IBS Part 1: Introduction to a Syndrome

Chances are, if you picked up this book, then you already have a basic understanding about irritable bowel syndrome, or IBS, and how it manifests. Or, at the very least, you have a general idea of what it is because your doctor diagnosed you with IBS, and you’ve taken advantage of the fact that there’s certainly no shortage of websites talking at length about the subject. All that said, let’s look at some basic facts that we know.

There are three general types of irritable bowel syndrome:

  1. IBS-C: Constipation-predominant

  2. IBS-D: Diarrhea-predominant

  3. IBS-M: Mixed constipation and diarrhea

Regardless of type, irritable bowel syndrome has abdominal pain as its principle feature, accompanied by either constipation, diarrhea, or an alternation between one and the other (“mixed”). In order to receive the diagnosis of IBS from your doctor, you won’t have merely one episode of abdominal pain and diarrhea, for example. Rather, this is something that you would have experienced for at least 6 months; the abdominal pain would be experienced for at least three days out of each month, in addition to having two of the following symptoms:

  1. The pain is alleviated when you have a bowel movement;

  2. When the pain began, you started having a bowel movement more or less often than you had previously; and/or

  3. The pain began when you also started seeing a change in the shape and form of the stool passed during bowel movements.

Other symptoms that tend to accompany IBS include abdominal bloating and distention, flatulence and gassiness, noisy bowel sounds, and/or a feeling of not having a complete bowel movement. Onset may also be associated with eating certain foods, insufficient or disturbed sleep (including insomnia), other digestive issues (including diverticulitis, acid reflux, gastroenteritis, etc.), psychological stress, PTSD, anxiety, and depression.

People who suffer from IBS, regardless of type, experience symptoms for an average of 10 years. [elaborate/explore] Studies have shown that, above all else, IBS negatively impacts quality of life. Work productivity, including the ability to concentrate and manage one’s time appropriately, are affected; social well-being, including self-confidence, also tend to decline with prolonged continuation of IBS’s symptoms.

Research has also shown that there is a difference between men and women in terms of how they experience IBS. Statistically, the number of women who go to their doctors for IBS treatment outnumbers men by between 3 and 5 to 1. What is also worth noting is that women tend to experience different IBS types than men, as well as different secondary symptoms. Men, for instance, tend to experience the diarrhea-predominant type, with loose and frequent stools; while women tend to experience the constipation-predominant type, with more bloating, distention, and difficulty having a regular bowel movement. In addition, the menstrual cycle can also have an effect upon the bowels, and the severity of symptoms.

There are other conditions that sometimes accompany IBS (called comorbidities), that also tend to be experienced either only by women, or at a higher rate than in men. These include interstitial cystitis, fibromyalgia, chronic fatigue syndrome, and migraines. This indicates that there is a role that hormones (particularly estrogen) play in visceral pain perception.


Meerveld, Beverley Greenwood-Van, and Anthony C Johnson. “Mechanisms of Stress-induced Visceral Pain.” Journal of neurogastroenterology and motility vol. 24,1 (2018): 7-18. Please visit this website to read more: doi:10.5056/jnm17137

Mulak, Agata et al. “Sex hormones in the modulation of irritable bowel syndrome.” World journal of gastroenterology vol. 20,10 (2014): 2433-48. Please visit this website to read more: doi:10.3748/wjg.v20.i10.2433

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