Living with irritable bowel syndrome (IBS) often means living with unpredictability, especially when you’re not sure of your IBS triggers. One week, your digestive system is gurgling along fine, the next you’re bloated, your whole abdomen is sore, and you’re constipated, dealing with diarrhea, or both. Or maybe your IBS manifests in different ways.
One of the primary characteristics of IBS is that symptoms and triggers vary between people, and even the same person, depending on lots of different factors. Some people tend to have diarrhea-predominant IBS while others experience the condition mainly as constipation, and it’s also possible to have a mix of both at different times, according to the Mayo Clinic. Maybe you experience additional symptoms like excess gas and mucus in your stool. It’s also not uncommon for people with IBS to go for a while without any symptoms, the Mayo Clinic explains.
While IBS is a mystery in many ways (experts aren’t totally sure what causes it, for starters), there do appear to be common triggers that kick off or exacerbate IBS symptoms for a lot of people. If you’re hoping to take some unpredictability out of life with IBS, here are various ways you could be making your IBS worse without realizing it.
1. Not managing stress
What’s going on in your brain affects your gut via the gut-brain axis. This pathway connects the central nervous system, which controls conscious and unconscious functioning (including breathing and thinking), with the enteric system, a network of nerves that regulates gut activity.
Thanks to the connection between your brain and your gut, stress—the excited kind and the nervous kind—can play a role in exacerbating IBS. For example, it’s believed that some of the abdominal pain that affects some people with IBS may be caused by visceral hypersensitivity. Basically, people with IBS appear to feel movements in their guts more sensitively than other people, and often experience these movements as pain. Since stress activates certain hormones that can affect gut motility, it may lead to increased sensitivity and more pain.
Clearly, telling people “don’t be stressed” is not helpful. Everyone experiences acute periods of stress sometimes. Many people also experience chronic stress, as well. Since you can’t wave a magic wand and get rid of all stress in your life, the best way to mitigate the effects is to learn how to handle the stress itself as best as you can under the circumstances. This can take the form of self-care. “For example, through mindfulness, yoga, meditation, exercise, reading a book—even bingeing on Netflix,” David M. Poppers, M.D., Ph.D., clinical associate professor of medicine in the division of gastroenterology at NYU Grossman School of Medicine in NYU Langone, tells SELF.
As the Mayo Clinic explains, it’s common for people with IBS to also have mental health issues like anxiety and depression. If this applies to you, it could take a more clinical approach to get to the issue at the root of your stress, and therefore possibly help relieve your IBS. If you can, reach out to a mental health professional for more guidance.
2. Medications that cause constipation or diarrhea
If you feel like your IBS symptoms are suddenly flaring, think about any medications you’ve taken recently. Some medicines appear to make IBS symptoms worse in some people.
If you have IBS, it’s a good idea to check any medication before you take it to see whether diarrhea or constipation (or other common IBS symptoms) are one of the possible side effects. “Anything that causes a transient worsening of diarrhea or constipation is certainly something that can make IBS symptoms worse,” James L. Buxbaum, M.D., assistant professor of clinical medicine specializing in gastroenterology at Keck School of Medicine in the University of Southern California, tells SELF. That’s not to say you shouldn’t take a drug if you need it. For example, constipation and diarrhea are common side effects of chemotherapy drugs. But talk to your doctor to weigh the cost versus the benefit before taking a medication if you’re concerned about your IBS.