6 Signs of IBS-C, IBS-D and IBS Flare-Up

Irritable bowel syndrome (commonly abbreviated as IBS) is an abnormal condition of the gut that is characterized by abdominal cramps and changes in bowel movement. Irritable bowel syndrome is a functional disease, which means that no anatomical abnormalities are discernible in the gut. However, the gut still functions in an abnormal manner.
Irritable bowel syndrome is a fairly common condition.

It is estimated that around 20% of the American population suffer from IBS. The affected individuals may have long periods of normal existence interrupted by sudden flare-ups. The chronic nature of this disease severely impairs the quality of life of the affected individuals. It is important to note that irritable bowel syndrome does not lead to lethal conditions such as colorectal cancer.

Read more on irritable bowel syndrome.


The cause of irritable bowel syndrome is thought to be an abnormality in the rate of contractions of the bowels (or bowel motility). Both overactive and underactive bowels are associated with irritable bowel syndrome. There is also an increased sensitivity to the contractions of the bowel. The abnormal bowel movements in irritable bowel syndrome result in abnormal bowel habits, such as diarrhea, constipation, and alternating episodes of diarrhea and constipation.

In cases where diarrhea predominates, the irritable bowel syndrome is referred to as IBS with diarrhea or diarrhea-predominant IBS (abbreviated as IBS-D). In cases where constipation predominates, the irritable bowel syndrome is referred to as IBS with constipation or constipation-predominant IBS (abbreviated as IBS-C).

IBS Flare Up

Irritable bowel syndrome is a chronic lifelong condition. However, the frequency and intensity of symptoms vary widely on an individual basis. Some patients experience mild symptoms constantly on a daily basis, whereas others may have symptoms only intermittently. In individuals who suffer from IBS symptoms intermittently, the flare-up of symptoms may occur suddenly and with high intensity. The flare-up of IBS symptoms in these cases may last from days to weeks.

Triggers for flare-up of IBS symptoms

Since irritable bowel syndrome has been classified as a functional disease, its exact cause remains unknown. No clear pathology has been associated with this condition. However, a variety of factors have been known to trigger the flare-up of symptoms in irritable bowel disease. These trigger factors can be broadly categorized as follows:

  • Specific kinds of foods and drinks
  • Certain diseases
  • Hormonal changes
  • Psychological stress

The exact nature of the trigger differs on an individual basis. In some cases, flare-up of symptoms may occur even in the absence of a clearly identifiable triggering factor. In addition, the factors that lead to the easing of IBS symptoms after a flare-up may not be clearly identifiable in all cases.

How to Spot IBS

The following are some of the key signs and symptoms that are apparent in various types of irritable bowel syndrome. Proper diagnosis of irritable bowel syndrome requires the expertise of a medical professional. Various diagnostic tests are used to exclude other conditions that may present with a similar constellation of signs and symptoms. Once these other conditions are ruled out, only then can a diagnosis of IBS can be made.

Read more on differences between IBD and IBS.

Abdominal cramps

One of the characteristic defining features of irritable bowel syndrome is the occurrence of abdominal pain and cramps. These abdominal cramps occur along with changes in the normal bowel habit. Abdominal cramps in irritable bowel syndrome are thought to result from spasms of the muscles in the walls of the intestine. One of the diagnostic criteria for irritable bowel syndrome is the occurrence of abdominal cramps that last for at least 3 days every month, for a period of 3 consecutive months. These abdominal cramps usually subside with the passing of stools.

Constipation and diarrhea

As mentioned previously, diarrhea and constipation are key features of irritable bowel syndrome. Diarrhea is defined as having more than three bowel movements within a day. The stools in diarrhea often tend to be watery. Constipation is defined as having less than three bowel movements in a week. The stools in constipation tend to be very hard. Some cases of IBS are diarrhea-predominant (IBS-D), some cases are constipation-predominant (IBS-C), and some are mixed -type IBS where episodes of both diarrhea and constipation alternate.

Excessive intestinal gas

Excessive gas formation is a common complaint of patients with irritable bowel syndrome. The excessive gas formed in the gut is expelled through either belching or flatulence. The increase in gas formation is usually associated with periods of flare-ups, and is accompanied by a feeling of abdominal distension or bloating. Even though excessive gas formation is a common complaint among the sufferers of irritable bowel syndrome, studies have failed to find any significant increase in intestinal gas formation in these patients.

Stomach bloating

Abdominal bloating refers to both the sensation of fullness in the stomach as well as a visible increase in the girth of the abdominal region. Excessive gas formation is believed to be responsible for both these types of abdominal bloating. However, it is not clear if the distention of the abdomen is really a result of excessive gas in the gut. Although accumulation of fluid in the abdominal cavity can also result in abdominal distention, this does not seem to be the case in irritable bowel syndrome.

Mucus in the stool

The presence of mucus in stool is not a unique feature of irritable bowel syndrome. In fact, mucus in stool may not even be noticeable in all cases of irritable bowel syndrome. However, it is usually evident during periods of flare-ups. It is important to note that mucus is a normal constituent of stool since it is secreted throughout the gut. Under normal circumstances, the mucus is present in small amounts and gets mixed up with the stool. When the mucus is present in excess, it appears as a stringy and sticky substance coating the stool.

Bleeding from the rectum

Bleeding from the rectum is usually due to the presence of hemorrhoids or piles. Both diarrhea and constipation, which are characteristic features of irritable bowel syndrome, can cause formation of hemorrhoids. During flare-ups, these hemorrhoids may burst, leading to rectal bleeding. Overt bleeding is observed in some severe cases. However, in many cases rectal bleeding only comes to notice while cleaning up after the bowel movement. The presence of rectal bleeding and other IBS symptoms without any accompanying hemorrhoids should be investigated seriously.

Serious Signs

The above mentioned signs and symptoms are not unique to irritable bowel syndrome. A variety of other gastrointestinal diseases could also exhibit similar signs and symptoms. Even though irritable bowel syndrome is not a fatal disease, other diseases with similar signs and symptoms may lead to fatal complications. The following signs and symptoms should be investigated seriously when they appear:

  • Bleeding from the rectum that is not caused by hemorrhoids.
  • A worsening of the abdominal pain.
  • Sudden, unintentional weight loss.
    Colorectal cancer and inflammatory bowel disease (commonly abbreviated as IBD) are two serious conditions that may display all three symptoms mentioned above, along with other signs and symptoms of irritable bowel syndrome.

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