What Is Irritable Bowel Syndrome?

IBS is a functional gastrointestinal disorder, meaning it affects the way the gut works rather than causing visible structural damage to the digestive tract. It is characterized by a group of symptoms that occur together and includes abdominal pain or cramping, changes in bowel habits such as diarrhea, constipation, or alternating between the two, and bloating or excess gas.

IBS is classified into three main subtypes based on the predominant bowel pattern:

• IBS-D (diarrhea predominant): Loose or watery stools are more common
• IBS-C (constipation predominant): Hard or infrequent stools are more common
• IBS-M (mixed): Alternating between diarrhea and constipation

IBS is not the same as inflammatory bowel disease (IBD). Unlike Crohn’s disease or ulcerative colitis, IBS does not cause inflammation or damage to the intestines. However, the symptoms can be just as disruptive to daily life and quality of living.

Recognizing the Symptoms of IBS

IBS symptoms can vary widely from person to person and may come and go over time. The most common symptoms include:

• Abdominal pain or cramping that is often relieved by a bowel movement
• Bloating and excess gas
• Diarrhea, constipation, or both
• Mucus in the stool
• A feeling of incomplete bowel emptying
• Urgency to have a bowel movement
• Nausea, especially after eating

It is important to note that IBS symptoms can overlap with other GI conditions. If you are experiencing persistent symptoms, especially rectal bleeding, unexplained weight loss, or symptoms that wake you from sleep, it is important to seek evaluation from a gastroenterologist right away. These may indicate a more serious condition that requires prompt attention.

What Causes IBS? Common Triggers to Know

The exact cause of IBS is not fully understood, but researchers believe it involves a combination of factors including gut-brain communication disruptions, changes in gut motility, heightened sensitivity in the intestines, and an imbalance in gut bacteria. Certain factors are known to trigger or worsen symptoms:

Diet and Food Choices

Many people with IBS find that certain foods worsen their symptoms. Common dietary triggers include high-fat foods, dairy products, caffeine, alcohol, carbonated beverages, and foods high in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols). Keeping a food diary can help identify personal triggers.

Stress and Mental Health

The gut and brain are closely connected through what is known as the gut-brain axis. Stress, anxiety, and depression are strongly associated with IBS flares. Many patients notice their symptoms worsen during periods of high stress or emotional difficulty. Managing mental health is an important part of managing IBS.

Hormonal Changes

IBS affects women more often than men, and many women notice that their symptoms worsen around menstruation. Hormonal fluctuations may play a role in gut sensitivity and motility changes.

Post-Infectious IBS

Some people develop IBS following a gastrointestinal infection such as food poisoning or a stomach virus. This is known as post-infectious IBS and can persist for months or even years after the initial infection has resolved.

How Is IBS Diagnosed?

There is no single test that diagnoses IBS. Instead, diagnosis is based on a thorough evaluation of your symptoms, medical history, and physical examination. Your gastroenterologist may use the Rome IV criteria, a standardized set of symptom-based guidelines, to help confirm the diagnosis.

Additional testing may be ordered to rule out other conditions that can mimic IBS, such as celiac disease, inflammatory bowel disease, or infections. This may include blood tests, stool tests, or in some cases, a colonoscopy or upper endoscopy. At Granite State Gastroenterology, we offer a full range of diagnostic and procedural services, including colonoscopy and upper endoscopy, to help ensure an accurate diagnosis and rule out more serious conditions.

Treatment Options for IBS

While there is no cure for IBS, the condition is highly manageable with the right approach. Treatment is tailored to each patient based on their symptom pattern, severity, and personal health goals.

Dietary Modifications

A low-FODMAP diet has strong evidence behind it for reducing IBS symptoms in many patients. Working with a registered dietitian in coordination with your gastroenterologist can help you identify which foods trigger your symptoms and develop a sustainable eating plan.

Medications

Depending on your primary symptoms, your gastroenterologist may recommend medications to help regulate bowel function, reduce cramping, manage diarrhea or constipation, or address pain. Some patients also benefit from low-dose antidepressants that help modulate the gut-brain connection. There are also newer prescription medications specifically approved for IBS-D and IBS-C that may be appropriate for certain patients.

Lifestyle and Stress Management

Regular physical activity, adequate sleep, and stress reduction techniques such as mindfulness, yoga, or cognitive behavioral therapy (CBT) can significantly reduce IBS symptom frequency and severity. The gut-brain connection means that caring for your mental health is caring for your gut health.

Gut-Directed Therapies

Probiotics, peppermint oil, and certain fiber supplements may also provide symptom relief for some IBS patients. Your gastroenterologist can help you sort through the options and identify which approaches are best suited to your individual situation.

IBS Care at Granite State Gastroenterology

Living with IBS does not have to mean living in discomfort. At Granite State Gastroenterology, our board-certified gastroenterologists and advanced practice providers bring expertise, patience, and genuine compassion to every patient appointment. We understand that IBS is different for every person, and we take the time to listen, evaluate, and build a treatment plan that works for your life.

We serve patients from across southern and central New Hampshire, including Manchester, Derry, Londonderry, Bedford, Raymond, Windham, Epping, Exeter, Fremont, Amherst, and Salem. Whether you are newly experiencing GI symptoms or have been dealing with IBS for years without satisfactory answers, our team is here to help.

Ready to get answers? Request an appointment online or call us at (603) 432-8802. We accept new patients and are here to support you every step of the way.

Frequently Asked Questions About IBS

1. Is IBS a serious condition?

IBS is a chronic condition, but it is not life-threatening and does not increase the risk of colorectal cancer or lead to serious intestinal damage. However, it can significantly impact quality of life if left unmanaged. The good news is that with proper diagnosis and a personalized treatment plan from a gastroenterologist, most patients can manage their symptoms effectively and live fully.

2. How is IBS different from IBD?

IBS (irritable bowel syndrome) and IBD (inflammatory bowel disease) are distinct conditions. IBD, which includes Crohn’s disease and ulcerative colitis, involves chronic inflammation and physical damage to the digestive tract and requires more intensive medical management, sometimes including biologic therapies or surgery. IBS involves no structural damage and is managed primarily through lifestyle, diet, and medication. Both conditions require evaluation by a GI specialist for proper diagnosis.

3. Can IBS be cured?

There is currently no cure for IBS, but the condition can be effectively managed in the vast majority of patients. Many people experience significant symptom improvement through dietary changes, stress management, and targeted medications. Some patients find their symptoms decrease or become more predictable over time. The goal of treatment at Granite State Gastroenterology is to help you achieve the best possible quality of life.

4. What foods should I avoid if I have IBS?

Trigger foods vary from person to person, but common culprits include high-fat or fried foods, dairy products, gluten-containing foods (for some), caffeine, alcohol, artificial sweeteners, carbonated drinks, and high-FODMAP foods such as onions, garlic, apples, and beans. Keeping a detailed food and symptom diary is one of the best ways to identify your personal triggers. Your gastroenterologist can also refer you to a registered dietitian for structured dietary guidance.

5. When should I see a gastroenterologist for IBS symptoms?

You should seek evaluation from a gastroenterologist if you have been experiencing persistent abdominal pain, bloating, or changes in bowel habits for more than a few weeks, if your symptoms are interfering with your daily life, or if you have any red flag symptoms such as rectal bleeding, unintentional weight loss, fever, or symptoms that wake you from sleep. These warrant prompt evaluation to rule out more serious conditions. If you are looking for a GI specialist in New Hampshire, the team at Granite State Gastroenterology is here to help. Visit granitegastro.com or call (603) 432-8802 to get started.

Take Control of Your Gut Health This April

IBS Awareness Month is a reminder that you do not have to accept digestive discomfort as your normal. Millions of people live with IBS and many do not realize that real, meaningful relief is within reach. At Granite State Gastroenterology, we are passionate about helping our patients understand their GI health, identify their triggers, and get back to living their lives fully.

Whether you are in Bedford, Londonderry, Derry, Manchester, Epping, Exeter, or anywhere across southern New Hampshire, our team is ready to partner with you on your health journey. Contact us today.