UNC Health Talk

Could It Be Irritable Bowel Syndrome?

Does your stomach cramp when you’re faced with a stressful situation? Do you find yourself in the bathroom multiple times a day, because it feels like you need to have a bowel movement?  Are you afraid to go out for a long hike or a car ride where you won’t have easy access to a bathroom? You could have irritable bowel syndrome.

Irritable bowel syndrome, or IBS, is a chronic condition marked by abdominal pain, bloating, gas, and frequent bouts of diarrhea or constipation—or both. The good news is that IBS doesn’t damage the digestive tract, as some gastrointestinal disorders can. It also doesn’t raise the risk for stomach or colon cancer. But IBS still causes great distress and can limit a person’s ability to live life to the fullest.

“It’s estimated that 10 to 15 percent of people are living with IBS, but only 5 to 7 percent are diagnosed with the condition,” says UNC Rex Digestive Healthcare gastroenterologist Silpa Yalamanchili, MD. “There are a lot of people suffering in silence.”

If you have IBS, you can live life without keeping an eye out for the bathroom at all times. Read on to learn how.

Symptoms of IBS

People with irritable bowel syndrome usually have one or more of the following symptoms:

  • Abdominal pain, typically associated with constipation, bloating and nausea
  • Changes in consistency or frequency of bowel movements
  • Fatigue and changes in energy level
  • Back pain
  • Low sex drive
  • Pain or difficulty urinating
  • Pain before defecating

If you have unexplained weight loss or blood in your stool, it’s important to see your doctor right away to rule out more serious conditions such as inflammatory bowel disease, diverticulitis or colon cancer.

Who gets IBS?

“IBS is twice as common in women as in men,” Dr. Yalamanchili says, “which may be due to differences in gut sensation between the two sexes. We think that IBS is caused by alterations in the nerves and muscles of the gut and is worsened by stress and anxiety.”

It typically affects adults under 50 years old. Children can have IBS, but it’s less common. It may be harder to diagnose IBS in children because “it’s difficult to tease out the symptoms because they have trouble identifying what’s going on,” Dr. Yalamanchili says.

What to Do If You Think You Might Have IBS

If your symptoms are interfering with your daily life, it’s time to see a doctor. Ask yourself if you are missing out on things because of your need to be a near a bathroom, or if pain is keeping you from participating in activities and time with family and friends. And again, if you have blood in your stool or unexplained weight loss, call your doctor right away.

Dr. Yalamanchili recommends starting with your primary care provider for digestive problems. Your doctor may recommend simple changes to help reduce symptoms of IBS, including adding more fiber and water to your diet or using a laxative and reducing stress where possible.

If those interventions aren’t working after a month or two, it may be time to see a gastroenterologist. The gastroenterologist can recommend a variety of tests that can help identify or rule out other disorders, such as inflammatory bowel disease, celiac disease or thyroid problems.

“IBS is not a dangerous condition. It does not lead to a shorter life span. It is not associated with colorectal cancer or inflammatory bowel disease.” Dr. Yalamanchili says. “The main issue is that it causes significant impairment in quality of life, and that’s what we want to improve.”

5 Treatments for Irritable Bowel Syndrome

Gastroenterologists recommend the following to ease symptoms of IBS, Dr. Yalamanchili says:

  1. Stress reduction. “The main thing you can do is decrease stress levels. There is a strong correlation with stress and anxiety and IBS,” Dr. Yalamanchili says.
  2. Regular exercise and adequate sleep.
  3. Eating a diet high in fiber-rich foods and plenty of water.
  4. The Low-FODMAP diet can be followed temporarily, with the patient reintroducing certain food groups over time. The Low-FODMAP diet reduces gas-producing foods such as dairy, beans and foods high in gluten.
  5. Prescription medication. Physicians may prescribe medications that combat specific symptoms, such as an antidiarrheal or anti-spasm medications for cramps. Sometimes doctors prescribe antidepressants for people with IBS to combat the anxiety that can result from IBS and then exacerbate it.

Talking About IBS with Your Doctor

When you’re ready to talk with your doctor about digestive issues that might be IBS, try not to be nervous. “If there’s one place you can feel safe talking about your bowel movements, it’s your gastroenterologist’s office,” Dr. Yalamanchili says.

Be prepared to talk about the following:

  • Frequency and consistency of stool. If you are feeling shy or embarrassed to talk in detail about this, Dr. Yalamanchili recommends reviewing the Bristol Stool Scale and classifying your bowel movements using Types 1-7. Types 1 and 2 indicate constipation, 3 and 4 are healthy stools, and 5, 6, and 7 are like diarrhea.
  • The type of pain you’re having. For example, share if you experience nausea, cramping or other pain before or during urination or defecation.
  • A food diary. Sometimes this can be helpful to identify food groups that are causing flare-ups.
  • Your medications. Some medications can have side effects that could contribute to constipation or diarrhea.

“When I see patients with IBS I always tell them, I’m here to work with you. I want to get to the bottom of this and get you feeling better,” Dr. Yalamanchili says. “We’re going to work together for as long as it takes to find a regimen that gets you feeling your best so you can go on and live your life.”


If you have digestive concerns, talk to your doctor. Need a doctor? Find one near you.