. Choose Soluble Over Insoluble Fiber
Fiber is essential for gut health, but not all fibers work the same for people with IBS.
- Soluble fiber dissolves in water and forms a gel-like substance. It helps soften stools and keeps bowel movements regular without causing irritation. Examples include: Psyllium husk, oats, apples (peeled), carrots, bananas, chia seeds, and sweet potatoes.
- Insoluble fiber adds bulk to the stool and speeds up digestion, sometimes triggering bloating, gas, or diarrhea in people with IBS. Examples include: Wheat bran, raw leafy vegetables, nuts and seeds (especially with skins), whole grains like brown rice and whole wheat bread.
A low dose of soluble fiber is usually better tolerated and can help reduce flatulence.
3. Consider Probiotics
Some studies (Black J et al., 2021) suggest that probiotics may help reduce abdominal pain and other IBS symptoms. Probiotics are “good” bacteria that support a healthy gut.
You can find probiotics in store-bought supplements or foods like yogurt, kefir, and fermented vegetables.
The Role of Exercise in IBS
Although IBS is mainly related to diet and stress, physical activity also plays a role in managing the symptoms.
An observational study by Hamaguchi et al. (2020) found that increasing the daily step count to around 9500 could reduce the severity of IBS symptoms by 50%. That’s a significant improvement for something as simple as walking more daily!
Even though more research is needed, regular exercise like walking, yoga, or light cardio may help improve digestion and reduce stress, which is often linked to IBS flares.
Final Thoughts
IBS may be a lifelong condition, but with the right care, its symptoms can be managed effectively. Many people can find relief by making simple changes to their diet, keeping track of trigger foods, gradually increasing fibre, adding probiotics, and getting regular exercise.
It’s also important to remember that IBS is a personal condition. What works for one person may not work for another. A food and symptom diary can help identify what’s best for your body.
If you suspect you have IBS or are struggling with ongoing digestive issues, talk to a doctor or a registered dietitian. Early diagnosis and the right approach can make a big difference in your quality of life.
References:
Altobelli, E. et al. (2017) ‘Low-FODMAP Diet Improves Irritable Bowel Syndrome Symptoms: A Meta-Analysis’, Nutrients 2017, Vol. 9, Page 940, 9(9), p. 940. doi: 10.3390/NU9090940.
Bonfrate, L. et al. (2015) ‘Effects of dietary education, followed by a tailored fructose-restricted diet in adults with fructose malabsorption’, European Journal of Gastroenterology & Hepatology, 27(7), pp. 785–796. doi: 10.1097/MEG.0000000000000374.
Black, C. J. and Ford, A. C. (2021) ‘Best management of irritable bowel syndrome’, Frontline Gastroenterology, 12(4), pp. 303–315. doi: 10.1136/FLGASTRO-2019-101298.
Ford, A. C. et al. (2008) ‘Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: Systematic review and meta-analysis’, BMJ. doi: 10.1136/bmj.a2313.
Hamaguchi, T. et al. (2020) ‘The effects of locomotor activity on gastrointestinal symptoms of irritable bowel syndrome among younger people: An observational study’, PLOS ONE, 15(5), p. e0234089. doi: 10.1371/JOURNAL.PONE.0234089.
Simrén, M. et al. (2001) ‘Food-Related Gastrointestinal Symptoms in the Irritable Bowel Syndrome’, Digestion, 63(2), pp. 108–115. doi: 10.1159/000051878.
