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Irritable Bowel Syndrome: Causes and Management Options

Evidence-based Reviewed Article

An image of a woman holding her stomachOn a global level, statistics indicate that 5%-10% of the population has irritable bowel syndrome (IBS). In the United States, it’s estimated that IBS affects up to about 15% of people, with women being more likely to suffer from the condition. While the exact cause is unknown, various symptoms may emerge that connect to the interaction between the gut, brain, and nervous system. IBS can impact people in varying degrees, from causing mild inconveniences to severe debilitation. This complex condition is unpredictable and symptoms vary from person to person. Addressing IBS may be challenging, but it often depends on finding the right approach for you as an individual. Read on to learn more about types, symptoms, causes, and management options for irritable bowel syndrome.

What Is Irritable Bowel Syndrome (IBS)?

Irritable bowel syndrome (IBS) is a disorder characterized by a group of symptoms that affect your digestive tract. These include abdominal pain or discomfort, and changes in bowel activity, from chronic or recurrent diarrhea, to constipation, or both. This gastrointestinal disease also goes by other names, including spastic colon, irritable colon, mucous colitis, and spastic colitis. It’s common and uncomfortable. However, IBS won’t lead to tissue damage in your GI (gastrointestinal) tract or increase your risk for colon cancer.

However, it’s a chronic condition that many people manage by modifying their daily routines, making adjustments to their diets and medications, and trying behavioral therapy. Many people with IBS also have other chronic pain conditions that increase the risk of IBS, including fibromyalgia, chronic fatigue syndrome, and chronic pelvic pain.

Types of Irritable Bowel Syndrome (IBS)

IBS can be categorized based on the appearance of your stools (poop) on the days when you’re experiencing symptoms. People with IBS might experience either normal bowel movements or abnormal ones on any given day. The days you have abnormal bowel movements define the types of IBS you have.

  • IBS with constipation (IBS-C): This occurs when your bowel movements are lumpy and hard.
  • IBS with diarrhea (IBS-D): This occurs when you have bowel movements that are loose and watery.
  • IBS with mixed bowel habits (IBS-M): This occurs when you have both hard and lumpy and loose and watery bowel movements.

The differences between the bowel movements are important since certain approaches to alleviating the condition are only effective for specific kinds of irritable bowel syndrome (IBS).

Symptoms of IBS

Your bathroom habits can change with irritable bowel syndrome, and you may have pain in your gut. You can experience IBS symptoms frequently, or you may have them primarily during flare-ups. Symptoms can come and go, and you may also have normal bowel movements at times as well.

While irritable bowel syndrome symptoms can vary, the most common ones include:

  • Abdominal pain, cramps, or bloating, typically related to the urge to have a bowel movement
  • Changes in the appearance of your bowel movements (e.g. may look whitish- a sign of mucus)
  • Diarrhea, constipation, or alternating between the two
  • Changes in the frequency of bowel movements
  • Excess gas and bloating
  • A feeling of incomplete evacuation of the bowels
  • Increased mucus in the stool

Causes of Irritable Bowel Syndrome

Researchers are unsure of the exact causes of irritable bowel syndrome.  However, there are several possibilities.

Brain-Gut Connection

an image of a doctor pointing at a stomach model with a penResearchers classify IBS as a neurogastrointestinal disorder. They also refer to it as a disorder of gut-brain interaction, where you experience issues with how your gut and brain coordinate to help your digestive system work. If your body has communication issues between your brain and gut, a few things could happen. This can cause:

  • Dysmotility: This occurs when your GI muscles cannot transport food through your GI tract properly. In the case of someone with irritable bowel syndrome, the muscles of your large intestine contract more, which causes both cramps and pain.
  • Visceral hypersensitivity: With this issue, the nerves in your GI tract may become extra-sensitive. A disruption of the autonomic nervous system (via brain-mediated activity) can contribute to IBS symptoms by disrupting visceral sensations. In the instance of poorly coordinated signals between the brain and your intestines, your body can overreact to changes that normally occur in the digestive process. For IBS patients, their pain tolerance is lower than people without the condition. As such, if you have IBS, your digestive tract may have high sensitivity to abdominal pain or discomfort.

Gut Bacteria

Based on research findings, irritable bowel syndrome may result from the alteration of bacteria in the GI tract, which contributes to certain symptoms of the condition. Based on an article published in the Journal of Clinical Medicine, dysregulation of communication between the brain and gut in IBS is linked to alterations in gut microbiome composition. However, the type of bacteria and the level of bacteria may vary from person to person with IBS.

Severe Infections

There is also an indication that IBS can appear in some people after a severe infection that affects the GI tract. According to an article in the journal Gastroenterology Clinics of North America, acute infectious gastroenteritis (bacterial, viral, and protozoal) has been shown to have the potential to significantly increase your risk of developing IBS. This suggests that these infections could potentially play a role in the development of IBS.

Childhood Stress

IBS may also appear in people who experienced severe stressors in childhood, such as physical, sexual, or emotional abuse. According to a 2019 study, the link between traumatic psychological events in childhood and IBS appears to stem from the triggering of abnormal signaling from the protein, nerve growth factor, which starts a series of changes that eventually lead to the development of IBS.

Chronic Stress and Inflammation

Chronic stress and related dysregulations in the body can also be connected to IBS. Adrenal Fatigue is a condition where the body is unable to keep up with long-term stress, resulting in various nonspecific symptoms such as tiredness, sleep disturbances, anxiousness, and weight gain. The inflammation circuit of the NeuroEndoMetabolic (NEM) stress response is the first to be affected by AFS. Chronic inflammation can cause symptoms like IBS that can lead to further inflammation. Having AFS can thus make managing IBS challenging. This can further lead to imbalances in the inflammation circuit.

Food Poisoning

This is one of the most common causes of IBS. Post-infectious irritable bowel syndrome (PI-IBS) is a type of IBS that results from food poisoning. Some of the risk factors for developing IBS after food poisoning include the severity of food poisoning, if you are female, if you had to take antibiotics, if you felt sick for over seven days, and if you experienced psychological factors like anxiety.

Irritable Bowel Syndrome Identification and Testing

An image of a woman holding her stomach while being checked by a doctorIBS is a diagnosis of exclusion, meaning other potential causes must be ruled out.

Because IBS can stem from food poisoning in your history, the first step is considering your medical history, a physical exam by your healthcare provider, and conducting tests to determine whether other health conditions may be responsible for your symptoms. When other health conditions are ruled out as possible causes of your symptoms, your healthcare provider may use certain criteria to determine if you in fact have IBS.

One such criterion is the Manning Criteria, which looks at your pain levels with stool excretion, incomplete bowel movements, your stool consistency, and the mucus content in your stool.

Another criterion is the Rome criteria that focuses on the level of abdominal pain that you experience and its duration. It should be for no less than once a week for three months. It also determines if the pain you experience has any connection to the defecation process and if there is a change in stool consistency.

Depending on the symptoms you exhibit, you may have one of the three types of IBS mentioned earlier.


Your healthcare provider may request certain lab tests to exclude other conditions that could be the source of your symptoms, like an infection or food intolerance. Comprehensive stool tests could help get to the root cause of your symptoms, whether it’s parasites, yeast, microbiome, leaky gut, enzymes, fecal fat, etc. Food sensitivity tests could rule out particular food groups as the reason for your symptoms.

With a blood test, your doctor can rule out conditions such as digestive disease, anemia, and celiac disease. Meanwhile, a colonoscopy can rule out cancer, colitis, and inflammatory bowel disease. Additionally, hydrogen breath tests can check for an overgrowth of bacteria in your gut, while imaging tests can rule out conditions related to inflammation or abnormal growths in your GI tract. Still, not every person needs the same tests.

How to Manage Irritable Bowel Syndrome

The is no current IBS therapy that offers a permanent fix for the condition. Instead, emphasis is placed on reducing symptoms. Common approaches to managing irritable bowel syndrome include:

Meal Changes

Adhere to a balanced, nutrient-rich diet. Furthermore, limit dairy products like milk and cheese and foods that can make you gassy, like beans, brussels sprouts, and cabbage. Opt for a gluten-free diet if you are sensitive to gluten. Some people do well on a low-FODMAP diet, focusing on foods that are low in certain carbohydrates that can be difficult to digest. This diet includes changes like opting for low-fructose fruits like banana, blueberry, and citrus rather than apples and pears; and focusing on veggies like carrots, spinach, and squash, while limiting legumes and cruciferous veggies. However, it's best to talk to your doctor before making any changes.

Exercise and Stress Relief

It may help to make certain changes to your daily activities. These include exercising regularly for 30 minutes a day. Those who deal with IBS caused by stress may also benefit from relaxation techniques like yoga, meditation, and cognitive behavioral therapy (CBT) to de-stress and calm an overtaxed nervous system. Also, get enough sleep by aiming for at least seven hours of quality sleep nightly.


An image of a prescription with Irritable Bowel Syndrome written and medicines on itThe medications used to address irritable bowel syndrome vary based on the symptoms you experience. Some medications that are specifically used to address IBS include dicyclomine (Bentyl®), hyosycamine (Levsin®), lubiprostone (Amitiza®), linaclotide (Linzess®), plecanatide (Trulance®), and rifaximin (Xifaxan®). However, note that it is best to avoid frequent use of motility drugs that contain opiates because they may cause permanent damage to the lining of your gut. Additionally, don’t do enemas frequently since long-term use may disrupt gut function.


Adding certain supplements to your routine may help to address symptoms of digestive system.

Other combination supplements to consider include:

  • Adrenal Gut Restore combines licorice and aloe to repair mucosal barrier of gut and a harmonious digestive environment.
  • GlutaMax is a glutamine-derived compound that provides brain fuel and enhances mental function, and alleviates fatigue.
  • Pro-B is enriched with Lactobacillus acidophilus, a probiotic that boosts the "good bacteria" for optimal digestion and nutrient absorption in the gut.

However, before you add any supplements to your diet, talk to your doctor, especially if you have AFS.

Find the Root Cause

Address the root cause, whether it be bacterial, fungal, dysbiosis, parasites, or candida. Do a comprehensive stool test if the above lifestyle measures aren't helping and find a provider to be able to help you get to the root of your bowel issues.

Overcoming Irritable Bowel Movement: The Takeaway

Symptoms of irritable bowel syndrome often differ from person to person. The cause of IBS varies, but a common cause is food poisoning in the past. Other causes include gut bacteria imbalances, food intolerance, infection, visceral hypersensitivity, and dysmotility. If you know your triggers, you can better understand how to avoid flare-ups and get your gut symptoms under control.

Steps that you can take to improve your symptoms include diet changes, regular exercise, reducing stress, and certain medications and supplements. Making simple lifestyle changes can help improve your overall health and reduce your stress levels. This can be key in helping to manage your IBS symptoms.

If you seek further guidance in navigating these steps or require personalized strategies tailored to your unique situation, don't hesitate to give us a call at +1 (626) 571-1234. Our coaching team is here to offer invaluable support and insights, empowering you on your journey to managing IBS effectively.

Licorice and Aloe to repair mucosal barrier of gut.

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Berumen, Antonio, et al. "Post-Infection Irritable Bowel Syndrome." Gastroenterology Clinics of North America, vol. 50, no. 2, 2021, pp. 445-461.

Shaikh, Sofia D., et al. "Irritable Bowel Syndrome and the Gut Microbiome: A Comprehensive Review." Journal of Clinical Medicine, vol. 12, no. 7, 2023, p. 2558.

Wong, H. L. X., et al. "Early Life Stress Disrupts Intestinal Homeostasis via NGF-TrkA Signaling." Nature Communications, vol. 10, article 1745, 2019.

Dr. Lam’s Key Question

Irritable bowel syndrome triggers include severe infections, food intolerance, gut bacteria imbalances, visceral hypersensitivity, and dysmotility. You can help manage symptoms of the condition with certain lifestyle changes, supplements, medications, regular exercise, and a balanced diet focusing on low FODMAP foods.

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