Types of Irritable Bowel Syndrome (IBS)


Everyone experiences some level of bowel discomfort during their lives, but irritable bowel syndrome (IBS) is different. IBS affects your large intestine. Symptoms vary, but the most common include:

  • abdominal pain
  • cramping
  • bloating
  • gas
  • diarrhea
  • constipation

These symptoms can come and go in waves. Flare-ups can occur frequently and last for hours, days, weeks, or even months. Although IBS is not life-threatening, it can certainly affect your quality of life by disrupting your work and social life.

Symptoms of IBS can vary from person to person. There are also four subtypes of IBS that are categorized based on the consistency of your stools. Proper diagnosis of the subtype of IBS you have is important so you can get the most effective treatment.

Tests and diagnosis

Your doctor will likely start the diagnosis process by asking what kind of symptoms you’ve been having and how often you’ve been experiencing them. Your doctor will also probably ask you about your medical history, stressors in your life, and medications you are taking.

Your doctor may also perform some tests that could include:

  • flexible sigmoidoscopy: an examination of the lower part of your colon, or sigmoid
  • colonoscopy: an examination of your colon
  • X-rays of your colon
  • CT scan of your abdomen and pelvis
  • lower GI series: an examination where the large intestine is filled with liquid barium and then an X-ray is taken to see different abdominal structures
  • blood tests
  • stool tests

Types of IBS

The Rome Foundation is an organization that researches, defines, and classifies functional gastrointestinal disorders such as IBS.

Doctors have defined four subtypes of IBS. Each subtype is defined by stool consistency during a flare-up.

Knowing the subtype of IBS you have will help your doctor pinpoint possible triggers and prescribe the appropriate treatment for you.

IBS with constipation (IBS-C)

This category of IBS causes hard, possibly painful stools more than 25 percent of the time. People with this subtype may also experience diarrhea or watery stools less than 25 percent of the time.

Your doctor may want to perform imaging tests to rule out anatomical abnormalities. You may also be encouraged to add more fiber to your diet either by eating more whole grains or taking a daily supplement. Additional fiber can help soften your stools, making them easier to pass.

IBS with diarrhea (IBS-D)

People with this subtype of IBS experience diarrhea, or loose, watery stools more than 25 percent of the time. Typically they don’t experience constipation or have difficulty passing stools.

To overcome diarrhea, your doctor may recommend eating smaller, more frequent meals. Food sensitivities may also be considered, so dietary modifications could be suggested. Limiting dairy products, spicy foods, and foods containing artificial sweeteners may cause loose stools.

Mixed type (IBS-M)

Some people with IBS don’t have subtype IBS-C or IBS-D. People with IBS that falls into this category experience constipation and diarrhea equally, both more than 25 percent of the time.

If this is the case, it’s important to identify triggers and find a balance of treatments so one symptom doesn’t cause the other.

In addition to identifying possible food sensitivities there are also other steps to take:

  • make necessary dietary changes
  • avoid stressful situations
  • get a prescription for anti-diarrheal medication and laxatives

Unsubtyped IBS

This subtype includes IBS symptoms such as:

  • cramping
  • abdominal discomfort
  • bloating
  • gas
  • passing mucus

However, people with this subtype don’t usually experience stool irregularities. Treatment requires identifying triggers and treating individual symptoms.

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