IBS Symptoms


​​IBS symptoms affect an estimated 10% - 20% in New Zealand, making this condition one of the most common gastrointestinal disorders we see today. As a naturopath, I've noticed that many people struggle to identify irritable bowel syndrome symptoms because they can vary widely from person to person.

Interestingly, IBS symptoms in females appear up to twice as frequently compared to men, with most people developing their first signs before age 40. The classic symptoms of IBS include abdominal pain, bloating, gas, diarrhoea, constipation, and mucous in the stool.

These symptoms can fluctuate over time, with periods of intense IBS flare ups followed by relatively symptom-free intervals.

What are the most common symptoms of IBS?

The hallmark symptom of IBS is abdominal pain or discomfort, which affects virtually everyone with this condition. This pain typically improves after having a bowel movement. In my clinical practice, patients often describe this discomfort in various ways, as sharp pain, cramping, bloating, or even a burning sensation.

Bowel habit changes represent another core symptom of irritable bowel syndrome. These changes can manifest as:
  • Diarrhoea (IBS-D): Characterized by frequent, loose, and watery stools that may contain mucous
  • Constipation (IBS-C): Involving infrequent, hard, and painful bowel movements
  • Mixed type (IBS-M): Alternating between diarrhoea and constipation, sometimes within the same day

Bloating and excessive gas affect numerous IBS patients, with many describing these as the most persistent and unpleasant symptoms. During my consultations, patients frequently mention feeling uncomfortably full and swollen in their abdomen. Additionally, people with IBS may not necessarily produce more gas than others but might be more sensitive to normal amounts.
The sensation of incomplete evacuation – feeling like you haven't fully emptied your bowels, is especially common. This frustrating symptom affects many with both IBS-C and IBS-D, often leading to unnecessary straining.

Furthermore, mucous in the stool represents another distinctive IBS symptom. White-coloured mucous is particularly common and while a small amount is normal, excess mucus can indicate irritation in the intestinal lining.

Other less common symptoms​ include fatigue, backache, sleep disturbances, and urinary issues like frequent urination or sudden urges. Moreover, some patients experience symptoms unrelated to digestion, such as migraines, anxiety, depression, or chronic pelvic pain.

Understanding these symptoms is crucial for identifying IBS. Nevertheless, it's worth noting that symptom patterns differ between individuals, and their severity often fluctuates over time, with certain triggers potentially worsening them.

How IBS symptoms show up differently in people

Gender plays a significant role in how irritable bowel syndrome symptoms manifest.  In New Zealand, women experience IBS at approximately twice the rate of men, with a female-to-male ratio of 2-2.5:1 among those seeking medical care.

What's fascinating is how symptoms distribute differently between genders. Women primarily suffer from constipation-dominant IBS (IBS-C), affecting 40% of female patients versus just 21% of males. Conversely, men typically experience diarrhoea-dominant IBS (IBS-D) at higher rates, 50% of men compared to 31% of women.

This symptom divide likely stems from hormonal differences. Female sex hormones like estrogen and progesterone inhibit smooth muscle contraction and slow digestive transit times. Consequently, many women notice their symptoms fluctuate with their menstrual cycle. Prior to and during menstruation, women often report increased abdominal pain and diarrhoea, whereas after ovulation (around day 14), they experience more bloating and constipation.
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Age likewise influences IBS presentation. The condition typically emerges during puberty, peaks in prevalence during childbearing years for women, then gradually decreases, approaching male rates around age 70. For men, IBS prevalence remains relatively stable from ages 20 to 70.
Brain responses to IBS differ between genders too. Women show increased activation in emotional processing areas like the amygdala, making them potentially more sensitive to pain signals. Men, meanwhile, exhibit more activation in sensory processing regions.

Beyond physiological factors, social norms shape symptom reporting. Western men seek medical help for IBS symptoms less frequently than women, possibly due to cultural expectations about masculinity.
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The intensity and duration of symptoms varies greatly too, some experience mild discomfort while others endure severe, life-disrupting episodes. For most, symptoms wax and wane over time, with periods of relative calm interrupted by flare-ups lasting from hours to weeks.

What can trigger or worsen IBS symptoms?

Triggers that spark IBS flares vary widely from person to person, making this condition uniquely challenging. Stress stands as perhaps the most significant factor in symptom intensity. Through the gut-brain axis, stressful situations send signals that alter digestive function. Chronic stress specifically can trigger increased muscle spasms, abnormal food movement through the digestive tract, and heightened sensitivity to pain.

For female patients, hormonal fluctuations play a crucial role in symptom intensity. Studies reveal that approximately 50% of women with IBS experience worsened bowel symptoms during their menstrual period. This occurs because receptor cells for female sex hormones exist throughout the gastrointestinal tract, affecting how quickly food travels through your system.
Food-related triggers affect up to 84% of IBS patients. Common culprits include:
  • High-fat foods and fried items that can trigger an exaggerated gastrocolic reflex
  • Alcohol, particularly after binge drinking
  • Caffeine, which stimulates the intestines and may cause diarrhoea
  • FODMAPs (fermentable carbohydrates found in certain fruits, vegetables, wheat products, and legumes)
  • Dairy products, especially for those with lactose intolerance, or dairy protein intolerance​​
Even eating habits themselves can worsen symptoms. Large meals often lead to stronger contractions in your large intestine. Additionally, eating too quickly without proper chewing reduces digestive efficiency and potentially increases discomfort.
​Fascinatingly, many IBS sufferers report symptoms appearing immediately after eating, not because of food sensitivities, but due to an exaggerated gastrocolic reflex. This normal digestive response becomes amplified in IBS patients, causing stronger intestinal contractions after meals.
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As a naturopath, I've observed that identifying personal triggers represents the first step toward symptom management. Keeping a detailed journal of foods, stress levels, and symptoms often reveals patterns unique to each individual. Notably, what triggers one person's symptoms may have no effect on another, highlighting the personalized nature of this condition.

Conclusion

Understanding IBS symptoms thoroughly provides the foundation for managing this complex condition effectively. Certainly, the way IBS manifests varies significantly between individuals, from gender differences through to the age-related changes in symptom intensity.

Above all, recognizing your personal triggers represents perhaps the most crucial step toward symptom management. Whether stress activates your gut-brain axis, specific foods cause discomfort, or hormonal fluctuations intensify symptoms, identifying these patterns empowers you to take control.

Once you’ve received a diagnosis from your GP, the next step is to look beneath the surface and address the root causes. From a clinical perspective, issues like a compromised gut lining or an imbalanced microbiome are often key contributors. When these are properly supported, many people experience significant relief, often without needing to cut out entire food groups or follow overly restrictive diets.
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If you’ve been diagnosed with IBS or are dealing with ongoing digestive symptoms, you don’t have to navigate it alone. Book a free 10-minute chat to find out how we can support your gut health and help you feel your best, naturally.
Vanessa Winter
​Naturopath & Medical Herbalist
BHSc (Deans Award for Academic Excellence), BED, Adv.Dip.Nat., Adv.Dip.Herb.Med., NMHNZ
​Registered with Naturopaths and Medical Herbalists of NZ (NMHNZ)

References

https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016
https://my.clevelandclinic.org/health/diseases/4342-irritable-bowel-syndrome-ibs
https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/symptoms/
https://www.monashfodmap.com/ibs-central/what-is-ibs/
https://www.hopkinsmedicine.org/health/conditions-and-diseases/irritable-bowel-syndrome-ibs
https://www.webmd.com/ibs/symptoms-irritable-bowel-syndrome-ibs