7 Sneaky Signs You Have IBS, According to Gut Experts

Most people have experienced gut discomfort sometimes, but how do you know if you have a specific condition, such as irritable bowel syndrome (IBS)? Statistics show that about 10% to 15% of Americans have IBS, and almost twice as many are women as opposed to men. So if you find yourself needing to run to the restroom more often than you want, or you feel pain when you “go,” it could be IBS.

So, what exactly is IBS? No one knows what causes it, but it’s a large intestine issue that results in abdominal pain, cramping, bloating and bowel movement changes. IBS can be painful and frustrating to live with, but the good news is that it doesn’t cause any harm to your body. And more good news: Many people find relief from IBS symptoms by making dietary changes and focusing on stress management.

Brisas Truncali, M.D., a gastroenterologist in Farmington, CT, says, “IBS is a gastrointestinal disorder of gut-brain interaction that can cause significant symptoms and negatively impact the quality of life. It’s a complex interplay between our mind, GI tract, and the associated neurohormones and microbiome (GI tract bacteria/fungi).” She says that to be diagnosed with IBS, patients usually have symptoms at least once per week for three months or more. 

Additionally, Tami Best, RD, a registered dietitian with Top Nutrition Coaching, says, “Your doctor will diagnose you with irritable bowel syndrome, generally after ruling out other causes of symptoms you may be experiencing.” There are several symptoms of IBS, and everyone can experience different ones. Yet, some of the most common IBS symptoms include the following.

1. Frequent Abdominal Pain

If your gut feels achy or crampy but improves after a bowel movement, it could be IBS. Other types of IBS-related abdominal pain can be described as gas-like, sharp or dull pain. While everyone has gas pains or an ache here and there, the key here is that the pain is related to bowel movements. Truncali says, “Symptoms often include abdominal pain, with associated change in bowel habits, such as diarrhea or constipation. Pain most often gets better after a bowel movement is passed.”

2. Bloating and Frequent Gas

Jonathan Scott, D.O., a gastroenterologist in Denver, CO, says, “Patients also often describe pain, bloating and increased flatulence as part of their symptoms.” Bloating is also called distension; it feels like your midsection is full, tight or swollen. While passing gas is a normal body function that everyone does, if it feels like it’s too frequent—and especially if you experience other gut symptoms, it’s likely IBS.

3. Changes in Bowel Movements

Along with abdominal pain, a change in bowel habits is the hallmark of IBS. However, not everyone experiences the same changes. Some people feel an urgency to rush to the restroom. Others may experience an incomplete evacuation—feeling like they need to go but can’t. And others may feel that stool is difficult to pass or see a clear or white mucus with their poop.

4. Nausea and Heartburn 

Research has found that patients who live with IBS often have nausea and gastroesophageal reflux disease (GERD), the more severe form of heartburn. Luckily, many people alleviate their heartburn and nausea through dietary changes. 

5. Constipation or Diarrhea (or Both)

Some people with IBS tend to experience constipation, and others have frequent diarrhea. But some people go back and forth between the two. While having either of these occasionally is normal, folks with a healthy gut don’t experience either too often. If you do, it’s time to talk to your healthcare provider about this so they can help you identify if it’s IBS. “These symptoms, while not life-threatening, can cause significant infirmity to the patients that experience it,” says Scott.  

6. Symptoms Triggered by Stress and Certain Foods

If your symptoms worsen during times of stress or after eating certain foods, it might be IBS. “Signs that you might have IBS are that you experience pain associated with a change in bowel habits when stressed or when eating certain foods/drinks. The pain from IBS most often improves after the bowel movement has passed,” says Truncali. 

7. Symptoms Worsen With Period

During your period, you may experience digestive symptoms such as abdominal pain and bloating. Additionally, people with premenstrual syndrome (PMS) can experience constipation or diarrhea. If you feel like your gut issues feel more intense during this time, it could be another IBS symptom.

IBS Subtypes

Doctors usually break IBS down into four major subtypes. Some patients tend to have constipation, others diarrhea, and still others experience both. IBS can be difficult to classify because, understandably, people try to improve symptoms by changing their diet or trying medications, which makes it more challenging to categorize the subtype correctly. The main four subtypes of IBS include: 

• IBS-C: IBS with constipation
• IBS-D: IBS with diarrhea
• IBS-M: IBS with mixed symptoms, both constipation and diarrhea
• IBS-U: Called unclassified, this means you have IBS but don’t fit the descriptions of the other types

Factors that Trigger IBS Symptoms

Triggers and symptoms differ for everyone, but there are a few hard and fast rules. “IBS flares can be caused by a diverse group of things. While every person has their own set of triggers, there are a few common inciting triggers for IBS flares. Low-fiber foods, GI infections and strong emotional stressors have all been associated with worsening IBS symptoms,” says Scott.

Stress doesn’t cause IBS, but it certainly triggers it. “Creating the conditions for individuals to successfully manage stress is necessary for long-term management and alleviation of IBS symptoms. There is a bi-directional pathway that exists between the gut and the brain,” says Best. Studies show that stress can lead to changes in the gut microbiome, a condition called dysbiosis. Stress also leads to low-grade inflammation in your gut lining, increasing your IBS symptoms. 

Another trigger? Some types of food. “One category of foods that seem to make IBS worse are fermentable carbohydrates. Collectively, they are known as FODMAPs: Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polyols. There are many foods that are high in FODMAPs,” adds Best. FODMAPS are carbs that are a little more difficult to digest, so reducing the amount of high-FODMAP foods in your diet may be helpful. High-FODMAP foods include:

• Fruit: apples, apricots, blackberries, mango, nectarines, pears, watermelon, cherries, and plums
• Vegetables: onions, cauliflower, garlic, mushrooms, lentils, asparagus, artichokes, cabbage, beans and sugar snap or snow peas
• Dairy: milk, yogurt, custard, ice cream, soft cheeses
• Sweet foods: honey, high-fructose corn syrup, candy, gum, and sweeteners ending with “-ol” such as xylitol, maltitol, mannitol, and sorbitol
• Grains: wheat and rye products

Tips to Manage Your Symptoms

Trying a low-FODMAP diet may be helpful, but Scott recommends against trying it on your own. “The FODMAP diet has been shown to have particular benefits for many patients and could be considered if you think that you are having symptoms of IBS. This diet, however, is not a permanent solution and should be done under the care of a dietitian or healthcare provider to ensure consistent long-term benefits,” notes Scott. He also recommends the Mediterranean diet and a high-fiber diet. The Mediterranean diet encourages you to eat foods that are packed with anti-inflammatory benefits and antioxidants that help support your gut health. Fiber, specifically soluble fiber, helps make stool softer and easier to pass.

Best also recommends asking for help. “Because IBS is so individualized, a gastrointestinal dietitian can work with you on an elimination protocol to determine which FODMAP foods trigger your IBS symptoms. The dietitian will help you to follow a three- to six-week elimination protocol. They will then work with you to reintroduce or challenge one FODMAP group at a time to determine a short list of foods that aggravate IBS symptoms,” adds Best.

Ease your tummy troubles with foods that Best recommends. “Foods that can be soothing to IBS symptoms are peppermint and fennel. These can be enjoyed in an herbal tea to soothe frustrating symptoms,” she says. Other foods that are great for managing IBS include salmon, bell peppers, eggs, avocado and more.

For a fresh meal using fennel, try our Fennel, Radish & Cucumber Salad. And this Sheet-Pan Roasted Salmon & Vegetables makes a delicious and quick low-FODMAP. 

The Bottom Line

IBS can be frustrating to live with and, in some cases, interfere with your quality of life. If you wonder if you have IBS, reaching out to a gastroenterologist, a registered dietitian or your primary healthcare provider is a good first step. Stress management and a few dietary changes can make a big difference and help you feel better.