Irritable bowel syndrome (IBS): clear, practical advice

IBS is one of the most common gut problems—affecting roughly 10–15% of people. If you have belly pain, bloating, and changes in bowel habits that come and go, this guide gives simple, useful steps to feel better now and longer term.

Symptoms and types

IBS symptoms differ person to person but usually include abdominal pain, bloating, gas, and either diarrhea (IBS-D), constipation (IBS-C), or both (IBS-M). Symptoms often improve after a bowel movement. Watch for 'alarm' signs—blood in stool, unexplained weight loss, fever, or new severe symptoms after age 50—and see a doctor right away if those appear.

Doctors usually diagnose IBS based on symptoms and basic tests to rule out infections, celiac disease, or inflammatory bowel disease. Tests can include blood work, stool tests, or a colonoscopy if needed. Keeping a symptom and food diary for 2–4 weeks helps your clinician spot patterns.

Practical ways to manage IBS

Diet changes often help. Try a low FODMAP approach for 4–8 weeks—this means cutting high-FODMAP foods like onions, garlic, wheat, apples, pears, beans, and certain dairy. Work with a dietitian to bring foods back in safely; long-term strict restriction isn’t recommended. Add soluble fiber (psyllium) if you’re constipated, but avoid large amounts of insoluble fiber like bran if it makes bloating worse.

Meds are targeted to your dominant symptom. Loperamide can control diarrhea. For constipation, polyethylene glycol (PEG) is a common osmotic laxative. Antispasmodic drugs can reduce cramping. Low-dose tricyclic antidepressants or SSRIs sometimes help pain and bowel symptoms—ask a doctor before trying them. Probiotics may ease symptoms for some people; strains like Bifidobacterium and Lactobacillus show modest benefit but results vary.

Don’t forget lifestyle fixes: regular exercise helps bowel regularity and reduces stress. Sleep well and eat regular, smaller meals. Alcohol and caffeine can trigger symptoms in some people—cut them back to test the effect. Stress has a big role: cognitive behavioral therapy (CBT), gut-directed hypnotherapy, or simple breathing and relaxation practices can reduce symptom flare-ups.

Track what works. Keep a short log of foods, stress, sleep, and symptoms to spot triggers. If basic steps don’t help after a few months, ask your clinician about referral to a gastroenterologist or a dietitian familiar with the low FODMAP plan.

IBS can be frustrating, but many people improve with targeted diet, meds for specific symptoms, and lifestyle changes. Small, consistent steps—like changing one food, adding a daily walk, or trying a short course of probiotics—often make the biggest difference.