Irritable Bowel Syndrome (IBS) is a chronic condition that is often complicated to diagnose and treat. Symptoms can vary between person and circumstance, resulting in many people going undiagnosed for years. It’s estimated that between 25 and 45 million people suffer from IBS, of which 65% are female.
If you’re living with irritable bowel syndrome or experience gastrointestinal issues frequently, this article is for you.
What is Irritable Bowel Syndrome?
IBS is a gastrointestinal (GI) disorder that affects the large intestine and gut. It can impact someone’s quality of life in many ways, as it causes ongoing discomfort and pain associated with the GI tract. Also called functional GI disorder, IBS is when the digestive system is sensitive compared to someone with normal gut health.
IBS causes people to have abnormal bowel functions, like watery stools or hard/dry stools. There are three types of IBS:
IBS-M (mixture of both constipation and diarrhea, sometimes on the same day)
Treatment depends on what type of IBS a person has chronically. Painful or abnormal digestion can be triggered by certain foods, stress levels, medications, or imbalances of bacteria in the gut. There are many studies still needed to fully understand the root cause and treatment for IBS, but diet and lifestyle changes can help minimize symptoms.
“It’s important to not just dismiss bloating as a ‘women’s problem’. But if symptoms don’t go up and down— if bloating stays persistent— there’s a problem.” - Dr. Peter Whorwell, Professor of Medicine and Gastroenterology at University of Manchester, UK
Learn more about IBS from Dr. Peter Whorwell on the Fempower Health podcast.
Why Does IBS Affect Women More than Men?
The International Foundation for Functional Gastrointestinal Disorders (IFFGD) notes that IBS is something that negatively affects women, especially if symptoms worsen during their menstrual cycle. However, it’s important to note that if symptoms are only during the time of a woman's period, it may not be IBS, as IBS is often ongoing.
Why do women have IBS at a larger rate than men? The answer is not so simple.
IBS and Gynecology
Some gynecology-related disorders like endometriosis come with symptoms similar to IBS, and pelvic pain has been found to increase symptoms of IBS in women. But according to the IFFGD, measurable effects of “estrogen, progesterone, and menstrual cycle patterns on bowel motility and pain sensitivity remain under-studied.”
IBS vs Endometriosis
In healthcare, endometriosis is classified on a scale, typically from one to four. Dr. Peter Whorwell, director of the South Manchester Functional Bowel Service, observed that IBS symptoms were more prevalent in endometriosis patients classified on a scale of 1 and 2. In people with endometriosis symptoms on the higher severity scale (3 and 4), abdominal pain was more prevalent.
Do I have IBS or Endo Belly Symptoms?
If you’ve been diagnosed with IBS but your symptoms get more severe during your period every month, you might see a gynecologist for other pelvic pain symptoms.
Notice your symptoms between periods. If IBS symptoms don’t occur except during the week of your period, it’s likely gynecologically related. But if you experience bloating, stomach cramping, digestive issues, or pain all month, it may be irritable bowel syndrome.
IBS and Pain During Sex
Painful sex and a decrease in sex drive are common in women with IBS. Since the gut becomes sensitive and inflamed, penetrative sex can be really uncomfortable. It can also impact a woman’s self-esteem, mood, continence, and feelings of desirability, which make sex less fulfilling.
What are the First Signs of Irritable Bowel Syndrome?
The main signs of IBS include stomach pain, bloating, and abnormal bowel movement patterns. But other early and ongoing symptoms can be:
Fluctuating bowel movements
Fullness in the stomach
Difficulty pooping (IBS-C) or difficulty controlling loose stools (IBS-D)
Symptoms become worse over time
One reason why it’s challenging to diagnose IBS early is that there are so many causes of acute digestive issues. Unless a doctor takes time to observe symptoms and eliminate underlying causes, it’s hard to diagnose until symptoms become chronic.
Irritable Bowel Syndrome Diagnosis and Treatment Options
Because there aren’t any designated tests for IBS yet, diagnosis usually only happens under careful examination by a doctor. Many people visit a list of doctors until they see a gastrointestinal specialist to receive the right diagnosis. They’ll cover your medical history, including symptoms and frequency, plus suggest any additional testing if it’s beneficial for you.
According to the interview with Dr. Whorwell, people may be more prone to IBS when:
There’s IBS in your family
You had tonsilitis as a child or teenager
History of acne
Bloating and abnormal bowel patterns are present
If you do get diagnosed with irritable bowel syndrome, it may take some time to get your symptoms under control.
What is the best treatment for irritable bowel syndrome?
There’s no “one size fits all” for treating IBS, but there are ways to decrease the pain and discomfort that comes with it. Talk to your doctor for the best type of treatment based on your health condition. Treatment usually includes getting healthy, diet, medication, and lifestyle changes.
Research has shown that a low FODMAP diet tends to help many IBS patients. FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. It eliminates certain foods that may trigger IBS symptoms, but it’s not a solution for everyone with IBS.
Since everyone’s digestion is different, there’s no singular “IBS diet” that will cure all cases. For example, fiber helps with constipation in some people but can increase inflammation and bloating in others. It may take time, but working with your doctor can help you find the nutritional needs that best tame your IBS.
Laxatives are commonly given to people with IBS-C to relieve constipation. Other medications that help stop bowel spasms, diarrhea, or stomach pain are sometimes given to IBS patients.
Many medical professionals link IBS with the gut-brain axis. Stress and other strong emotions can sometimes trigger IBS. Doing things that relieve stress and conflict in your life is a helpful step toward managing emotional-related digestive discomfort.
Where to Learn More about IBS
Although IBS is still under-researched, check out the book Take Control of Your IBS to learn more about what is known today.
“We need multidisciplinary teams to be collaborating, but it’s not how our healthcare system is set up.” - Georgie Kovacs