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Pelvic + Sexual Health

The Top Treatments to Try for Irritable Bowel Syndrome (IBS)

Dec 15, 2022Dr. Ashley Rawlins, PT, DPT3 MIN
a photo of a white toilet that's been turned into a planter, with beautiful green catcus plants growing out onto the wall for a story on irritable bowel syndrome

Whether it's a 24-hour bug, stress-induced diarrhea, or gas and bloating brought on by holiday food or travel, stomach aches are an unavoidable part of life. And, in general, they're nothing to worry about, provided they go away within days and don't turn your life upside down.

But if you regularly battle bowel issues that include abdominal pain, cramping, and urgent bowel movements, you could be dealing with irritable bowel syndrome (IBS) — a chronic condition that can leave you constantly worried that you might not have access to a bathroom when you need one.

Don't let the word "syndrome" fool you, IBS is a legitimate condition (it's not "all in your head") that affects the lower part of your gastrointestinal tract, aka your colon. While there's a lot we still don't know about IBS, there are treatments that can help.

What is Irritable Bowel Syndrome?

Irritable Bowel Syndrome (IBS) is one of several functional bowel disorders, where the GI tract looks normal, but isn't working the way it should. IBS is characterized by symptoms that include abdominal pain/discomfort, diarrhea, and/or constipation.

Depending on your symptoms, your doctor may diagnose you with one of 3 types of IBS:

  • IBS with constipation (IBS-C): when your dominant bowel symptom is constipation
  • IBS with diarrhea (IBS-D): when your dominant bowel symptom is diarrhea
  • IBS mixed (IBS-M): when you have both constipation and diarrhea

What's the Difference Between IBS and IBD?

Irritable bowel disease or IBD is different from IBS, even though it shares many of the same symptoms (including diarrhea, constipation, abdominal pain, and cramps). With IBS, the GI tract appears normal and healthy. With IBD, there's visible swelling or inflammation of the intestines and symptoms tend to be more severe.

IBS doesn't have long-term negative effects on the intestinal tract and is not associated with an increased risk of cancer. IBD, on the other hand, is more damaging and is a known risk factor for colorectal cancer.

What are the Symptoms of IBS?

Symptoms of IBS vary from person to person, but typically include:

  • Bloating
  • Abdominal pain
  • Constipation, diarrhea, or both
  • Mucus in stool
  • Feeling of incomplete bowel emptying

The intensity and impact of symptoms can vary as well, ranging from mild to debilitating in those that are affected. Typically, the symptoms of IBS come and go, but stick around for longer than 6 months. Some people experience IBS for years.

Although not symptoms of IBS, it is common for someone with IBS to have overlapping functional gastrointestinal disorders such as indigestion, or other non-gastrointestinal disorders such as fibromyalgia, chronic fatigue syndrome, TMJ, and chronic pelvic pain.

How is IBS Diagnosed?

There is no specific test to diagnose IBS. Your physician will ask about your symptoms, family and medical history, and may perform tests to rule out any medical conditions such as celiac disease or colon cancer. Often, the Rome Criteria are used to classify someone’s symptoms as IBS and guide decision-making around the best treatment options.

What Causes IBS?

Currently, there is no single, specific cause of IBS. But researchers have found clues to factors that may contribute to IBS, and these clues are leading to new treatments.

For example, disruptions in the brain-gut interaction, psychological factors like stress or other emotions, and physiological factors (altered gastrointestinal motility, etc.) may interact to produce symptoms of IBS.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, there may be important links between IBS and trauma, certain emotional disorders such as depression or anxiety, bacterial infections in the GI tract, small intestinal bacterial overgrowth (SIBO), food sensitivities and/or intolerances, and even possible genetic links. 

What treatments can help me manage IBS?

Since there's no known cause of IBS, treatment is typically focused on relieving the symptoms that you're experiencing. The top treatment options for IBS are:

Diet & Supplements

Evidence is limited, but it can be helpful to adjust your diet to avoid foods that you're sensitive to, and to help improve your stool consistency and gas production. Some research suggests that a low FODMAP diet, avoiding certain sugars and/or supplementing with fiber and probiotics may be helpful for bloating related to bacterial imbalances in the gut. Working with a nutritionist to change up your diet when you have IBS is a great place to start. 

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Medications

Medications are also often prescribed to help manage your predominant bowel symptoms. Most commonly, medications include laxatives and stool softeners for those with constipation, antidiarrheals for those with diarrhea, and antispasmodics for abdominal cramping. Antidepressants may also be prescribed to help manage pain and bowel symptoms. 

Pelvic Floor Physical Therapy

Pelvic floor physical therapy can improve some of the common symptoms of IBS. Manual therapy can be helpful for improving soft tissue restrictions and muscle dysfunction in the abdominal and pelvic areas, and in improving bowel motility. If pelvic floor muscle dysfunction is present, pelvic PT can help to improve muscle function to better support bowel health. Exercises may also be recommended to encourage normal movement, and to help decrease stress, since stress can exacerbate IBS symptoms. 

Psychotherapy

For those with psychological co-morbidities, psychotherapy can be a helpful option for helping to manage stress, and minimize IBS symptoms. Treatment options can include cognitive behavioral therapy, hypnotherapy, and even relaxation training.

If you think you have IBS or if you're sure you do and you haven't yet found a treatment that works, don't give up. Talk to your doctor about the treatments above and what you can try next.

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Dr. Ashley Rawlins, PT, DPT

Dr. Rawlins is a physical therapist at Origin who specializes in the treatment of pelvic floor muscle dysfunctions including pelvic pain, sexual dysfunction, pregnancy related pain, postpartum recovery, and bowel and bladder dysfunction. In addition to being a practicing clinician, she is a passionate educator and author.

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