Do You Have Irritable Bowel Syndrome—Or Just a Sensitive Stomach?

There’s nothing more annoying than not being able to, you know, go, when you know you have to (or not being able to stop). Constipation and diarrhea affect nearly everyone at one point or another, but the culprit behind ongoing digestion problems could be irritable bowel syndrome, a.k.a. IBS. Here’s how to tell if your tummy troubles are more than just a sensitive digestive system.

IBS is a chronic disorder that affects your digestive system’s ability to finish doing its job. There are two types—if you have IBS-C (the most common form of the condition), you’re mostly dealing with chronic constipation; if you have IBS-D, your main issue is diarrhea. While doctors don’t know exactly what causes IBS, more women than men suffer from it. “Women are at higher risk of IBS because the bowel tends to be less supported in the pelvis than [in] men,” says Elana Maser, M.D., a gastroenterologist and assistant professor at the Icahn School of Medicine at Mount Sinai. “The bowels are flopped down in our wide pelvises and even more so as we age or have surgeries like c-sections or hysterectomies, which can lead to scar tissue development. This can lead to changes in bowel motility [contractions] and development of pain or air trapping.”

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The hallmark of IBS is pain and discomfort associated with constipation or diarrhea. “IBS is a hypersensitivity syndrome, which means you’re going to feel pain in your bowel [area] because of stool, whereas somebody with chronic constipation doesn’t feel that same pain,” says Elana Maser, M.D., a gastroenterologist and assistant professor at the Icahn School of Medicine at Mount Sinai. IBS is connected to other hypersensitivity issues, such as migraines, fibromyalgia, and chronic fatigue, too. Talk about a one-two punch.

In order to be diagnosed with IBS, you need to have abdominal pain or discomfort for at least three days per month in the last three months, says Maser. Any change in the frequency, appearance, or consistency of your stool matters, too. You should also feel better once you do go to the bathroom.

Besides passing the three-month mark, red flags include constipation or diarrhea that’s “associated with fever, blood in the stool, unusual weight loss, or an abrupt change in bowel pattern,” says Maser.

If you’re as regular as Jamie Lee Curtis in an Activia commercial and your pattern changes all of a sudden, it might be a good idea to see your doc. A family history of colon cancer or other bowel disorders is also a reason to make an appointment at the first sign of anything unusual.

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IBS is mainly treated through lifestyle changes, including exercising more, cleaning up your diet, and increasing water consumption by both drinking more and by eating hydrating foods, like fruits and veggies.

Keep in mind, though, that some healthy foods can wreak havoc on your colon. In people who have trouble digesting certain fruits and vegetables, the low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet is often prescribed. “FODMAPs are short-chain carbohydrates, and they’re poorly absorbed in the small intestine, so [low-FODMAP] foods will draw water into the bowel and help the food evacuate,” says Maser.  Low-FODMAP foods include bananas, blueberries, carrots, cucumbers, oatmeal, and meats like chicken and turkey.

“The main difference is that IBS is associated with pain or discomfort, and chronic constipation or diarrhea is not,” says Maser. If you don’t have IBS, your diet could be to blame for your pooping problems. If you experience regular constipation or diarrhea, aim to get 25 to 30 grams of fiber a day from whole foods. While fiber bars may help supplement fiber in your normal diet, they are made with a lot of gelatin and gummy substances to hold them together, which may actually cause constipation, says Maser. 

It’s especially important to drink eight glasses of water every day when you’re eating that much fiber, too. “What fiber does is it absorbs water and it expands, and if you’re not drinking enough, fiber will cement in your stomach and it’s going to make things worse,” says Maser.

If that doesn’t do it, “reach for a safe laxative, like a polyethylene glycol like Miralax or milk of magnesia,” says Maser. These stool softeners won’t make your body dependent on them to do its job (whereas a stimulant laxative can).

Whether you’ve got IBS or just a stubborn digestive system, the good news is you can usually treat either without intense medications or major procedures, and a gastroenterologist can help you make sure your digestion issues don’t hold up your life.

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