Many people with irritable bowel syndrome (IBS) report symptoms not directly related to the bowel—symptoms healthcare providers call extra-intestinal symptoms. You may experience these in other parts of the digestive system or elsewhere in your body.
That means, along with IBS symptoms, you may also be dealing with puzzling, chronic symptoms that can be uncomfortable and have a major impact on your life.
GI Symptoms
The main IBS symptoms are related to your digestive system. This includes:
- Diarrhea
- Constipation
- Abdominal pain
You may also experience symptoms elsewhere in the body, including some related to digestion, but not the bowel. The most common are:
- Nausea
- Heartburn
- Reflux
Non-GI Symptoms
The physical symptoms of IBS that are completely separate from the digestive tract can be harder to wrap your head around.
According to researchers at the University of North Carolina, the most commonly reported non-gastrointestinal symptoms associated with IBS are:
- Headache
- Back pain
- Frequent urination
- Fatigue
- Bad breath or a bad taste in the mouth
Other reported symptoms include:
- Sleep difficulties
- Muscle aches
- Cold, clammy, or trembling hands
- Heart palpitations
- Dizziness
- Pain during menstruation or intercourse
Effects
People with IBS often have their extra-intestinal symptoms minimized or dismissed by healthcare providers—even by their own friends and family. People with IBS report hearing things like:
- That's not supposed to happen. Other people don't have those symptoms.
- It's not cancer. It won't kill you.
- It's in your head.
- If you're not responding to medical treatment, you must be misdiagnosed.
- If you don't have preexisting mental health issues, your problem isn't psychological. See a doctor.
- You must be doing something wrong.
- You must be misdiagnosed.
- Live with it.
Causes
Theories abound as to why IBS increases your risk of these extra-intestinal symptoms. The wide variety of reported physical problems makes it challenging to find a common, underlying explanation.
It may be a combination of factors—including those yet to be uncovered—that contribute to the problem of extra-intestinal symptoms. The debate on this subject is ongoing and includes two main areas of inquiry.
Underlying Biological Cause
In the search for a unifying biological factor, researchers are looking at several systems that may be dysregulated or dysfunctional, including:
- The nervous system, including the role of neurotransmitters
- The body's innate pain regulation systems
- The immune system
Psychological Factors
Research into the role of psychological factors as possible contributors to extra-intestinal symptoms has pinpointed two possibilities. IBS patients may be more likely to:
- Experience emotions as physical symptoms
- Have a tendency to be hyper-aware of bodily sensations
Other Theories
Some people theorize that food sensitivities may be the underlying cause of the various ailments experienced by people who have IBS.
Along the same lines is the theory that increased intestinal permeability (leaky gut syndrome) is playing a part. At this point, there is not enough research to make any firm conclusions.
Treatments
The high frequency of extra-intestinal symptoms in IBS suggests that this is a problem that needs to receive proper attention from the medical establishment.
The strength of the healthcare provider-patient relationship appears to have a beneficial effect on patient outcomes, particularly in IBS. Your healthcare provider needs to take your health concerns seriously and work to develop an effective treatment plan that addresses all of your physical complaints.
Focusing on interventions that address the body as a whole might prove helpful. This includes dietary modifications, herbal supplements, antidepressants, and brain/gut interventions such as cognitive behavioral therapy (CBT) or hypnotherapy.
IBS Doctor Discussion Guide
Get our printable guide for your next doctor's appointment to help you ask the right questions.
You can educate yourself about red-flag digestive symptoms to ease the anxiety that something more serious is being missed.
A Word From Verywell
If you're touched by IBS, you may want to consider advocating for and donating to research aimed at understanding the possible underlying causes of, and effective treatment for, these puzzling extra-intestinal physical complaints.
Meanwhile, work closely with your healthcare team to find ways to manage all of your symptoms so you can feel better and enjoy your life.