Understanding IBS

Gemma Knaap
Jul 28
3 min read

Irritable Bowel Syndrome (IBS) is one of the most common digestive conditions — but it’s also one of the most misunderstood.

If you’ve been told you have IBS, or suspect it might be part of what’s going on for you, it’s important to understand what that label really means — and what it doesn’t.

IBS is a Diagnosis of Exclusion

Despite being so common, IBS isn’t diagnosed with a single test. It’s what’s known as a diagnosis of exclusion — meaning other possible causes should be ruled out first. That includes:

Coeliac disease
Inflammatory bowel disease (IBD)
Chronic infections or parasites
SIBO
Endometriosis (which often causes bowel-related symptoms)

If you’ve been told you have IBS without proper testing or follow-up, it’s worth seeking a more thorough workup. You deserve clarity — and support that goes beyond managing symptoms alone.

How Is IBS Diagnosed?

The most up-to-date criteria for diagnosing IBS are called the Rome IV Criteria. To meet them, you must have:

- Recurrent abdominal pain at least 1 day per week in the last 3 months

Plus 2 or more of the following:

- Pain related to bowel movements

- A change in stool frequency

- A change in stool form (e.g. loose, hard or both)

IBS can present in many ways. For some, it’s constipation-dominant. For others, it’s urgency, bloating, or alternating bowel habits. Symptoms can change over time — which is part of why it’s so frustrating to live with.

IBS Is Real — And Not Just “In Your Head”

There’s still a lot of stigma around IBS. Too many women are told to “just reduce stress” or are made to feel their symptoms are overblown. But IBS isn’t imagined — it’s a complex condition that involves:

Gut–brain axis dysregulation
Altered motility
Changes in microbiome composition
Heightened nervous system sensitivity

Supporting IBS isn’t just about food elimination — it’s about restoring healthy communication between the gut, brain, and body.

So, What Actually Helps?

Once other causes have been ruled out, the goal isn’t just symptom suppression — it’s to build a foundation for long-term gut resilience. Here’s what that looks like:

1. Low FODMAP Diet — But Only Short Term

The Low FODMAP diet can be incredibly helpful in calming IBS symptoms, especially bloating, cramping, and loose stools. But it’s not a forever diet.

This approach removes certain fermentable fibres that trigger symptoms. But over time, it can reduce microbial diversity and lead to nutrient insufficiencies. A Low FODMAP approach should be done with guidance — and only for 6–8 weeks before reintroducing foods systematically.

2. Gentle Nutrition > Chronic Restriction

Many people with IBS feel safer avoiding food — but this often backfires. Low fibre, low diversity, and stress around meals can worsen symptoms over time.

Instead, focus on:

- Slowing down and chewing properly

- Eating regularly

- Supporting digestive function (stomach acid, enzymes, motility)

Often, the gut needs nourishment and support more than avoidance.

3. Regulate the Nervous System

Stress plays a major role in IBS — not because it’s the “cause,” but because the gut and brain are constantly communicating. When the nervous system is stuck in fight-or-flight, digestion suffers. Nervous system support might include:

- Breathwork

- Walking or gentle movement

- Body-based therapy or vagus nerve exercises

- Sleep hygiene and wind-down routines

This piece is often missing in IBS care — and it matters.

4. Support the Gut Environment

The goal is to create a thriving, balanced gut ecosystem. Depending on your symptoms and testing, this might include:

- Diverse plant fibres to support microbiome diversity

- Bitter herbs to stimulate digestion

- Magnesium or ginger to support regular motility

- Targeted probiotics (when appropriate)

- Prebiotics introduced gradually and with care

Working with a practitioner helps tailor this to your needs — and avoid doing too much at once.

The Bottom Line

IBS is real — but it’s not a one-size-fits-all condition. It deserves a proper diagnosis, personalised care, and a plan that addresses both gut and nervous system health.

If you’ve been given an IBS label and told to “just live with it,” know that there is more support available. You deserve more than symptom control. You deserve to feel calm, nourished, and in tune with your body again.