Coping With IBS-A

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If you been diagnosed with alternating or mixed-type irritable bowel syndrome (IBS-A or IBS-M), you’re likely dealing with bowel symptoms that range from diarrhea to constipation. While there isn’t a cure for IBS-A, there are strategies that you can use to help manage symptoms and cope with daily life.

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Emotional

IBS symptoms can often be triggered by stress. Your digestive system and brain communicate with each other in what’s called a brain-gut connection. When stress disturbs that, your symptoms can be aggravated.

Finding ways to cope with emotions and manage stress can help ease symptoms of IBS. Some strategies include:

  • Deep breathing: A 2015 study found that breathing exercises, plus meditation, helped manage IBS symptoms and anxiety. Try dedicating a few minutes a day to deep breathing. Place one hand on your stomach above your belly button. Take a slow breath inward, bringing the air down to your stomach so you can feel your hand rise. Pause briefly, and exhale slowly through your nose and mouth. Continue these slow breaths five to 10 times each.
  • Yoga: Another study found that a 12-week yoga class improved symptoms and quality of life for IBS patients. The combination of poses and movement with deep breathing was found to reduce the stress related to IBS.
  • Cognitive behavioral therapy: Cognitive behavioral therapy (CBT) helps you identify stressful or negative thoughts and learn how to modify your response. A 2019 study found that virtual and phone CBT sessions with a professional helped reduce IBS symptoms and increase quality of life for participants for up to 24 months. 

If you’re experiencing anxiety or depression, talk to your healthcare provider. They can help you find support and treatment.

Physical 

As you are likely already well aware, diet can play a role in triggering IBS-A symptoms. Your healthcare provider may recommend specific changes to your diet to see if they help.

You may need to change what you eat for several weeks before you can tell if your symptoms are improving. Strategies include:

  • Avoiding trigger foods: These can include caffeine, alcohol, dairy, chocolate, and fried, fatty foods. Your healthcare provider may also suggest avoiding gluten to see if your IBS symptoms improve. Gluten is found in pasta, cereal, bread, and many processed foods.
  • Increasing soluble fiber: Soluble fiber can improve symptoms in mixed-type IBS. If you're constipated, it can help make stools softer so you can pass them more easily. If you have diarrhea, foods with soluble fiber, like berries and oats, can help by slowing the passage of food to the intestines and adding bulk to stools. Make sure you add foods slowly so that your body can adjust. If you add more fiber too quickly, it can cause gas, bloating, and abdominal pain.
  • Eating low-FODMAP foods: FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. Studies have found that about 70% of IBS patients have fewer symptoms with a low-FODMAP diet. Low-FODMAP foods include bananas, strawberries, grapes, chicken, tofu, eggs, carrots, and corn. You might want to avoid high-FODMAP foods, which are carbohydrates that are hard to digest. Examples include apples, watermelon, artichokes, garlic, beans, mushrooms, dairy, wheat, and rye products. 

Talk with your healthcare provider before making any changes to your diet. Dietary changes that work for IBS can vary from person to person, and any adjustments will need to take your overall nutrition into account—especially since malabsorption of nutrients can occur with IBS.

Social 

Sometimes talking with people about IBS can help to reduce your stress. IBS support groups or online groups are available to connect you with people with similar conditions. They can be a great source of advice and perspective on the challenges of living with IBS. Sometimes even just hearing that someone else is facing similar challenges can help you feel less alone.

Group therapy sessions may help reduce stress as well as symptoms. One study found that cognitive behavioral group therapy helped IBS patients in improving symptoms, psychological stress, and quality of life.

Ask your healthcare provider about IBS support groups or therapy groups. They may be able to help you to find ones that meet in your area. 

Talking with friends and family can also help you to manage your IBS-related stress. Let them know that IBS-A might affect you differently day-to-day, so they have a better understanding of it.

Even if they don't personally know what you are going through, they may be able to offer support when you’re changing your diet or try new relaxation techniques along with you. And at the very least, they can provide some welcome distraction.

Reach out to friends and family for support. You don't have to go it alone.

Practical

While you may have limited control over some of what you experience, taking on more practical challenges can go a long way in easing the burden of your condition, and making life more enjoyable.

A few things to consider:

  • Ask for help: If you’re experiencing symptoms, ask for assistance when you need it. Talk to your family and friends and let them know what they can do when you’re not feeling your best. It may help to have a list handy.
  • Travel wisely: When you’re traveling, carry a “survival kit” with you. That might include a change of clothes, wet wipes, tissues, and any medication that you need. If you’re on a plane, ask for a seat that’s closest to the restroom. Consider driving to destinations if it makes it easier to stop for a restroom.
  • Plan ahead when dining out: Don't miss out on dinner with a friend. Look at a restaurant's menu online, if possible, and ask for substitutions if there’s an ingredient that makes your symptoms act up.

A Word From Verywell

While these coping strategies can go a long way, they alone may not be enough to help ease your symptoms and improve life with IBS-A. If you're struggling, speak with your healthcare provider. An adjustment in your treatment may be needed.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Harvard Health Publishing. Soothing solutions for irritable bowel syndrome.

  3. Kuo B, Bhasin M, Jacquart J, et al. Genomic and clinical effects associated with a relaxation response mind-body intervention in patients with irritable bowel syndrome and inflammatory bowel disease. PLoS ONE. 12(2):e0172872. doi:10.1371/journal.pone.0123861

  4. Kavuri V, Selvan P, Tabesh A, Raghuram N, Selvan S. Remedial Yoga module improves symptoms of irritable bowel syndrome: Replication in the Wait-list group and sustained improvements at 6 months. Eur J Integr Med. 7(6):609-616. doi:10.1016/j.eujim.2015.11.002

  5. Everitt H, Landau S, O'Reilly G et al. Cognitive behavioural therapy for irritable bowel syndrome: 24-month follow-up of participants in the ACTIB randomised trial. Lancet Gastroenterol Hepatol. 4(11):863-872. doi:10.1016/s2468-1253(19)30243-2

  6. National Institute of Diabetes and Digestive and Kidney Diseases. Eating, diet, and nutrition for irritable bowel syndrome.

  7. Cleveland Clinic. Foods to choose if you have mixed irritable bowel syndrome.

  8. Gibson PR. The evidence base for efficacy of the low FODMAP diet in irritable bowel syndrome: Is it ready for prime time as a first-line therapy? J Gastroenterol Hepatol. 32(Suppl. 1):32-35. doi:10.1111/jgh.13693

  9. Tkachuk G, Graff L, Martin G, Bernstein C. Randomized controlled trial of cognitive-behavioral group therapy for irritable bowel syndrome in a medical Setting. J Clin Psychol Med Settings. 10(1):57-69. doi:10.1023/a:1022809914863

By Barbara Bolen, PhD
Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome.