Irritable bowel syndrome is an intestinal disorder characterized by cramping, bloating, and bouts of constipation and diarrhea, among other symptoms. A disrupted communication between the gut and the brain is at the root of the signs and symptoms of irritable bowel syndrome (IBS).
Historically, people thought of IBS as a functional gastrointestinal disorder, meaning it’s caused by abnormal function, not a tumor or infection. However, researchers have found that the overgrowth of bacteria in the small intestine may play a role in this condition in some people.
Research continues to determine the exact reason why some people suffer from IBS. Their gut may be particularly sensitive to stress or certain foods. Women are twice as likely to suffer from IBS as men. It is also more common in people under the age of 50.
In this article, we explore 10 symptoms of IBS. Read on to learn how to recognize it. We also discuss other conditions that may cause similar symptoms.
1. Pains and cramps
Pain and cramping in the lower abdomen can be symptoms of ailments ranging from minor to severe. These are two of the main symptoms of IBS.
A hypersensitivity of the intestine is probably the cause of these symptoms. Irritable bowel syndrome affects how the brain and gut work together, and this condition can cause the muscles in the gut to contract more than they should for normal bowel movement. Excessive contraction of the intestinal muscle can lead to pain and cramping in the lower abdomen.
A 2014 study found that IBS was the third most common diagnosis given by GPs for pain and cramping in the lower abdomen, after “no diagnosis” and gastroenteritis. More rarely, the pain is caused by:
pelvic inflammatory disease
inflammatory bowel disease
2. Excess gases
People with IBS may have excessive gas. Doctors do not know the exact reason for this phenomenon, but there are several theories. According to one of them, IBS is due to a problem of bacteria in the intestine. Bacteria can create certain toxins that can cause excessive gas. Another theory is that people with IBS are less able to tolerate and transport gas through their gut, leading to a feeling of gas. Gas often accompanies other symptoms, such as bloating, constipation, and belching. If they show up half an hour after eating, they could be due to IBS. In this case, doctors can screen for celiac disease.
Symptoms indicating something more serious include:
a lump in the abdomen
difficulty or pain in swallowing
new symptoms in someone age 55 or older
family history of colon cancer or pancreatitis.
Doctors may ask a person about their family medical history and eating and drinking habits to understand possible causes. A rectal exam can determine if there is pelvic floor dysfunction.
Bloating is another symptom of IBS. Bloating refers to a buildup of gas in the intestine, which can make the abdomen feel full and appear rounder than usual. A person may also feel bloated without their belly being rounded. The same factors that cause excess gas in the IBS can also cause bloating.
Other causes of bloating include:
overgrowth of bacteria in the small intestine
specific foods, such as beans and legumes
Bloating that occurs with constipation will be evaluated for signs of other conditions, including:
pelvic floor dysfunction
slowly developing constipation
Observing any patterns related to bloating and eating meals can provide clues to determine if IBS is the cause.
Diarrhea is a key symptom of IBS. It occurs when the muscles of the intestine contract more than necessary. A feeling of muscle cramps may accompany diarrhea. To have a bowel movement, the bowel contracts and relaxes rhythmically. In the case of IBS, however, this rhythm is disrupted. IBS can speed up or slow down the contractions of the intestinal muscles, which means it can cause both constipation and diarrhea at different times. IBS that manifests primarily as diarrhea is called IBS-D. It occurs in about a third of people with IBS. It is more common in men. As with other IBS symptoms, diarrhea may be related to how the brain and gut communicate. Research into the exact reason for this phenomenon continues.
Symptoms indicating something more serious include:
diarrhea that lasts longer than two weeks
unintentional or sudden weight loss
presence of blood in the stool
The doctor will want to know if there is a family history of colon cancer, celiac disease, or inflammatory bowel disease.
Constipation occurs when a person has difficulty passing stool. A person is constipated when they have:
less than three bowel movements in a week
hard, dry, or lumpy stools
difficulty or pain when having a bowel movement
a feeling of incomplete defecation
Constipation can have many causes, including dehydration, a lack of fiber in the diet, and stress. Irritable bowel syndrome can also cause constipation by affecting the way the muscles in the intestine contract.
When a person is constipated, their intestinal muscles do not contract as much as they should. IBS that manifests primarily as constipation and only occasionally with diarrhea is called IBS-C. It can be difficult to distinguish it from chronic idiopathic constipation, which is another functional gastrointestinal disorder.
Constipation is a common condition. If it cannot be relieved with treatment, or if additional signs appear, doctors may want to rule out more serious conditions. These include in particular:
pelvic floor dysfunction
6. FODMAP Sensitivity
People with IBS may be more sensitive to foods high in FODMAPs, which are “fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.” These are types of carbohydrates that can cause inflammation or irritation in the gut. FODMAPs can increase the amount of water that passes through the gut, and bacteria in the gut can cause them to ferment. This can increase intestinal gas.
It is possible to reduce the symptoms of irritable bowel syndrome by avoiding foods high in FODMAPs, including the following:
For many people with IBS, consuming FODMAPs triggers other signs and symptoms of the disease. A 2017 meta-analysis found that consuming a low-FODMAP diet can relieve IBS symptoms.
Up to half of people with IBS experience fatigue or exhaustion. A 2016 study found that fatigue occurs alongside other symptoms of IBS, including bowel symptoms, psychological distress, and impact on quality of life. It has also been found to be more common in young women. A 2018 study found a possible link between dysfunctional serotonin regulation and fatigue in women with IBS. Further research is needed on possible genetic markers of a predisposition to fatigue.
8. Joint pain
People with IBS may be more likely to experience joint pain. Scientists still don’t know why, but it could be due to increased inflammation in the body. A 2019 study found that following a low-FODMAP diet relieved symptoms of joint hypermobility syndrome in people with IBS. The results were strongest for people with IBS-C. A 2017 study found that people with IBS had an increased risk of a type of joint pain called temporomandibular disorder. However, further research is needed to understand this link.
9. Feeling stressed
There is a strong link between IBS and stress. Up to three quarters of people with IBS report feeling stressed. The nervous system controls the gut and also responds to psychological stress. The link between IBS and stress goes both ways. Feeling stressed can make IBS symptoms worse, and the physical symptoms of IBS can cause psychological distress. A 2021 study found that chronic stress and lack of sleep were associated with self-reported irritable bowel syndrome. Shorter-term stress was strongly associated with reports of gastrointestinal symptoms.
10. Brain Fog
Intestinal gas and bloating, which are symptoms of irritable bowel syndrome, are also linked to brain fog. Brain fog, or foggy thinking, describes mental confusion, impaired judgment, and difficulty concentrating. More research is needed to fully understand the link between gut issues and brain fog.
When to talk to a doctor
IBS can be stressful for people experiencing the symptoms. People who experience discomfort or pain should talk to their doctor.
Doctors use the Rome IV criteria to assess possible cases of IBS. To be eligible, a person must present:
– abdominal pain that occurs at least once a week for three months
– abdominal pain that occurs recurrently with bowel movements
– changes in the frequency or consistency of stools.
Worrying symptoms are:
– unintentional weight loss
– nocturnal pain
– blood in stool
– family history of colorectal cancer
IBS is a long-term health condition that can affect a person’s well-being if left untreated. Understanding the signs and symptoms of IBS can help someone who suffers from it get proper help. Many treatment options are available to help a person with IBS manage their condition. Many of these focus on the link between stress and IBS. A doctor may also recommend progressive relaxation counseling and techniques to help ease symptoms.