Irritable bowel syndrome - aftercare
IBS; Mucus colitis; IBS-D; IBS-C
Irritable bowel syndrome (IBS) is a disorder that leads to abdominal pain and bowel changes. Your health care provider will talk about things you can do at home to manage your condition.
Are your off again, on again, bathroom habits affecting your daily life? If so, you may have Irritable Bowel Syndrome, or IBS. IBS is a problem that causes abdominal pain, cramping, and changes in your bowel movements. IBS is known as a functional bowel disorder, and is not considered a disease. What I mean by that, is when a doctor passes a colonoscope into the colon to look around, everything may look perfectly normal - but yet, Your colon may not be not be acting normal at all! Symptoms of IBS can range from mild to severe. The main symptoms are diarrhea, constipation, or both. And you will probably experience abdominal pain, bloating, and gas. These symptoms often will temporarily improve after having a bowel movement, and that instant relief of course feels good. But, the important thing to understand is that the root of the problem often isn't here (abdomen), its here (head). IBS is a classic example of your mind affecting your bowels. It's rarely seen in folks who are not stressed, anxious, or depressed. It's often hard to determine why people get IBS. It has been found that IBS is twice as common in women as it is in men, and can develop at any age, but most get it as teenagers or in early adulthood. Diet can also cause IBS. Foods that often cause IBS symptoms are Fatty foods, such as French fries, or any drink containing caffeine like coffee and tea. One great idea is to keep a Food Diary. Write down what you're eating and when, and include the symptoms you experience after you eat. This information can be helpful to your doctor in identifying if you have IBS. The way most doctors diagnose IBS is by gathering your history and ruling out other things like lactose intolerance, gluten intolerance or some sort of bowel infection. Your doctor might recommend a colonoscopy just to make sure the colon looks okay. But remember, there is no specific test to diagnose IBS. So, how do you manage IBS? For some people, symptoms can reduce their ability to work, travel, and attend social events, and some may have to deal with IBS the rest of their life. There are several ways to manage your IBS. Large meals can make your symptoms worse. Try eating 4 to 5 smaller meals per day. Extra Fiber can bulk up your stools to help with diarrhea or help draw in extra water to help with constipation. Laxatives can help with difficult constipation. Drugs like Hyoscyamine help to calm down an overactive digestive tract. Lastly, since stress, depression and anxiety can fuel IBS, work on ways to relax. Perhaps, try exercise, meditation or yoga - and if that doesn't work, consider trying an antidepressant drug to help improve your mood. Oh, and keep in mind that blood in your stool or significant weight loss are not part of IBS, so be sure to let your doctor know if that ever shows up. Remember that the mind and the body are interconnected. You can't expect to feel good here (head), without feeling good down here (abdomen), and vice versa.
What to Expect at Home
Irritable bowel syndrome (IBS) may be a lifelong condition. You may be suffering from cramping and loose stools, diarrhea, constipation, or some combination of these symptoms.
For some people, IBS symptoms may interfere with work, travel, and attending social events. But taking medicines and making lifestyle changes can help you manage your symptoms.
Changes in your diet may be helpful. However, IBS varies from person to person. So the same changes may not work for everyone.
- Keep track of your symptoms and the foods you are eating. This will help you look for a pattern of foods that may make your symptoms worse.
- Avoid foods that cause symptoms. These may include fatty or fried foods, dairy products, caffeine, sodas, alcohol, chocolate, and grains such as wheat, rye, and barley.
- Eat 4 to 5 smaller meals a day, rather than 3 larger ones.
Increase the fiber in your diet to relieve symptoms of constipation. Fiber is found in whole grain breads and cereals, beans, fruits, and vegetables. Since fiber may cause gas, it is best to add these foods to your diet slowly.
No one drug will work for everyone. Some medicines are prescribed specifically for IBS with diarrhea (IBS-D) or IBS with constipation (IBS-C). Medicines your provider may have you try include:
- Antispasmodic medicines that you take before eating to control colon muscle spasms and abdominal cramping
- Antidiarrheal medicines such as loperamide, eluxadoline and alosetron for IBS-D
- Laxatives, such as lubiprostone, linaclotide, plecanatide, bisacodyl, and other ones bought without a prescription for IBS-C
- Antidepressants (tricyclic and selective serotonin reuptake inhibitor [SSRI] classes) to help relieve pain or discomfort
- Rifaximin, an antibiotic that is not absorbed from your intestines
It is very important to follow your provider's instructions when using medicines for IBS. Taking different medicines or not taking medicines the way you have been advised can lead to more problems.
Stress may cause your intestines to be more sensitive and contract more. Many things can cause stress, including:
- Not being able to do activities because of your pain
- Changes or problems at work or at home
- A busy schedule
- Spending too much time alone
- Having other medical problems
A first step toward reducing your stress is to figure out what makes you feel stressed.
- Look at the things in your life that cause you the most worry.
- Keep a diary of the experiences and thoughts that seem to be related to your anxiety and see if you can make changes to these situations.
- Reach out to other people.
- Find someone you trust (such as a friend, family member, neighbor, or clergy member) who will listen to you. Often, just talking to someone helps relieve anxiety and stress.
When to Call the Doctor
Call your provider if:
- You develop a fever
- You have gastrointestinal bleeding
- You have bad pain that does not go away
- You lose over 5 to 10 pounds (2 to 4.5 kilograms) when you are not trying to lose weight
Ford AC, Talley NJ. Irritable bowel syndrome. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier ; 2021:chap 122.
Mayer EA. Functional gastrointestinal disorders: irritable bowel syndrome, dyspepsia, esophageal chest pain, and heartburn. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier ; 2020:chap 128.
Waller DG. Constipation, diarrhoea and irritable bowel syndrome. In: Waller DG, ed. Medical Pharmacology and Therapeutics. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 35.
Last reviewed on: 5/3/2023
Reviewed by: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.