IBS (Irritable Bowel Syndrome) Triggers and Prevention

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)
    Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)

    Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)

    Dr. Anand received MBBS degree from Medical College Amritsar, University of Punjab. He completed his Internal Medicine residency at the Postgraduate Institute of medical Education and Research, Chandigarh, India. He was trained in the field of Gastroenterology and obtained the DPhil degree. Dr. Anand is board-certified in Internal Medicine and Gastroenterology.

  • Medical Reviewer: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Irritable Bowel Syndrome (IBS) Facts

IBS triggers and prevention facts

  • Irritable bowel syndrome (IBS) is a recurrent disease of the bowel. Treatment and management of symptoms include psychological support, dietary measures, management of food intake, and management of medications and/or psychological conditions.
  • Foods and drinks that dehydrate the body can trigger constipation in people with irritable bowel syndrome.
  • Fatty foods can trigger diarrhea in people with the condition, but specific food triggers of diarrhea and other symptoms may vary between individuals.
  • Stress and anxiety can stimulate symptoms in many people with IBS.
  • Drugs like antibiotics, antidepressants and/or medicines that contain sorbitol may trigger symptoms.
  • In many women with IBS, menses and/or menstrual pain is related to the onset of symptoms.
  • Other triggers for symptoms may include
    • a chronic lack of exercise,
    • frequently eating while under stress, and
    • eating foods that are very hot or very cold.
  • There are several ways to reduce or stop many of the causes that trigger symptoms; for example, eat a balanced diet, avoid food and drinks that dehydrate the body or may cause diarrhea, keep a journal to identify personal triggers, reduce stressors or causes of anxiety, and discuss medications you are taking that may be triggering your symptoms with your doctor.
  • Consequently, for each individual, it is important to determine what foods, medications and/or conditions trigger symptoms. This short article is designed to be an introduction to treatment and management and provides common triggers of the condition. These are general descriptions of items that can trigger IBS.
  • IBS is not contagious from person to person and researchers are actively trying to determine the cause of this disease.

What is IBS (irritable bowel syndrome)?

Irritable bowel syndrome (IBS) is a chronic relapsing gastrointestinal (mainly the large intestine or colon) disorder with signs and symptoms that may include:

IBS is a chronic condition that can be triggered in individuals by certain items in their diet, medications and/or by other conditions such as stress.

Some health-care professional categorize and term IBS into one of four categories:

  1. IBS-D (predominant symptoms is diarrhea)
  2. IBS-C (predominant symptoms is constipation)
  3. IBS-M (mixed diarrhea and constipation)
  4. IBS-U (unclassified)

Not all health-care professionals recognize these four categories.

Are stress and anxiety triggers for IBS?

Stress and anxiety may be triggers for IBS and the development of recurrent symptoms. Chronic stress experienced early in life (less than age 18) may increase the chances of developing the condition. Moreover, people diagnosed with IBS can have stress or anxiety trigger symptoms, such as:

  • Diarrhea
  • Constipation
  • Abdominal bloating
  • Mucus defecation
  • Feelings of incomplete bowel movements

Are menstrual pain and IBS related?

Some studies show that many women with IBS have worse symptoms during their menstrual periods. Although the mechanism is not clear, some gastrointestinal cells have receptors for estrogen and progesterone so that changes in the hormone levels during the menstrual cycle may trigger increasing IBS symptoms. Women are twice as likely to develop IBS as men.

Quick GuideIBS - Irritable Bowel Syndrome: Symptoms, Diet, Treatment

IBS - Irritable Bowel Syndrome: Symptoms, Diet, Treatment

5 Foods to Avoid Constipation

Sometimes nature just doesn't call. At some point, everyone has experienced the gas, bloating, and discomfort of constipation. Fortunately, there are certain foods you can eat and avoid for relief.

When planning your healthy diet, it helps to include plenty of high-fiber choices to help you stay regular. Try these five foods:

  1. Prunes
  2. Beans
  3. Kiwi...

What foods in the diet trigger constipation in IBS?

Any food or fluids that tend to dehydrate a person is likely to trigger constipation in people with irritable bowel syndrome. Foods that may promote constipation and should be avoided in an IBS diet include:

  • Chocolate
  • Dairy products such as milk and cheese (particularly those that contain lactose)
  • Red meat
  • Unripe bananas
  • Items that contain caffeine if you are slightly dehydrated.
  • Coffee, carbonated drinks and alcohol may lead to dehydration and constipation in IBS patients (and other people, too).

Foods that help prevent constipation in IBS

Foods that help prevent constipation and should be included in an IBS diet include:

  • Prunes
  • Various types of beans
  • Whole grain breads like rye bread
  • Pears and fruits like kiwi
  • Vegetables that will help boost fiber intake

What foods in the diet trigger diarrhea in IBS?

  • Several foods may play a role in developing diarrhea in people with IBS. Major categories of foods that are thought to contribute are those that contain fats (fatty meats, fatty dairy products, for example). Each individual is slightly different and may respond differently to food types. Consequently dietitians and health care professionals who treat people with IBS often suggest that they keep a journal or diary to track those foods that cause diarrhea.
  • Some foods that trigger diarrhea do so because they are ingested in large quantities; for example, a bite of a banana may not cause diarrhea, but eating a whole banana in some people with IBS may trigger diarrhea.
  • Other foods that contain high levels of fructose, artificial sweeteners, high FODMAP foods, and fried foods may also trigger diarrhea.
  • Broccoli, onions, cabbage and large helpings of beans may produce gas and increase the discomfort of diarrhea.
  • Probiotics may help reduce the symptoms of diarrhea and gas in some individuals.

What prescription or OTC drugs trigger IBS?

Some drugs can trigger IBS symptoms resulting in colonic spasms, constipation and/or diarrhea. Such drugs include antibiotics (especially those administered over a long period of time), tricyclic antidepressants, for example, amitriptyline (Elavil, Endep) nortriptyline (Pamelor), and doxepin, and medicines containing sorbitol (for example, some cough syrup preparations and common pain medicines like Advil gel capsules). Consequently, patients with the condition should check the ingredients, both active and inactive, for the presence of sorbitol as sorbitol is often listed as an "inactive" ingredient.

What are the other IBS triggers?

Other triggers of IBS are variable and differ from person to person. However some other common triggers include:

  • Lack of exercise
  • Eating foods too quickly
  • Eating while under some other stress such as driving or working
  • Eating foods that are very hot or cold
  • Chewing gum

Keep a journal and record the symptoms and the activities you are doing when symptoms develop. This can help you determine your personal triggers for any symptoms. Researchers also suggest that changes in hormone levels and/or other acute illnesses such as infectious diarrhea may also trigger symptoms.

Which specialties of doctors treat irritable bowel syndrome?

Although a patient's primary care physician may care for IBS patients, specialists in gastroenterology, immunology, psychiatry and dietary professionals may be consulted to help patients manage the condition.

How can I prevent IBS triggers?

There are many different ways to help prevent you from triggering IBS symptoms such as:

  • Eat a balanced diet with a moderate amount of fiber.
  • Avoid extremes of food temperatures (very hot or cold foods).
  • Do not eat while experiencing anxiety or under stressful conditions (for example, while working or driving).
  • Avoid foods and drinks that may cause dehydration or diarrhea.
  • Keep a journal to help identify those foods that are do or do not trigger symptoms.
  • Try biofeedback, exercise, meditation, or yoga to reduce anxiety.
  • Discuss medications you are taking that may be triggering symptoms with your doctor.
  • Avoid those foods and drinks that are likely to increase or trigger symptoms.
  • Avoid foods that increase intestinal gas (some legumes and vegetables like broccoli, cauliflower, cabbage, and Brussels sprouts).
  • Talk to your doctor or health-care professional about taking probiotics.

REFERENCES:

National Institute of Diabetes and Disgestive and Kidney Diseases. "Irritable Bowel Syndrome (IBS)."
<https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome>

Wald, A. MD. "Patient information: Irritable bowel syndrome (Beyond the Basics)." UpToDate. Updated: Aug 12, 2015.
<https://www.uptodate.com/contents/irritable-bowel-syndrome-beyond-the-basics>

Abraczinskas, D. MD. "Patient information: Gas and bloating (Beyond the Basics)." UpToDate. Updated: Jun 24, 2016.
<https://www.uptodate.com/contents/gas-and-bloating-beyond-the-basics>

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Reviewed on 1/23/2017
References
REFERENCES:

National Institute of Diabetes and Disgestive and Kidney Diseases. "Irritable Bowel Syndrome (IBS)."
<https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome>

Wald, A. MD. "Patient information: Irritable bowel syndrome (Beyond the Basics)." UpToDate. Updated: Aug 12, 2015.
<https://www.uptodate.com/contents/irritable-bowel-syndrome-beyond-the-basics>

Abraczinskas, D. MD. "Patient information: Gas and bloating (Beyond the Basics)." UpToDate. Updated: Jun 24, 2016.
<https://www.uptodate.com/contents/gas-and-bloating-beyond-the-basics>

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