Frequently Asked Questions

Do you have a question about IBS? Please send your question to us at ibs@iffgd.org. While we cannot provide specific advice, we will try to post questions and answers that generally apply to those with IBS.

What is IBS?

IBS is a group of symptoms. It is a long-term disorder of gastrointestinal (GI) functioning. It usually involves the large and small bowel/intestine (also called the gut). 

What are the symptoms of IBS?

Common IBS symptoms are abdominal pain or discomfort, altered bowel habits (diarrhea and/or constipation), and bloating or a sense of gaseousness.

Abdominal pain or discomfort is the key symptom of IBS. It may feel better with a bowel movement. The pain occurs when stool frequency or consistency changes. Symptoms can come and go, and even change, over time. 

How is IBS diagnosed?

A doctor will diagnosis IBS by asking about your past history and doing a physical examination. In IBS, certain typical symptoms occur. The diagnosis is based on symptoms and in the absence of signs not typical of IBS.

The symptom-based Rome diagnostic criteria for IBS emphasize a “positive diagnosis” rather than exhaustive tests to exclude other diseases.  

Are there tests to confirm irritable bowel syndrome?

There are no tests that confirm the diagnosis of IBS. Laboratory tests, x-rays, and procedures such as colonoscopy are used to rule out other diseases of the bowel. Research is ongoing to find biological markers for IBS.

I have been diagnosed with irritable bowel syndrome (IBS), but tests found nothing wrong. Do I need more tests?

In IBS, tests are expected to find nothing. In the absence of physical findings, the symptom-based Rome diagnostic criteria have been shown to be reliable. In addition, a physical exam and limited diagnostic tests help confirm this diagnosis with a high level of confidence. Extensive testing may be reserved for specific situations. 

What is the Rome Criteria?

The Rome Criteria is a classification system that uses specific symptom patterns to identify functional GI disorders, such as IBS. 

How common is IBS?

Irritable bowel syndrome (IBS) is the most common functional GI disorder. Worldwide prevalence rates range from 9–23%.

What is a “functional” bowel disorder?

A functional bowel disorder occurs when there is a problem with the way the bowels work, not their structure. The body's normal activities are impaired involving:      

• movement of the intestines, 
• sensitivity of the nerves of the intestines, or 
• the way in which the brain controls some of these functions.  

What does “irritable” mean?

Irritable means that the nerve endings in the bowel wall are unusually sensitive.

What causes IBS?

The cause of IBS is not yet completely understood. In IBS there is an altered pattern of muscle contraction in the colon. There is increased sensitivity within the GI tract. Normal regulation of the communication between the brain and the gut becomes altered. This leads to changes in normal bowel function. 

Does lactose intolerance cause IBS?

Lactose (milk sugar) intolerance can cause similar symptoms to IBS. Lactose intolerance and IBS can occur at the same time in a person. But they are separate conditions which are treated differently.

Is IBS a “serious illness”?

For many people, IBS causes symptoms that are mild, which do not interfere with daily activities. For others, IBS may severely compromise their quality of life. 

Is IBS a risk factor for other serious disease?

There are no long-term organic complications associated with IBS. People with IBS have no greater need of preventive checkups than other people.

Will my IBS symptoms resolve?

Each year, approximately 10% of IBS patients get better. This suggests that most people with IBS will eventually get better. But this is not true for every person.

Can the menstrual cycle affect irritable bowel symptoms?

Gut function does appear to be influenced by changes in the level of female hormones. Symptoms like looser stools and cramping can become worse at certain times of the cycle, particularly at the time of menses. It is reported as more intense in women with IBS, than in healthy women without IBS. Sometimes it's hard to tell whether it's coming from the pelvic organs or from the GI tract.

What is the relationship of stress to IBS?

Stress does not cause IBS. It can influence symptoms. Stress is the body’s normal response to stimuli, or stressors. It has been shown to increase motility and sensation of the colon to a greater degree in IBS patients compared to healthy individuals without IBS.
 
Stress may modify signals between the brain and the intestinal tract. Factors that might normally affect the bowel might then affect it more. The stress factors could be physical, dietary, psychologic, or environmental. A person with IBS might eat a regular meal and experience a bowel problem. For them, it's an overreaction of the bowel to the stressors.

Doesn’t everyone experience stress in their life?

Yes, and stressful events can cause a brief change in bowel habits and even abdominal pain for most people. However, this response in people with IBS is more pronounced on a recurrent or chronic basis.

Does diet cause IBS?

Diet does not cause IBS. Nevertheless, dietary factors may worsen symptoms in some persons. In IBS the bowel may over-react to stimuli. Even the act of eating, and not a particular food, may aggravate symptoms at times.

Do certain foods affect symptoms?

This varies from person to person. Certain foods are known to stimulate the gut in general, and in those with IBS eating too much of these might worsen symptoms. Maintaining a food and symptom diary for a minimum of one to two weeks can help identify triggering foods.

My doctor prescribed an antidepressant to treat my IBS. Does that mean I have a psychological disorder?

In IBS low-dose antidepressants are useful, not to treat depression, but to reduce pain and also overall symptoms. Doses are much lower than what is used to treat depression.

Is IBS a Disability?

Depending on the circumstances it is up to each employer, insurer, or governing authority to determine individual disability.

The U.S. Social Security Administration (SSA) defines disability as the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. (SSA Pub. No. 64-039, May 2002) However, the SSA does not recognize irritable bowel syndrome on its Listing of Impairments -- Adults, Section 5, Digestive System.

To our knowledge, the only regulation that specifically recognizes IBS as a disability is the Veterans Affairs, Veterans Education and Benefits Expansion Act of 2001, Public Law 107-103 signed by President Bush on December 27, 2001. Section 202 -- Payment of Compensation for Persian Gulf War Veterans with Certain Chronic Disabilities -- includes this provision: (2) For purposes of this subsection, the term "qualifying chronic disability" means a chronic disability resulting from any of the following (or any combination of any of the following): (B) A medically unexplained chronic multi-symptom illness (such as chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome) that is defined by a cluster of signs or symptoms. The law authorizes funding to expand and increase educational, housing, burial and disability benefits for chronic multi-symptom illnesses to the list of service-connected conditions for Gulf War veterans.