Irritable Bowel Syndrome (IBS)

Young women's version of this guide
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Approximately 8% of middle school students and 17% of high school students have symptoms of IBS which is similar to the amount of adults who are affected.

What is Irritable Bowel Syndrome (IBS)?

Irritable bowel syndrome is a condition that involves the muscles in the intestines. Normally these muscles tighten and release in a regular pattern to move waste through the intestines. However with IBS it is believed that the contractions may be too fast (causing diarrhea), slow (causing constipation), or go back and forth between both. That’s why it is called “irritable” bowel syndrome.

Symptoms may include:

  • Stomach pain
  • Constipation
  • Loose stools (diarrhea)
  • Both constipation & loose stools
  • Change in bowel habits
  • Bloating
  • Gas

What causes IBS?

Scientists don’t know the exact cause of IBS. Possible causes are thought to be:

  • Abnormal movement/contractions of the colon and intestines
  • Extra sensitive organs in the abdominal cavity
  • Feelings of anxiety (or nervousness), stress, and anger
  • A germ or infection
  • Sensitivity or allergy to certain food

How is IBS diagnosed?

IBS is diagnosed by a health care provider based on a person’s symptoms, their medical history, physical exam, blood work, and sometimes with the help of other diagnostic tests. These tests and other minor procedures may be done to make sure the symptoms are not caused by another medical problem. To be diagnosed with IBS, a person will typically have had certain symptoms such as stomach pain/discomfort for at least three days a month for at least 3 months in a row, along with a change or look of their BM and how often they have them.

Tests may include:

  • Blood test(s)- to check for infection and inflammation or other cause of symptoms such as celiac disease
  • Stool sample- to check for parasite infections and hidden blood
  • Lactose breath hydrogen test- to find out if you have trouble digesting milk products
  • Abdominal x-ray- to check internal organs
  • Abdominal ultrasound- to check internal organs using sound ways
  • Endoscopy- this is rarely done to look at the inside of part of the digestive tract

How is IBS treated?

The goal of the treatment is to decrease pain and to make the digestive process more normal. Treatment is started only after the diagnosis is made by a health care provider and can vary based on age, overall health, medical history, and how bad the symptoms (such as gas, bloating, diarrhea, constipation, stomach pain) are. There is no “cure” for IBS at this time but there are effective treatments to manage symptoms. Management of IBS symptoms often includes a combination of the following:

  • Meeting with a Registered Dietitian
  • Limiting milk and milk products (if you are lactose intolerant)
  • Finding positive ways to deal with stress
  • Complementary therapies such as biofeedback, acupuncture, and yoga
  • Medicine (if necessary)
  • Counseling to help lower stress

How can I find out if the foods I am eating are causing me to have IBS symptoms or making my IBS symptoms worse?

If you think that your IBS symptoms are related to different foods you are eating, the best way to find out more is to work with a Registered Dietitian. He/she can explain about certain diets that have been studied that improve symptoms of IBS. You can get a better idea if the foods you are eating are affecting your symptoms by writing down what you eat and the symptoms that you have in a “food diary” (see sample below).

When keeping a food diary, try to pay attention to the following things:

  • Foods that do not cause symptoms within 3 days of eating them and at least 3 times after eating them are probably not the cause of your symptoms.
  • If there’s a food that you think causes IBS symptoms most of the time, try to stop eating it for at least 2 weeks, and then try small amounts slowly to see if you notice a change in your symptoms.
  • If there are foods that you know are causing symptoms, don’t eat them for 3-6 months. After that, try them again and watch to see if symptoms come back or become worse.
Sample Food Diary
MealFood & DrinkSymptomsSupplements
BreakfastCheerios®, milk, banana, eggsGas, bloatingVitamin D
SnackApplesauce
LunchMacaroni & CheeseGas, bloating, diarrhea
SnackApple
DinnerChicken, rice, carrots

Download a blank food diary sheet here. Make a copy for each day, and track what you ate and whether or not you had any symptoms.

What has been helpful to others with IBS?

In general, people react to foods differently but many people with IBS find that certain things tend to bring on symptoms or make them worse.

Try avoiding or limiting:

  • Large meals (eat smaller more frequent meals instead)
  • Dairy foods and foods that contain lactose
  • Artificial sweeteners like sorbitol, mannitol, xylitol which are mainly found in sugarless gum and candy
  • High fructose corn syrup sources such as candy, sweetened cereals, and soda as well as other sources which can be found by checking the ingredients section of food labels
  • Caffeine
  • Foods that are gas-producing (beans, peas, broccoli, cabbage, and bran)
  • Foods high in insoluble fiber (wheat bran, corn bran, and ground flax seed)

Try adding:

Some people have found that increasing their intake of foods or supplements that are high in soluble fiber by 2-3g/day can be helpful with symptoms. In comparison to insoluble fiber which adds bulk to the stool and speeds up digestion, soluble fiber turns into a gel and slows down digestion. Soluble fiber supplements include Ispaghula and psyllium. Foods that are good sources of soluble fiber include oats, oat bran, legumes, and barley. Check the chart below for sources of soluble fiber.

Good sources of soluble fiber:

Cereal Grains

  • Barley
  • Oatmeal
  • Oatbran

Seeds

  • Psyllium seeds, ground

Fruit

  • Apple
  • Banana
  • Blackberries
  • Citrus fruit (orange, grapefruit)
  • Nectarines
  • Peaches
  • Pears
  • Plums
  • Prunes

Legumes

  • Black beans
  • Kidney beans
  • Lima beans
  • Navy beans
  • Northern beans
  • Pinto beans
  • Lentils (yellow, green, orange)
  • Chickpeas
  • Black eyed peas

Vegetables

  • Broccoli
  • Brussel sprouts
  • Carrots

Is IBS the same as inflammatory bowel disease (IBD)?

No. IBD is an ongoing disease that is caused by the immune system fighting the GI tract. It includes two different diseases, ulcerative colitis and Crohn’s disease.

Signs that you might have IBD include:

  • Bloody diarrhea
  • Abdominal pains (in your stomach) that last a long time
  • Long-term watery diarrhea
  • Fevers for no reason
  • Joint swelling
  • Poor growth or a delay in puberty
  • Anal infections

IBS is different than IBD. With IBS the intestine is not inflamed and it almost never causes rectal bleeding.

What other ways can IBS affect me?

Irregular bowel habits can be frustrating and lead to emotional stress. Luckily there are healthy ways to lower your stress level, such as taking a proactive role in your treatment plan–keeping track of what you eat so you can figure out what foods seem to trigger symptoms, doing activities that you enjoy and that help you to de-stress, and talking with a friend, parents, and/or counselor about your feelings.

Although IBS symptoms can be uncomfortable and stressful, most teens do not develop chronic health problems. With the help of your health care provider and a registered dietitian, you can learn ways to make changes to your diet that can improve, or even get rid of, some or all of your symptoms.