IBS has no single known cause. The NIDDK page, last reviewed November 2017, says doctors aren’t sure what causes it, and that experts think a combination of problems, including how the brain and gut work together, may lead to it. IBS does not damage your digestive tract, and Cleveland Clinic says there is no cure, but many people manage symptoms by avoiding their triggers and using treatments when they need them.
Does childhood antibiotic use cause IBS?
Antibiotic use has been linked to IBS in some research. A link like this is an association. It shows the two tend to show up together, not that antibiotics caused IBS.
The research on this is not settled. Harvard Health’s Harvard Health article on IBS causes says that repeated or long-term antibiotic use may alter gut flora in a way that disrupts the colon’s normal function. It adds that studies “have not had consistent results, so more research is needed.” A PubMed Central review of IBS diagnosis and treatment says that treatment with antibiotics has been associated with increased risk after an enteric infection.
If you have had antibiotics, that alone does not mean you have IBS. Talk with your clinician about your symptoms before changing any treatment.
What causes IBS in men and women?
IBS is linked to problems in how the brain and gut communicate. Stanford Health Care says IBS may be caused by problems with the way signals are sent between the brain and the digestive tract, and that some people have spasms, unusually sensitive intestines, or muscles that move food at the wrong speed. The Stanford Health Care causes page lists these possible triggers of symptoms:
- Stress and psychological issues, such as anxiety and depression
- Hormonal changes, such as during the menstrual cycle
- Some medicines, such as antibiotics
- An infection in the digestive tract, such as salmonella
- Genetics, since IBS may be more likely in people with a family history of it
The NIDDK’s NIDDK symptoms and causes page adds bacterial infections in the digestive tract, small intestinal bacterial overgrowth, and food intolerances or sensitivities as factors that experts think may play a role.
Experts don’t agree on how much bacteria matter. Cedars-Sinai’s gastroenterologist Mark Pimentel says research there found that about 60% of IBS cases are caused by certain bacteria in the gut resulting from food poisoning. That is one research group’s claim, not an established cause. NIDDK and Harvard say the exact cause is unknown. The PubMed Central review, however, says that a causal link between small intestinal bacterial overgrowth and IBS is not secure.
For women, periods matter. Cedars-Sinai says women are almost twice as likely as men to have IBS.
What are the symptoms of IBS?
The NIDDK says the most common symptoms of IBS are pain in your abdomen, often related to your bowel movements, and changes in your bowel movements. Those changes may be diarrhea, constipation, or both.
Other symptoms the NIDDK and Cleveland Clinic name include:
- Abdominal pain or cramps, often linked to the urge to have a bowel movement
- Diarrhea, constipation, or alternating between the two
- Bloating and excess gas
- The feeling that you haven’t finished a bowel movement
- Whitish mucus in your stool
What are the symptoms of constant IBS?
IBS symptoms don’t always stay the same. The Cleveland Clinic says symptoms can appear frequently or during flare-ups, and they may go away and then return. The NIDDK says IBS is a chronic disorder that lasts a long time, often years. To diagnose it, a doctor looks for a pattern in your symptoms over time.
Symptoms of IBS in females
The NIDDK says women with IBS often have more symptoms during their periods. Stanford Health Care lists hormonal changes, such as during the menstrual cycle, as a possible cause of symptoms.
What triggers IBS flare-ups, and which foods are bad for IBS?
A trigger doesn’t cause IBS itself, but it can cause or worsen a flare-up, according to the Cleveland Clinic. Cleveland Clinic lists periods and certain foods as common triggers. Harvard Health says stress can cause more contractions in the intestines and increase sensitivity.
No food is bad for everyone. Cleveland Clinic says food triggers vary from person to person, and Stanford Health Care says no particular foods have been linked with IBS. The PubMed Central review says that individuals with IBS often discover that certain foods aggravate symptoms. Foods that people often limit include:
- Dairy, since lactose intolerance is more common in people with IBS
- Gas-making foods such as beans, brussels sprouts and cabbage
- Carbonated sodas and chewing gum
- Gluten, since people with IBS tend to be more sensitive to it, even without celiac disease
Advice on fiber differs. Cleveland Clinic recommends more fiber for constipation, added slowly. Cedars-Sinai’s Pimentel recommends a low-fermentation diet, which restricts foods that are harder to digest, such as fiber or non-digestible sugars. A food diary can help you find your own pattern, and a dietitian can help you choose which approach fits.
Is IBS dangerous, and why does it feel so debilitating?
The NIDDK says IBS can be painful but doesn’t lead to other health problems or damage your digestive tract. Cleveland Clinic says it doesn’t raise your risk for colitis, Crohn’s disease or colon cancer.
It can still wear you down. The PubMed Central review says patients with IBS report poorer quality of life and use the health care system more. It says they visit the doctor more often, use more diagnostic tests, consume more medications, and miss more workdays. Cleveland Clinic adds that living with IBS can be challenging because symptoms come and go throughout your life.
Can IBS go away, or is it permanent?
There is no cure for IBS, according to Cleveland Clinic. Most people manage symptoms by avoiding triggers and taking medications when necessary. Cleveland Clinic says changing the foods you eat and your activity levels usually improves symptoms with time, though symptoms may not disappear.
IBS can last for years. The PubMed Central review says nearly 75% of patients continue to have a diagnosis of IBS 5 years later.
Cedars-Sinai’s Pimentel describes antibiotic treatment for bacteria-linked cases: “Two weeks of the antibiotic and you’re good for six months.” This is one researcher’s account; Harvard Health and the PMC review describe the evidence as mixed. He also says bacterial growth can start to recur around the six-month mark, and that the race is on to develop more durable treatments.
What is commonly mistaken for IBS?
Cedars-Sinai says IBS is not the same as inflammatory bowel disease or other gut-based diseases. IBS has become a kind of catch-all for gut-related pain that does not fit the profile of those conditions.
The PubMed Central review says that if there are no alarming findings, routine diagnostic testing is not recommended. It lists alarm features that call for more testing, including weight loss, rectal bleeding, iron deficiency, and anemia. It also says colonoscopy is acceptable for patients over 50, and for people with a family history of colon cancer or inflammatory bowel disease. Celiac testing is worth doing for people with IBS associated with diarrhea, according to the same review.
See your provider if symptoms continue for more than three months or are getting worse, Cleveland Clinic advises. Do not wait if you notice any of the alarm features above.
What is the treatment for IBS?
Cleveland Clinic says no specific therapy works for everyone, but most people with IBS can find a plan that works for them. Many treatments take time to work. The options below are the ones named across these pages.
| Option | What the studies and guides say | Who it may suit | Limits |
|---|---|---|---|
| Medicines used for IBS (dicyclomine, hyoscyamine, lubiprostone, linaclotide, plecanatide, rifaximin) | Cleveland Clinic lists these as medications used to treat IBS. | People whose symptoms match what the medicine treats; your clinician decides. | Check each medicine’s label for its approved uses and ask a pharmacist about side effects. |
| Antispasmodics (dicyclomine, hyoscyamine) | The PubMed Central review says “the evidence of the effectiveness of these agents is not compelling.” | People mainly bothered by abdominal pain. | Anticholinergic effects include constipation, dry mouth, visual disturbances and urinary retention. The review reports 69% vs 16% anticholinergic side effects versus placebo in one trial. |
| Antidepressants (tricyclic antidepressants, SSRIs) | Cleveland Clinic lists them for people with depression and anxiety along with significant abdominal pain. | People with those conditions alongside significant pain. | Your clinician decides whether they fit. |
| Fiber supplements, laxatives and anti-diarrheals | Cleveland Clinic lists medications to ease constipation and medications to firm stools. | People whose main problem is constipation or diarrhea. | Introduce fiber slowly, according to Cleveland Clinic. |
| Antibiotics aimed at small-intestine bacteria | Harvard Health says some research found IBS symptoms often decrease after this treatment. Pimentel says growth can recur around six months. | Evidence is mixed per Harvard Health and the PMC review. Your clinician decides whether testing points to it. | Harvard Health says the breath test used to diagnose small-intestine bacterial overgrowth has debated reliability. |
| Probiotics | Cleveland Clinic says research into their effectiveness is ongoing, and your provider may recommend them. | People whose provider suggests them. | Effectiveness research is ongoing. |
| Low-FODMAP diet | Cleveland Clinic says it reduces hard-to-digest carbohydrates and recommends alternatives. | People who want a structured food plan. | Cleveland Clinic recommends working with a dietitian. |
| Low-fermentation diet | Pimentel recommends it and says diet can help prevent recurrence once bacteria are treated. | People whose clinician recommends it. | It restricts fiber, which conflicts with the fiber advice for constipation. |
| Cognitive behavioral therapy, hypnotherapy, biofeedback | The PubMed Central review says hypnotherapy and cognitive-behavioral therapy seem to be the most widely accepted by IBS patients. Cedars-Sinai’s Brennan Spiegel says that with eight to twelve weeks of daily practice, 60%-80% of people with IBS will see their symptoms improve. That figure refers to cognitive behavioral therapy only. | People who want a non-drug option. | Takes weeks of daily practice to show results, per Spiegel. |
| Yoga | In a two-month study cited by the PubMed Central review, yoga improved IBS symptoms equivalently to conventional treatment. The comparison was with loperamide, in IBS with diarrhea, in a single study. | People interested in an exercise-based routine. | The review cites this as one study. |
Costs vary by option and by insurance. Ask your clinician or pharmacy what each option costs for you before you start.
What calms IBS quickly?
Cleveland Clinic says many of these treatments take time to work.
Can I treat IBS myself with diet and routine?
Some steps are easy to start on your own. Cleveland Clinic suggests exercising regularly, aiming for 150 minutes of moderate exercise weekly, getting seven to nine hours of sleep, keeping a food diary, and trying relaxation techniques.
Diet changes are better made with help. Cleveland Clinic advises working with a dietitian, and says if you choose a gluten-free diet you should work with your provider to make sure you get enough fiber, iron and calcium.
Are probiotics and IBS products worth considering?
Cleveland Clinic says probiotics may help relieve IBS symptoms, though research into their effectiveness is ongoing. For related reading on our site, see probiotics and tinnitus, which looks at probiotics in another condition, and yourbiology gut+, which covers a gut probiotic formula. You can read more about what probiotics human studies (our research library) have tested.
Check any product’s claims carefully. In a November 5, 2020 warning letter about CoQ10 and turmeric products, the FDA warning letter to a supplement maker said that claims on those products’ website established them as drugs under the Federal Food, Drug, and Cosmetic Act because they were intended for the “cure, mitigation, treatment, or prevention of disease.” That letter does not concern probiotics or IBS. It shows the kind of website claims the FDA warned about in that letter. Prices change, so check the current price and refund terms directly with any seller before you order.
Before you talk to a clinician
- Start a food diary and note when symptoms flare, including periods and stressful days.
- Ask which treatment options from the table fit your main symptom and what each costs with your insurance.
- Ask whether testing is needed, and whether it could be for celiac disease or small-intestine bacteria.
- If getting an in-person appointment is hard, ask the clinic what visit options it offers and what they cost.
- Before buying any product, ask the seller for its label and refund terms in writing.
Your clinician can help you decide which of these options is right for you.
By Sense and Evidence Health Research Team
This article is for general information purposes only and does not constitute medical advice. Consult your doctor or qualified healthcare provider before making changes to your health routine.