Irritable Bowel Syndrome (IBS)

What to know about IBS

• IBS is defined by a pattern of abdominal pain along with changes in your bowel habits. It’s more than just having a sensitive stomach.
• There isn’t one specific test for IBS. Doctors look at your symptoms and may do certain tests to make sure you don’t have another condition that needs a different treatment.
• Trying a low-FODMAP diet can help some people but should be done only briefly and with guidance from a trained doctor or dietitian.
• If you notice blood in your stool, unexplained weight loss, anemia, fever, symptoms that wake you up at night, or have a strong family history of digestive disease, seek medical evaluation from a qualified physician.

What is IBS?

IBS is a long-term digestive problem in which the intestines and nervous system become more sensitive or do not work together well. Factors such as gut motility, intestinal sensation, the gut microbiome, immune signaling, stress, and certain foods can affect symptoms.

IBS symptoms often come and go. You might have tough weeks, then feel better for a while, followed by a flare-up after an infection, a stressful event, a new medication, disrupted sleep, or eating foods that do not suit you. The aim is not to react to every symptom with a new restriction. Instead, the goal is to notice patterns, maintain strong nutrition and quality of life, and have a plan you can adjust safely over time.

IBS Subtypes

Doctors commonly describe IBS based on the predominant type of stool pattern. These labels are used to help guide the right treatment, but they are not fixed. A person's symptoms can change over time, and some people may not fit into just one category.

• IBS-C means constipation is the main problem. People with this type often have hard stools, may need to strain, and can feel like they have not fully emptied their bowels. Bloating or stomach pain are also common.
• IBS-D means diarrhea is the main issue. People with this type often have loose or watery stools, may need to go to the bathroom quickly or often, and can have cramping or worry about being far from a restroom.
• IBS-M is when both constipation and diarrhea happen, often taking turns.
• IBS-U is when someone has IBS symptoms, but their stool pattern does not clearly match the other types.

Symptoms people experience

The main symptom of IBS is recurring abdominal pain linked to bowel movements or changes in stool frequency or appearance. The pain can feel like cramps, aches, sharp stabs, or a general soreness. Some people feel relief after a bowel movement, while others feel worse. Bloating and a visibly swollen belly are also common and can sometimes be more distressing than the pain itself.

Other symptoms can include needing to rush to the bathroom, straining, feeling like you haven’t fully emptied your bowels, mucus in your stool, nausea, or discomfort after eating.

IBS can also affect your sleep, work, exercise, travel, relationships, and social life. Feeling anxious or depressed is common with ongoing symptoms, and both your body and mind deserve care and support.

How IBS is evaluated

There is no single blood test, scan, or stool test that can confirm IBS. Usually, a doctor begins by asking about your symptoms, including when they started, how often they occur, whether they are linked to meals or bowel movements, whether they wake you at night, and how they affect your daily life. A physical exam and a review of your medications, supplements, past infections, surgeries, family history, and diet can also provide helpful information.

Testing is tailored to each person. Based on your history, your doctor might order a blood count, check for inflammation, screen for celiac disease or thyroid problems, or order stool tests. Testing is especially important if your symptoms are new, severe, changing, or not improving as expected. Sometimes, more detailed stool or breath tests are helpful, but each test should have a clear purpose.

IBS should not be used to explain new or concerning symptoms. If your doctor suspects you might have inflammatory bowel disease, celiac disease, an infection, a medication reaction, a pelvic or gynecologic issue, or another condition, they will recommend appropriate tests and follow-up to determine the cause.

Why IBS symptoms can flare

There isn’t a single cause of IBS. People can have different reasons for their symptoms, and several factors may happen together. For example, some people develop IBS after having gastroenteritis. Changes in how the gut moves can lead to constipation or diarrhea. Some people experience pain during normal gut movements because their intestines are more sensitive. Sleep problems, stress, medications, supplements (including some antibiotics, laxatives, iron, and magnesium products), the menstrual cycle, or changes in activity can also affect symptoms.

Food often plays a role in IBS, but what bothers one person might not affect someone else. For some, large meals, eating too quickly, alcohol, too much caffeine, fizzy drinks, high-fat foods, or certain carbohydrates can make symptoms worse. Instead of cutting out many foods for a long time, it can help to keep a simple diary of symptoms and foods.

IBS requires personalized treatment

Treating IBS often means trying different manageable approaches rather than seeking a single cure. A doctor might start by recommending regular meals, staying hydrated, gentle exercise, good sleep habits, and a review of your current medications and supplements.

Adding soluble fiber can help some people, especially if you increase it slowly and drink enough water. However, adding too much fiber too quickly can worsen gas or bloating.

Sometimes, medication is the right choice. Depending on your symptoms, a doctor may suggest treatments for constipation, diarrhea, stomach pain, or other specific issues.

Some people find relief with psychological therapies that target the gut-brain connection, such as cognitive behavioral therapy or gut-focused hypnotherapy. These treatments do not mean your symptoms are just in your head. Instead, they help calm the nervous system and make it easier to manage this chronic condition.

Any plan should consider factors such as pregnancy, age, kidney or liver issues, allergies, current medications, and whether another diagnosis could explain your symptoms.

The low-FODMAP approach

The low-FODMAP diet can help some people, but it is meant to be a temporary tool, not a long-term strategy. Commonly used to identify foods that trigger symptoms, a low-FODMAP diet limits certain short-chain carbohydrates (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) that some people have trouble absorbing. Eliminating certain foods may help with bloating, gas, pain, or changes in bowel movements. However, the low-FODMAP diet is not a solution for everyone with IBS, and it is different from cutting out all carbs, gluten, or healthy plant foods.

A proper low-FODMAP approach has three steps: a short period of eliminating certain foods, slowly reintroducing them, and then adjusting the diet to fit your needs. The aim is to determine what you can tolerate, not to remain on the strictest phase long-term.

Staying on a strict diet for too long can limit the variety, fiber, and nutrients in your meals, making eating less enjoyable and more stressful. Working with a registered dietitian or a trained health professional can help you follow the diet safely and achieve better results.

The functional medicine approach

Standard IBS care starts by checking for serious conditions like inflammatory bowel disease, celiac disease, or colorectal cancer. If these are ruled out but symptoms continue, functional medicine can provide a more personalized and structured way forward.

Functional medicine puts the patient at the center and considers the whole system. It aims to identify and address the root causes of chronic health issues by using a detailed history, targeted tests, lifestyle changes, and tailored treatments.

Functional medicine testing can help find treatable causes in people with ongoing IBS. It is most effective when used carefully, alongside proven dietary changes, and when patients and their healthcare providers make decisions together. The aim is not to replace standard care but to offer additional options when routine tests do not provide clear answers.

Specific tests can help tailor care for people with ongoing IBS symptoms. For example, food sensitivity tests can detect delayed reactions to foods. Microbiome tests show which bacteria are present. Stool tests can detect infections, parasites, or signs of imbalance or inflammation. Breath tests can detect SIBO (small intestinal bacterial overgrowth), which is linked to bloating, gas, and changes in bowel habits. Zonulin tests can show whether the gut lining is more permeable than normal.

Doctors review functional medicine test results alongside your symptoms and past test results to get a full picture. For example, if a stool test detects a pathogen, treatment will target that infection. If a breath test shows SIBO, you might receive antibiotics or herbal treatments, along with dietary changes and support for gut motility. If tests show an imbalance or low levels of beneficial bacteria, your care may include probiotics, prebiotics, or other therapies to support the microbiome.

When to seek care

IBS can be uncomfortable, but some symptoms are uncommon in simple IBS and require quick evaluation. Get urgent care if you have severe or rapidly worsening belly pain, a hard or swollen belly with vomiting, fainting, signs of dehydration, or cannot pass stool or gas. Call your doctor immediately if you notice blood in your stool, black or tarry stool, unexplained weight loss, ongoing fever, anemia, repeated symptoms at night, or a strong family history of colorectal cancer, inflammatory bowel disease, or celiac disease.

If your symptoms are new, have changed significantly, began later in life, or make it hard to eat, sleep, work, or do daily activities, schedule a visit with your doctor instead of trying to treat this frustrating condition on your own. At NaturoMedica, our goal is to help you find a safe and achievable plan, not just a diagnosis.

How NaturoMedica can help

Many people from the Eastside come to NaturoMedica when their digestive symptoms persist despite basic advice or when they want a more thorough review. We start by listening closely to your experiences—what you feel, what you have tried, what has helped or made things worse, and what you hope to do again.

Please bring a list of your medications and supplements, any past test results, a brief timeline of your symptoms, and any questions about food, bowel habits, or your treatment goals. You do not need a perfect diet diary or a self-diagnosis—a clear description of your experience is more helpful than weeks of food logs.

During your visit, we may review your health history, perform a physical exam, review past lab results and imaging, review your medications and supplements, and discuss whether additional tests are needed. Depending on your needs, we might suggest nutrition counseling, targeted testing, lifestyle changes, or carefully selected prescription treatments or supplements. These services complement but do not replace urgent care, gastroenterology visits, colonoscopies when needed, or other standard medical treatments.

Symptoms that need medical attention

These symptoms are not typical of uncomplicated IBS. Contact a clinician promptly, or seek urgent care when symptoms are severe.

• Blood in the stool or black, tarry stool
• Unexplained weight loss or loss of appetite
• Persistent fever, anemia, or marked fatigue
• Symptoms that repeatedly wake you from sleep
• Severe, rapidly worsening, or localized abdominal pain
• Persistent vomiting, dehydration, or inability to pass stool or gas
• A strong family history of colorectal cancer, inflammatory bowel disease, or celiac disease
• New or substantially changed symptoms, especially later in adulthood

IBS FAQs

Is IBS the same as inflammatory bowel disease?

No. IBS is a condition that affects how the gut and brain work together. Unlike Crohn’s disease or ulcerative colitis, it does not cause inflammation or damage to the intestines. Because some symptoms are similar, it is important to see a doctor if symptoms last or seem serious.

Can IBS be cured?

No single cure works for everyone. Many people find that a personalized plan helps reduce symptoms and improve daily life. Since symptoms can change, treatment may need to be adjusted over time.

Should everyone with IBS follow a low-FODMAP diet?

No. A short, structured low-FODMAP diet may help some people. After the initial phase, it’s important to reintroduce foods and adjust your diet to suit your needs. Avoiding foods for too long can lead to nutritional gaps and take the enjoyment out of eating.

What testing is used for IBS?

Doctors cannot confirm IBS with just one test. Instead, they look at your symptoms, medical history, and do a physical exam. Sometimes, they may order blood or stool tests to rule out other conditions.

Can NaturoMedica help with IBS in the Seattle Eastside?

NaturoMedica’s Issaquah clinic serves patients from Sammamish, Bellevue, Redmond, Renton, Kirkland, and nearby communities. Our naturopathic physicians can review your history and coordinate nutrition, selected testing, adjunctive services, and referrals as appropriate.

Related services

• Nutrition Counseling — Build a flexible food and symptom strategy without unnecessary long-term restriction.
• Functional Testing — Discuss whether a targeted lab or stool evaluation can answer a specific clinical question.
• Acupuncture & Chinese Medicine — Explore an adjunctive option for digestive discomfort, stress, pain, and whole-person support.

Medical information sources

This page is for education and does not replace medical advice, diagnosis, or treatment.

• NIDDK: Irritable Bowel Syndrome — Definition & Facts
• NIDDK: Diagnosis of Irritable Bowel Syndrome
• NIDDK: Treatment for Irritable Bowel Syndrome
• NICE: Irritable bowel syndrome in adults — diagnosis and management