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Bites: April 2025 - The IBS Check-In

Bites: April 2025 - The IBS Check-In

World IBS Day is coming up on April 19, 2025, and it’s a cause close to our hearts. While our meal programs have grown to support a variety of health needs, ModifyHealth was originally founded to serve people living with IBS—and that mission still drives us today. In honor of IBS Awareness Month, this edition of Bites is dedicated to raising awareness and empowering you to advocate for yourself, whether you’re living with IBS or just beginning to explore whether it could be affecting you.

 

 

IBS 101: Symptoms, Causes, and Treatments 

Irritable bowel syndrome (IBS) is a disorder that occurs when your gut and brain don’t work well together to manage the functions of digestion and elimination. Symptoms include abdominal pain, excess gas, and bloating. If you have IBS, you might have diarrhea, constipation, or alternate between the two. 


The underlying cause of IBS is unknown. That is part of what makes it a syndrome. A syndrome is a collection of symptoms without a clear cause. People with GI symptoms explained by a disease or surgery are usually diagnosed with something else, rather than IBS (see the next article).  We do know that IBS is a “multi-factorial” condition. That means that more than one thing usually contributes to symptoms. Some of the factors that might impact your IBS are gastroenteritis (viral, parasitic, or food-borne illness), hormones, medications, stress and anxiety, how and when you eat, and what you eat and drink.


Treatment for IBS varies depending on symptoms, and on which factors play the biggest role in your individual case.  Most people with IBS benefit from improving the mind-gut connection through exercise, guided meditation, diaphragmatic breathing, therapy, supplements, or medications. You may also feel better when you eat at consistent times and follow a Mediterranean or low FODMAP diet.




When it isn’t IBS: Red Flag Quiz 🚩

We've come a long way since the days when it was considered obligatory to rule out everything else with a long, expensive, and invasive series of tests before making an IBS diagnosis. These days it's a more straightforward process. IBS can often be diagnosed during an office visit, based only on the patient’s reported symptom history: abdominal pain plus altered bowel habits lasting for at least a few months.


However, we know that abdominal plain, diarrhea, and constipation can occur in a tremendous number of diseases and disorders. While there is no need to jump right to worst-case scenarios, it’s important to make sure that we screen for other conditions that would require different or more targeted treatments. Screening for red flags means that we look for signs that further investigation should be considered. You and your provider should be reassured that nothing else is amiss before proceeding with treatment for IBS.


If you have IBS, or think you might have IBS, take this quiz to screen yourself for red flags. Tell your primary care or gastroenterology provider if you answer “yes” to any of the questions on this quiz.

 

  • Do you ever pass bloody stools (poop)?
  • Do you ever pass greasy or oily stools (poop)?
  • Do you have diarrhea that wakes you up at night?
  • Do you ever have bowel accidents (poop in your pants or don’t make it to the toilet in time)?
  • Do you have a fever that lasts more than a few days with your symptoms?
  • Have you been told that you have any nutrient deficiencies, like low iron or Vitamin B-12 levels or anemia?
  • Have you experienced unintentional weight loss?
  • Are you underweight?
  • Are you experiencing fear of food or eating or concern that your diet is too restricted?
  • Is your abdominal pain or bloating constant and/or severe?
  • Did your symptoms suddenly after the age of 50?
  • Does one of your parents, siblings, or children have celiac disease, Crohn’s disease, ulcerative colitis, colon cancer or pancreatic cancer?
  • Did you start taking a new medication around the time of onset of your symptoms, or when they got worse?

If you are passing large amounts of blood, or dark black blood that looks like coffee grounds, or have severe pain, vomiting, and a complete inability to pass any stool or gas, you should be evaluated on an emergency basis. 





Tips for talking with your doctor about IBS

Do you suffer from ongoing abdominal pain, bloating, diarrhea, or constipation and wonder whether you have IBS? Do you worry about your symptoms, or feel they haven’t been taken seriously? Perhaps it’s time to have a frank discussion with your primary care provider or gastroenterologist. As they say in medicine, present yourself for evaluation.

 

  • Your provider’s job. Your provider has a workflow for gathering your history and comparing it to diagnostic criteria. To get the full benefit of their training and experience, let them do their job, especially during an initial visit. You are only hurting yourself when you try to take over the agenda, to steer them toward a particular diagnosis. 

  • Your job. For a productive meeting with your provider, please complete your pre-visit forms, whether on paper or online. Yes, it really makes a difference to how your doctor prepares for your visit! Know ahead of time how long your visit is scheduled for. During the visit, provide concise answers to questions about your medical history, diet, medications, symptoms, prior evaluations and treatments. Write these down ahead of time, with dates, for your own reference. Bring a list of questions that you can ask when it's your turn. Start with the most important questions, in case there isn’t time to discuss all of them. 

  • Describe your symptoms. What are they? How frequently do they occur? Is there a pattern? How severe are they? When did they start? Was there a change in your diet, routine, or medications at that time? Be sure to include any Red Flag symptoms. If talking about intimate bodily functions is difficult for you, make a list of your symptoms in writing and give it to your provider.  

  • If your concerns aren’t addressed by the provider’s process, it’s OK to ask direct questions: “Would you say I have IBS? How do we know it’s IBS and not something else?” Or, “If you don’t think I have IBS, do you have an idea what could be causing my symptoms?” These questions provide an opportunity for your doctor to provide either reassurance or next steps.

  • Ask for what you need, in a way that encourages collaboration. “How can we figure this out?” “How do you decide when more tests are needed?” “How can I learn more about this?” “Can you refer me to someone for education or guidance on the treatment you’ve suggested?” “What should I expect?” “When can you or your team member see me again to check on my progress?” 

Knowing that your provider thinks you have IBS may explain a lot and be oddly reassuring. It can help you access appropriate treatments. I can help you figure out whether information you read online or on social media applies to you. Everyone deserves clarity about the nature of their condition, so go ahead and schedule that evaluation today. 


March Bites Survey Results: What fresh herbs or spices do you reach for the most in your cooking?

Rosemary: 60%
Oregano: 53.3%
Basil: 46.7%
Paprika: 46.7%
Cilantro: 40%
Dill: 40%
Mint: 20%
Other: 33.3%