A study in 2010 found that IC patients are nearly eight times more likely to also be diagnosed with Irritable Bowel Syndrome (IBS) than the general population.(1) Being aware of the symptoms of IBS, how it’s diagnosed and treated is important for ICers. The syndrome, which isn’t a disease, has some similarities to IC in that it can be affected by diet and can cause abdominal pain and discomfort. Also like IC, the condition affects more women than men.(2)

Symptoms

The symptoms of IBS vary from one patient to another. But the most common ones are abdominal pain related to bowel movements and changes in your bowel movements (diarrhea, constipation or both). IBS can also cause bloating, feeling like you haven’t finished a bowel movement and whitish mucus in your stool. Females with IBS are more likely to have increased symptoms during their periods.(3)

One of the challenges with IBS in IC patients is that its key symptom is abdominal pain, just like in IC. However, abdominal pain that is often relieved with the passing of a bowel movement or pain or discomfort connected to a change in bowel habits can indicate IBS.(4)

Symptoms of IBS can wax and wane. While it is normal for everyone to feel some sort of bowel-related discomfort sometimes, patients with IBS have those symptoms more often and more intensely than the average population.(4) Patients with IBS can also have a sudden onset urge to have a bowel movement.(5)

Risk Factors

Being female increases your chances of having or developing IBS. About twice as many women have IBS as men.(6) Other risk factors include being young (people in their teens through 40s are most often diagnosed), having a family history of IBS and having high stress and anxiety levels.(6)

Another risk factor for IBS is having food sensitivities. Just like with IC, some foods can irritate the bowels. For IBS this includes dairy, wheat, fructose, sugar substitutes, fatty foods, alcohol and carbonated drinks. While these foods do not cause IBS, they can trigger its symptoms.(6)

Having an acute illness that affects the bowels can also result in the onset of IBS for up to 32% of patients. After having the stomach flu, for example, some patients can take two or thee years for their symptoms of abdominal discomfort and diarrhea to stop.(6)

Diagnosis

IBS has no definitive test for diagnosis. In the past, doctors would often diagnosis IBS after having patients go through a variety of medical tests to rule out any other problem. In more recent years, however, doctors usually base their diagnosis of IBS on a patient’s history and symptoms. There are two different criteria used for diagnosing IBS: the Rome criteria and the Manning criteria.(7)

  • The Rome Criteria include abdominal pain and discomfort that lasts at least once a day in the previous three months. This pain and discomfort is associated with bowel movements, including how often bowel movements happen and a change in stool consistency.
  • The Manning Criteria focus on pain that is alleviated by having a bowel movement, having incomplete bowel movements, finding mucus in the stool and changes in the stool consistency. The more of these symptoms a patient has, the more likely he or she has IBS.

Some additional testing may be needed for some patients. For example, if you have IBS with diarrhea, your doctor will probably test you for celiac disease (which causes a gluten intolerance).(7) Other factors that might require additional testing are being over the age of 50 when symptoms start, weight loss, rectal bleeding, fever, recurrent vomiting or nausea, abdominal pain not relieved by a bowel movement that occurs at night, persistent diarrhea and anemia due to low iron.(7) However, if a patient doesn’t have symptoms such as blood in the stool or fevers, doctors are more confident to rule out other conditions and diagnose IBS.(8)

In general, doctors will usually diagnosis IBS if you have abdominal pain along with pain related to bowel movements, a change in how often you have a bowel movement and/or a change in the way your stools look. Having at least two of those as symptoms along with abdominal pain that have all occurred at least once a week for three months is usually indicative of IBS.(9)

Treatment

IBS doesn’t have a one-size-fits-all treatment. But that doesn’t mean all hope is lost. Both medical and self-help treatments can help with the symptoms of IBS. In order to best find treatments for each patient, IBS is divided into three types based on symptoms: IBS-C (mostly constipation), IBS-D (mostly diarrhea) or IBS-M (constipation and diarrhea).(7)

The FDA has approved four prescription medications specifically for the treatment of IBS.(10)

  • Alosetron hydrochloride (Lotronex) blocks cells in the gastrointestinal tract from releasing serotonin.
  • Eluxadoline (Viberzi) targets the nervous system and reduces the bowel contractions that cause diarrhea.
  • Lubiprostone (Amitiza) activates chloride channels to reduce symptoms of constipation in women 18 and older.
  • Rifaximin (Xifaxan) is for patients with IBS-D. It is an antibiotic taken three times a day for 14 days and doctors speculate it works because it affects the bacteria in the gastrointestinal tract.

There are some other prescription and OTC medications that can help with IBS and its symptoms. Fiber supplements, probiotics, laxatives, anti-depressants and pain medications can help with IBS symptoms.(7)

Self-help is also big part of managing IBS symptoms. Diet, stress and anxiety can contribute to IBS symptoms, so finding ways to manage those are helpful in getting relief. Avoiding gaseous foods (like broccoli, cauliflower and cabbage) and carbonated drinks are a great place to start and see if your symptoms improve.(10)

An elimination diet can help identify food triggers for IBS symptoms. Avoiding those trigger foods, eating plenty of fiber, staying hydrated, exercising and getting good sleep can also help improve IBS symptoms.(7)

The “IC’s Related Conditions” series takes a look at conditions that can go hand-in-hand with IC. Not all patients have all of these conditions, but IC patients are more prone to be diagnosed with these conditions than the general population. (As always, this is not intended as medical advice and is for informational purposes only. Any and all medical questions should be addressed with your doctor.)

References

  1. Nickel JC, et. al. Interstitial Cystitis/Painful Bladder Syndrome and Associated Medical Conditions with an Emphasis on Irritable Bowel Syndrome, Fibromyalgia and Chronic Fatigue Syndrome. J. Urol. Oct. 2010 Volume 184, No. 4.
  2. Herndon J, et. al. Everything You Want to Know About IBS. Healthline. Updated March 17, 2019.
  3. Chang L. Symptoms & Causes of Irritable Bowel Syndrome. National Institute of Diabetes and Digestive and Kidney Diseases. Nov. 2017.
  4. International Foundation for Gastrointestinal Disorders. About IBS: Recognizing Symptoms. Updated July 6, 2016.
  5. Thorpe M. 9 Signs and Symptoms of Irritable Bowel Syndrome. Healthline. Updated July 19, 2019.
  6. Khatri M. Who is at Risk for Irritable Bowel Syndrome? WebMD. March 8, 2020.
  7. Mayo Clinic Staff. Irritable Bowel Syndrome: Diagnosis and Treatment. MayoClinic. March 17, 2018.
  8. International Foundation for Gastrointestinal Disorders. About IBS: Diagnosis of IBS. Updated Nov. 27, 2016.
  9. Chang L. Diagnosis of Irritable Bowel Syndrome. National Institute of Diabetes and Digestive and Kidney Diseases. Nov. 2017.
  10. Nall R. Understand IBS Treatment Expectations. Healthline. Updated May 31, 2019.