What We Need To Stop Getting Wrong About IBS

Photographed by Alexandra Gavillet.
When you think of irritable bowel syndrome (IBS), you probably imagine frequent trips to the bathroom and — let's just get it out there — diarrhea. But IBS isn't just an unhappy, gassy tummy. In fact, there are three major types of IBS, and each has its own set of quirks.
"IBS is divided into subsets based on whether patients’ abnormal bowel movements usually involve diarrhea, constipation or both," explains Shilpa Ravella, MD, a gastroenterologist at NewYork-Presbyterian and Columbia University Medical Center. To figure out what counts as an "abnormal" poop and to keep track of how often you're having them, she suggests using the Bristol Stool Scale.
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The most common IBS subtype is IBS-D, meaning the patient is primarily experiencing frequent diarrhea, Dr. Ravella says. But there's also IBS-C, which indicates that the patient's main symptom is constipation, and IBS-M (mixed), which means that the patient has both diarrhea and constipation. There's also unclassified IBS, a diagnosis saved for patients with some symptoms of the other types, but not enough to qualify as one of those types. All of those come with abdominal discomfort and gassiness.
In addition to the gastrointestinal symptoms, Dr. Ravella says patients may experience other issues, such as menstrual cycle irregularities and frequent urination. These are often exacerbated by stress and certain foods. So diarrhea is hardly the only symptom of IBS, and, for some, it may not even be a symptom at all.
If you think you may have any form of IBS, it's crucial to check in with your doctor. The symptoms of IBS can sometimes mimic those of more serious illnesses, so the first step is to make sure it's really IBS that you're dealing with. Specifically, IBS can often be confused with inflammatory bowel disease (IBD), in both symptoms and acronyms — and because IBD (unlike IBS) can cause permanent damage to your body if left untreated, it's crucial to get an accurate diagnosis.
From there, treatment depends on how severely your IBS is impacting the quality of your life. If it's relatively mild, Dr. Ravella says she'll start by suggesting diet and lifestyle changes, such as cutting out foods that "are poorly absorbed in the small intestine" and "rapidly fermented by gut bacteria." She also emphasizes the value of staying physically active and finding ways to manage stress, both of which may help ease IBS symptoms. In more extreme cases, she says, doctors recommend fiber supplements to counter constipation and other medications to manage diarrhea.
But any time you're concerned about your bathroom habits it's worth checking in with a professional. Our pooping patterns tend to be more normal than we realize, but if you do need treatment, know that you can get it — and it might be more simple than you'd think.
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