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Health education · DigestionDigestive health
Irritable bowel syndrome (IBS), also called “irritable colon,” causes abdominal pain linked to changes in bowel movements.1
It can cause constipation, diarrhea or a mix of both. It is common: about 18 % of Canadians may have it.2 Symptoms vary from person to person and can have a major effect on daily life.
How it works
IBS is recognized as a disorder of gut-brain interaction. Signals between the two are misread, so normal bowel activity can be felt as painful.2,5
Bowel contents can move more slowly or more quickly than normal, and the gut microbiota is often disturbed.2 Poor absorption of certain carbohydrates, the FODMAPs, can also play a role.5
Anxiety, life changes and digestive infections can trigger IBS.1 No single cause explains every case.
The gut-brain link goes both ways: your psychological state can influence symptoms.2 This does not mean the pain is imaginary.
Care can therefore address several aspects: diet, bowel habits, pain and gut-brain communication.
This distinction helps choose treatments.4
Diagnosis
The diagnosis is clinical: it is based on symptoms, how they change over time, medical history and the exam.5 No test can, on its own, confirm or rule out IBS.1
Depending on the situation, the following may be offered:5
No. Celiac disease tests should be done before removing gluten from your diet, so the testing is not compromised.6
If you have already stopped eating gluten, tell the professional assessing you.
Habits
Treatment is personalized. These habits are a good first step:4
You don’t need to automatically cut out every suspected food: mainly limit the ones that make your symptoms worse.
FODMAPs
FODMAPs are small carbohydrates that some people’s bowels absorb poorly. They hold water in the bowel and are fermented by bacteria, producing gas.3 They are found in onion, garlic, legumes, dairy products, some fruits such as apples and pears, honey and some sweeteners.3
Gradually reintroduce foods to find out which ones are well tolerated.3,4
Keep your diet as varied as possible, limiting only the triggers you identified.4
About half of people with IBS may benefit: this approach is not needed for everyone.3 It is ideally done with a registered dietitian, before starting a restrictive diet.1,3
The low-FODMAP approach should not be seen as a lifelong treatment.4
Fibre
Yes, but the type should match your symptoms. Soluble fibre, such as psyllium, is recommended, while highly fermentable fibre is best reduced.4,5 With constipation, other fibre sources, such as bran or whole-grain products, can also help.1
Introduce a supplement gradually, for example 5 g at a time for 8 to 10 days before increasing, and drink enough.1 Increasing too quickly can make bloating worse.
Treatments
Medications mainly target the main symptom. Their effect is moderate, and they work better combined with diet and behavioural approaches.2
| Symptom | Possible options depending on the assessment |
|---|---|
| Constipation | Laxatives, such as polyethylene glycol (PEG), or specific prescription medications.4,5 |
| Diarrhea | Antidiarrheals, such as loperamide, taken under a professional’s supervision, or some prescription medications.4,5 |
| Pain and cramps | Antispasmodics, including peppermint oil, taken 30 to 60 minutes before a meal.4 |
Some medications also used as antidepressants, the tricyclics, may be prescribed at a low dose to act on pain and gut sensitivity.5 Their use does not mean that depression is causing the symptoms.
Evidence on probiotics is still limited; ask for advice before choosing one.4,5 Pelvic floor physiotherapy may also be offered in some situations.1
Outlook
IBS often comes in flare-ups, with calmer periods.5 It can start at any age and may even go away over time.1 Symptoms can improve with suitable care.
After age 45, the chance of another digestive disease appearing is higher.5 A new or unusual symptom should therefore be assessed, even if IBS has already been diagnosed.
Seeking care
See a professional if symptoms persist, disrupt your activities or change despite treatment. If in doubt, call Info-Santé at 811, option 1.7
An assessment is especially important if you have:5
Go to the hospital without waiting if you have:7
These signs should not be automatically blamed on IBS, even if you have already been diagnosed.
The diary
A diary helps spot patterns and personalize care, without adding more food restrictions.1
You can record:
A nurse practitioner can assess your symptoms, check for warning signs, order appropriate tests, offer treatment based on your main symptom and refer you to a dietitian or a specialist if needed.
Bring your symptom diary and, if you have stopped eating gluten, mention it before testing.
This sheet mainly concerns irritable bowel syndrome in adults. It provides general information and does not replace an assessment by a health professional. Published October 29, 2026.
