Irritable bowel syndrome (IBS) affects tens of millions of Americans every year, and that makes it one of the most prevalent gastrointestinal problems. As a syndrome, IBS is characterized by a series of signs and symptoms that usually present together. The core symptoms of IBS include stomach pain and changes to bowel movement regularity and consistency, but there are also some less common symptoms that some people experience. One less common symptom that occasionally occurs with IBS is nausea.

Facts About Irritable Bowel Syndrome

Irritable bowel syndrome is considered a functional digestive disorder, which means that it stems from problematic gut-brain interactions; in other words, the brain and digestive system aren’t working well together. This state is believed to be the fundamental cause of changes to sensitivity in the gut and to the contraction of muscles related to digestion. It is these changes that affect the digestive process and lead to the common symptoms of irritable bowel syndrome:

  • abdominal pain
  • changes in bowel habits
  • diarrhea
  • constipation
  • bloating
  • cramping
  • feeling of an incomplete bowel movement
  • mucus in the stool

There are several different types of IBS, and they are differentiated by the way they affect a person’s bowel habits. IBS-C, for instance, is IBS with constipation, and that means that bowel movements are infrequent and tend to involve hard, dry stools that are difficult to pass. IBS-D means diarrhea, which is the opposite and involves loose, watery stools. The third type is IBS-M, which means mixed bowel habits; this is characterized by sometimes having constipation and sometimes having diarrhea.

IBS is sometimes confused with another common gastrointestinal disease, inflammatory bowel disease (IBD). Both IBS and IBD are chronic disorders, and they both share some symptoms like abdominal pain and bloating. The main difference between them is that IBS is a functional disorder and IBD is an autoimmune disorder. The two main types of IBD are Crohn’s disease and ulcerative colitis, and they both involve symptoms arising from inflammation of either the small intestine or large intestine. In addition to classic symptoms like abdominal pain and diarrhea, IBD can also present with rectal bleeding, anemia, and weight loss.

What Is the Cause of IBS?

Unfortunately, doctors aren’t really sure what causes IBS. As noted above, it is believed to be related to gut-brain interactions, but it’s unclear what may bring about such an underlying cause. However, there are a number of different factors that seem to be related. Some medical problems or experiences that tend to be more common in IBS patients include:

  • bacterial infections in the digestive tract
  • small intestine bacterial overgrowth (SIBO), a change in the balance of gut microbiota
  • food intolerance or sensitivities
  • mental disorders like depression or anxiety
  • physical or sexual abuse or other stressful early-life events

IBS and Nausea

While IBS is typically known for the symptoms listed above, there are some patients who experience additional gastrointestinal and even some non-gastrointestinal symptoms. One example of such a symptom that presents in about 20-30% of IBS patients is nausea. Even though nausea has been known to be a problem, it still isn’t considered an actual symptom of IBS. Instead, it appears that nausea is most likely an unrelated symptom of a disorder that overlaps with IBS.

As with many other digestive diseases, the symptoms of IBS are known to be similar and may make diagnosis difficult. This explains why an IBS patient can experience nausea and yet not be a symptom of IBS. Functional dyspepsia (indigestion) and gastroesophageal reflux disease (GERD) are two relatively common digestive problems that might cause nausea alongside IBS; the heartburn associated with GERD, for example, is often a source of nausea. Migraine headaches are another potential source of nausea that sometimes overlaps with IBS.

IBS Diagnosis

The fact that IBS is characterized by a collection of symptoms means that the diagnosis can sometimes be elaborate. In addition to taking a family history and performing a physical exam, there are usually a number of tests done to rule out other problems. Blood tests can rule out infection or anemia, for instance, and stool tests can rule out the presence of blood. In some cases, the gastroenterologist may need to perform an endoscopy or colonoscopy to directly visualize the digestive tract to identify abnormalities.

IBS Treatment Options

There is no cure for irritable bowel syndrome, so treatment is focused on managing the symptoms in order to improve quality of life. For cases where the symptoms are relatively mild, successful management involves lifestyle changes and modifications to one’s diet. Below are some common approaches to treating IBS:

  • Increase fiber: Eating a daily diet that includes 20-35 grams of fiber can make a significant difference in regulating bowel movements and reducing abdominal pain.
  • Avoid FODMAPs: Short for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, FODMAPs are foods that are poorly absorbed in the small intestine and therefore tend to ferment once they reach the large intestine. Avoiding or reducing these foods can help limit IBS symptoms.
  • Probiotics: Though more research is needed, there is strong evidence that probiotics found in foods like yogurt and kefir may help reduce IBS symptoms and improve bowel motility.
  • Hydrate: Drinking plenty of fluids can help keep the digestive tract lubricated as well as contribute to consistency in bowel movements.
  • Physical activity: Increasing your physical activity level through regular exercise has been shown to improve IBS symptoms.
  • Reduce stress: Stress seems to increase the incidence of IBS flare-ups, so reducing stress through life changes or relaxation techniques can potentially prevent some symptoms from happening.
  • Sufficient sleep: Sleep is important for many aspects of health, but it is also known to be a factor in IBS.

For cases that are more severe, there are additional methods that a gastroenterologist may employ to manage the symptoms. Over-the-counter or prescription laxatives can help with constipation, and anti-diarrheal medications can help with watery stools. There is also some evidence that certain antidepressants and antispasmodics can help with abdominal pain. Peppermint oil supplements may also be helpful.

Contact Cary Gastro

Many people have irritable bowel syndrome without realizing and never seek out help from a healthcare provider. At Cary Gastro, we are passionate about providing excellent digestive health so that you can improve your quality of life. If you have been experiencing any of the symptoms noted above, please contact us to request an appointment.