Types Of IBS

Reviewed by: HU Medical Review Board | Last reviewed December 2022

Living with irritable bowel syndrome (IBS) means you live with uncomfortable and painful gastrointestinal (GI) symptoms. Stomach pain accompanied by diarrhea, constipation, or both is typical of IBS.1

There are 3 types of IBS. Each type is based on different patterns or changes in bowel movements.1,2

IBS with constipation (IBS-C)

IBS with constipation (IBS-C) is characterized by hard, lumpy stools. IBS-C is more common in women than men.1-3

People with IBS-C report:1,2

  • Stomach pain and cramping
  • Straining
  • Infrequent stools
  • Stools that are hard and lumpy
  • Bloating and gas

IBS with diarrhea (IBS-D)

IBS with diarrhea (IBS-D) means you have loose, watery stools. IBS-D is more common in men than women.1-3

People with IBS-D report:1,2

  • Stomach pain and cramping
  • Loose, watery stools
  • Sudden urges to have a bowel movement
  • Bloating, gas, and flatulence

IBS with mixed bowel habits (IBS-M)

IBS with mixed bowel habits (IBS-M) means you have a combination of constipation and diarrhea. One day you may have constipation. The next day you may have diarrhea.1,2

Why IBS occurs

A human’s gut microbiome is made up of trillions of microorganisms. These healthy bacteria coexist and make our guts thrive. But when something interferes with that symbiotic environment – such as an infection – the diversity of microbes is at risk. This change to the gut microbiome is thought to be one of several factors in the development of IBS.4

A 2021 study found that the specific microorganisms that exist in people with IBS-C and IBS-D are quite different. This information could help experts uncover why certain people develop a specific type of IBS.4

Diagnosing different types of IBS

Doctors use what is called the Rome IV criteria to decide which type of IBS you have. It looks at the amount of time you have very hard or very loose stools.5,6

An IBS diagnosis begins with a physical exam and an overview of your medical history. Depending on your symptoms, your doctor may recommend you see a gastroenterologist – a doctor who specializes in the digestive system. They may perform additional tests, such as stool tests or blood tests, to confirm a diagnosis.1

Treating different types of IBS

There is no cure for IBS. But there are ways to manage it. Some medicines are only successful with certain types of IBS. And some medicines make some types of IBS worse.1,2

Treating IBS – no matter the type – involves a combination of:5,6

  • Diet and nutrition
  • Drug therapy
  • Stress management
  • Mental health counseling

For IBS-C, laxatives can help relieve constipation. These may be prescribed:5,6

  • Lubiprostone (Amitiza®)
  • Linaclotide (Linzess®)
  • Plecanatide (Trulance®)

For IBS-D, anti-diarrheal medicines are often prescribed. They help slow the movement of stool. These may include:6

  • Loperamide
  • Rifaximin (Xifaxan®)
  • Eluxadoline (Viberzi®)
  • Alosetron (Lotronex®)

Other medicines may help stomach pain and IBS symptoms, including:1,6

  • Fiber supplements
  • Prebiotics and probiotics
  • Antispasmodics
  • Antidepressants
  • Coated peppermint oil capsules

Talk with your doctor

IBS symptoms fall on a spectrum. Knowing which type of IBS you have helps determine the right type of treatment. Talk with your doctor if you are having symptoms you think may be related to IBS.1,2

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