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Coping with irritable bowel syndrome

April 27, 2023 | UCI Health
Young woman holding her stomach because of IBS pain.

"Making well-informed decisions about your care with your doctor is the best way to help control your IBS symptoms and improve your quality of life," says UCI Health gastroenerologist Dr. Christina Ling.


Irritable bowel syndrome is a gastrointestinal disorder that causes recurrent episodes of abdominal pain or discomfort and a change in bowel movements. It affects an estimated 5% to 10% of people globally, including children and adults.

In the United States, people under age 50 are more likely to develop irritable bowel syndrome (IBS) and it affects twice as many women as men.

The duration and frequency of IBS episodes vary, but it is a chronic condition that generally requires long-term management, says IBS specialist Dr. Christina Ling, a gastroenterologist with the UCI Health Inflammatory Bowel Disease Program. She discussed the latest findings and therapies for the disorder with Live Well.

What are the symptoms of IBS?

Abdominal cramping and distension — along with diarrhea, constipation and sometimes both — are common symptoms of IBS.

Typically, there is a disruption in sensory perception of the gut, making the bowels are more sensitive to movement, which can lead to pain. Sometimes the bowels move too often or not enough.

What causes IBS?

There is ongoing research to find the causes of IBS but some contributing factors appear to be:

  • Genetics and a family history of IBS
  • Abnormalities in gut motility and the immune system
  • Alterations in the gut microbiome
  • Minor increases in bowel inflammation
  • The central nervous system’s interpretation of signals coming from the gut

Other factors may include:

  • A history of stressful or difficult life events, such as abuse, in childhood
  • Having a severe infection in your digestive tract

Food poisoning or a bowel infection may also cause IBS. In these cases, most people improve over time and some recover completely.

When it’s more than IBS

If your IBS symptoms are accompanied by bloody stools that are bright red to black in color, there could be something else going on. Other causes for concern are unintentional weight loss, diarrhea that wakes you at night or anemia detected in blood tests.

If you have any of these symptoms, consult your healthcare provider immediately for a full evaluation as these may indicate a more serious problem.

How is IBS treated?

Treatment starts with an effective patient-physician relationship and an understanding of IBS and making diet and lifestyle changes, depending on the symptoms. IBS treatment is based on the severity of the symptoms — mild, moderate and severe. You and your provider may also discuss drug therapy, depending on your dominant bowel symptoms.

Regardless, it is important to understand that IBS symptoms can recur and change over time and that the symptoms, themselves, are not life-threatening.

Diet, lifestyle and IBS

Traditionally, IBS patients have been advised to eat more soluble fiber and to avoid gluten, fatty, fried and spicy foods. But many people have reported eating foods that trigger symptoms sometimes but not always.

That’s why keeping a diary can help identify food and lifestyle factors — like stress and loss of sleep — that may bring on symptoms.

Do complementary health approaches work?

I do recommend certain complementary health approaches for my IBS patients, including:

  • Stress-relief techniques and exercises such as yoga can be helpful.
  • Gut-directed hypnosis and cognitive behavioral therapy may relieve bowel symptoms, anxiety and depression.
  • Peppermint oil may provide short-term relief for bloating, gas and abdominal pain.
  • Certain probiotics have been found to be helpful in some studies, but different types may have different effects.

It’s important to discuss any complementary therapies you use with your physician and learn what studies have shown about their effectiveness. For example, some herbal products can interact with medications you may be taking or aggravate your symptoms.

Making well-informed decisions about your care with your doctor is the best way to help control your IBS symptoms and improve your quality of life.

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