IBS-M: Understanding the Symptoms, Treatment, and Diet for IBS Mixed

Do you ever feel like your digestive system is playing a game of tug-of-war with your well-being? Are you constantly juggling between diarrhea and constipation? Or perhaps you know someone who does?

That’s the essence of IBS-M, a fascinating subtype of Irritable Bowel Syndrome (IBS) that we’re about to explore.

IBS-M, or IBS Mixed, is like a symphony of alternating bowel habits and abdominal pain, orchestrated by a complex interplay of your gut, brain, and lifestyle.

In this journey of understanding IBS-M, we’ll unravel its distinctive symptoms, causes, and effective treatment strategies. You’ll discover how stress and lifestyle factors can impact your gut health and what you can do to regain harmony.

Key Takeaways

  1. IBS-M, or Irritable Bowel Syndrome Mixed, is a subtype of IBS characterized by alternating bouts of diarrhea and constipation.
  2. The unique challenges of IBS-M include fluctuating bowel habits, abdominal discomfort, stress sensitivity, and overlapping symptoms like bloating and urgency.
  3. Understanding the causes of IBS-M can be complex, involving a combination of genetic, environmental, gut motility, and gut-brain axis factors.
  4. Treatment for IBS-M often includes a combination of medication, lifestyle modifications, psychological interventions, and complementary therapies.
  5. Lifestyle modifications such as stress reduction, regular exercise, and sleep hygiene can play a significant role in managing IBS-M.
  6. Medications like antispasmodics, laxatives, low-dose antidepressants, and even antibiotics may be prescribed to alleviate IBS-M symptoms.
  7. Complementary and alternative therapies like probiotics, peppermint oil, and acupuncture can be considered as additions to conventional treatment but should be discussed with a healthcare provider.

By understanding these key takeaways, individuals with IBS-M can better navigate their symptoms and work with healthcare professionals to develop personalized treatment plans.

What is IBS Mixed (IBS-M)

IBS-M, or Irritable Bowel Syndrome Mixed, is a specific subtype of IBS characterized by a mix of both diarrhea and constipation. While all types of IBS share some commonalities, IBS-M has a unique set of challenges and symptoms that set it apart.

IBS-A, or IBS with alternating constipation, is another term for IBS-M. The main difference between IBS-M and IBS-A is the terminology used to describe the condition, as IBS-M is more specific about the stool consistency changes.

Understanding the Unique Characteristics of IBS-M:

  • Fluctuating Bowel Habits: Those with IBS-M may experience days of constipation, followed by episodes of diarrhea, making it hard to predict or manage symptoms.
  • Abdominal Discomfort: Pain and discomfort in the abdomen are typical, often relieved temporarily by bowel movements.
  • Stress Sensitivity: Stress and emotional factors can trigger or exacerbate IBS-M symptoms.
  • Overlapping Symptoms: Some individuals with IBS-M may also experience bloating, gas, or urgency to have a bowel movement.

Why is IBS-M a Subtype on its Own

The dual nature of IBS-M can make it more challenging to diagnose and treat. It combines the characteristics of both IBS-D (diarrhea-predominant) and IBS-C (constipation-predominant).

The treatment approach for IBS-M often requires a delicate balance, as therapies targeting one symptom (e.g., anti-diarrheal medication) may worsen the other (e.g., constipation).

Decoding IBS-M Symptoms

For those with IBS-M, or mixed bowel habits, the roller coaster of symptoms can be especially frustrating. Imagine days of constipation followed by episodes of urgent diarrhea—talk about a gut whirlwind.

Here’s what distinguishes IBS-M from other subtypes, like IBS-C or IBS-D:

  • Alternating bowel habits: The hallmark of IBS-M is the unpredictable swing between constipation and diarrhea. On some days, you may struggle with hard, lumpy stools, while on others, it’s all about loose and watery bowel movements.
  • Abdominal pain: The pain experienced with IBS-M can vary in intensity and location. It may be a dull ache that lingers or a sharp twinge that comes and goes.
  • Other common symptoms: Bloating, excessive gas, urgency, and a sense of incomplete bowel movements are also par for the course with IBS-M.

Unraveling the Causes of IBS-M

The causes of IBS-M can be as varied as its symptoms. Researchers believe that IBS-M is a complex interplay among genetic, environmental, and lifestyle factors.

Here’s a closer look at the intricate web of potential causes:

  1. Genetic and Environmental Factors: Studies have shown that IBS-M tends to run in families, suggesting a genetic predisposition. However, it’s important to note that having a family member with IBS-M doesn’t guarantee you’ll develop it. Environmental factors like diet, stress levels, and exposure to certain infections may also influence the development of IBS-M.
  2. Gut Motility and Sensitivity: The motility of your gut, or how fast or slow it moves food through your digestive system, can play a role in IBS-M. Some people with IBS-M have faster gut transit times, leading to diarrhea, while others have slower transit times, resulting in constipation. The sensitivity of your gut, or how it senses and reacts to stimuli, can also contribute to the discomfort and pain associated with IBS-M.
  3. The Gut-Brain Axis: The gut-brain connection is a hot topic in the world of IBS. Stress and anxiety can trigger or worsen IBS-M symptoms, and this is partly due to the communication between the gut and the brain via the gut-brain axis. Research suggests that alterations in the gut microbiome (the community of bacteria in your gut) and the release of certain neurotransmitters in the gut may contribute to the gut-brain connection in IBS-M.

IBS-M is a complex condition with no clear-cut cause. Instead, it’s a convergence of various factors, from genetics to stress levels.

By identifying your triggers and making targeted lifestyle changes, you can better manage your symptoms and improve your quality of life.

IBS-M Treatment Approaches

There isn’t a one-size-fits-all approach to IBS-M treatment. A combination of different strategies—medications, lifestyle modifications, psychological interventions, and complementary therapies—may be tailored to your specific needs to help you find the relief you’re seeking.

If one treatment doesn’t work, don’t lose hope; there are often other options to explore.

1. Medications for IBS-M

Medications can play a crucial role in alleviating symptoms and improving your quality of life.

Here’s a look at the options available:

Over-the-Counter (OTC) Medications

  • Antispasmodics: These relax the muscles in your gut, reducing cramping and pain. Common OTC antispasmodics include peppermint oil and dicyclomine.
  • Laxatives: IBS-M can cause constipation, and OTC laxatives like polyethylene glycol (PEG) can help regulate bowel movements.
  • Anti-diarrheal: Doctors may recommend anti-diarrheal medications to manage frequent loose stools.

Prescription Medications

  • Tricyclic Antidepressants (TCAs): While primarily used to treat depression, TCAs like amitriptyline can also help with IBS symptoms by reducing pain and improving gut motility.
  • Serotonin Reuptake Inhibitors (SRIs): Medications like fluoxetine and sertraline, commonly used to manage depression and anxiety, can also impact the gut-brain connection and provide relief for both pain and changes in bowel habits.
  • Rifaximin: This antibiotic targets gut bacteria and has shown promise in reducing IBS symptoms, especially in those with diarrhea-predominant IBS-M.
  • Antispasmodic Medications: Doctors may prescribe antispasmodic drugs to reduce intestinal cramping, a common symptom of IBS-M. These medications work by relaxing the muscles of the intestines, easing the discomfort.

It’s essential to work closely with your healthcare provider to find the right medication regimen for your specific symptoms and lifestyle. They can help tailor a treatment plan that includes both medication and lifestyle modifications.

Always follow your doctor’s instructions and keep them informed of any changes or concerns you may have.

2. Lifestyle Modifications and Stress Management

To truly tackle IBS-M, it’s essential to address the intricate dance between the mind and the gut. Stress and lifestyle factors play a significant role in symptom flares and overall gut health.

Here’s what experts recommend to help you regain control:

1. Stress Reduction Techniques

  • Stress management: Since stress can exacerbate IBS-M symptoms, stress-reducing techniques like deep breathing, meditation, or regular exercise may be suggested.
  • Mindfulness and meditation: Practicing mindfulness and deep breathing exercises can work wonders in calming the gut-brain axis.
  • Cognitive Behavioral Therapy (CBT): A form of psychotherapy that helps reframe negative thoughts and cope with stress. It helps identify and change negative thoughts and behaviors that contribute to symptom flare-ups.
  • Gut-directed hypnotherapy: This therapy combines relaxation techniques and guided imagery to help improve gut function and reduce pain.
  • Mindfulness-based stress reduction (MBSR): MBSR techniques, like body scans and mindful eating, can help individuals become more aware of their body’s signals and manage stress.

2. Exercise for Symptom Control

  • Regular physical activity: Engaging in moderate exercise, such as walking or yoga, can promote regular bowel movements and reduce stress.
  • Gentle movement: Engaging in activities like walking, yoga, or tai chi can reduce stress and promote healthy digestion.
  • Regular exercise routine: Aim for at least 30 minutes of moderate-intensity exercise most days of the week.

3. Prioritize Sleep Hygiene

  • Stick to a schedule: Go to bed and wake up at the same time every day to regulate your body’s internal clock.
  • Create a sleep-friendly environment: Keep your bedroom cool, dark, and free from electronic distractions.

4. Food and Diet Adjustments

  • Dietary changes: Some individuals with IBS-M find relief by avoiding trigger foods such as fatty or spicy dishes, caffeine, or alcohol. A dietitian can assist in identifying and implementing suitable dietary modifications.

By making lifestyle modifications, you’re not just addressing your IBS-M symptoms; you’re also improving your overall well-being. Give these techniques a try, and you might be pleasantly surprised by the positive impact they can have on your gut and your life.

3. Complementary and Alternative Therapies

While traditional medicine plays a central role in managing IBS-M, there are complementary and alternative therapies that some individuals find helpful in alleviating symptoms.

It’s important to note that these therapies should never replace conventional medical advice, but they may serve as valuable additions to your treatment plan when used under the guidance of a healthcare professional.

Here are a few that show promise for IBS-M:

  1. Probiotics: These are beneficial bacteria that can help restore balance in your gut. Research suggests that certain strains, such as Bifidobacterium and Lactobacillus, may reduce IBS symptoms. Before adding a probiotic to your routine, consult your doctor to identify the most suitable strain and dose.
  2. Herbal remedies: Peppermint oil and fennel are two herbal options that may offer relief from IBS-M symptoms. The natural properties can help relax the muscles of your gastrointestinal tract, potentially reducing abdominal pain and bloating. It’s important to discuss these options with a healthcare provider before starting.
  3. Acupuncture: This traditional Chinese therapy involves the insertion of thin needles into specific points on your body. While the evidence for acupuncture in IBS treatment is mixed, some studies have shown promising results in alleviating symptoms like abdominal pain and bloating. If you’re considering acupuncture, ensure that you choose a licensed and experienced practitioner.

It’s worth noting that while these complementary therapies may offer relief for some, the evidence supporting their use in IBS-M varies. What works for one person may not work for another. It’s important to remember that these therapies are additions, not substitutions, for medical advice.

That’s why it’s crucial to consult a healthcare professional before trying any complementary or alternative therapy. Your doctor can help you navigate the options, ensure they don’t interfere with your current treatment, and tailor a plan that meets your specific needs.

Tailoring the Diet for IBS-M

Diet plays a crucial role in managing IBS-M, as certain foods can either soothe or aggravate symptoms.

Identifying Trigger Foods That Can Aggravate Symptoms

Regular meal patterns and mindful eating are crucial when managing IBS-M. Introducing structure to mealtimes can help regulate bowel movements and prevent symptom flare-ups. Here’s why it matters:

  • Try to establish set meal and snack times to promote regularity.
  • Slow down and chew food thoroughly to aid digestion.
  • Avoid eating on the go or in a rushed manner.

Adequate fluid intake is also important, as it helps soften stools and prevent constipation. Pair that with smart fiber choices for a digestive win:

  • Aim to drink at least 8 cups (64 ounces) of fluids daily, preferably water.
  • Foods like oats, chia seeds, and flaxseeds offer a healthy dose of soluble fiber to promote regularity.

Certain foods commonly trigger IBS-M symptoms. While the list varies from person to person, some common culprits include:

  • High-Fat Foods: Fried foods, fatty cuts of meat, and rich desserts can be problematic.
  • High-Fiber Foods: While fiber is generally good for digestion, some people with IBS-M find that excessive amounts can worsen symptoms.
  • Gas-Producing Foods: Beans, lentils, onions, and carbonated drinks can lead to bloating and increased gas.

To personalize your approach, consider keeping a food diary. Jot down what you eat and how you feel afterwards. This record can help you pinpoint your individual triggers.

  • A food diary should be detailed. Include portion sizes, cooking methods, and any added sauces or condiments.

By identifying your trigger foods, you can tailor your diet to manage IBS-M more effectively. A registered dietitian can further guide you in creating a personalized eating plan that minimizes symptom exacerbation.

Using this information, you can make well-informed choices about what to eat, when to eat, and how to eat.

Low FODMAP Diet and IBS-M

One approach that might help you find some IBS-M symptom relief is the low FODMAP diet.

FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) are a group of carbohydrates that can be difficult to digest for some people. In IBS-M, these carbs can ferment in the gut, causing gas, bloating, and changes in bowel movements.

So, how does the low FODMAP diet fit in? Essentially, it’s a three-step process that involves restricting high-FODMAP foods, reintroducing them one at a time, and then personalizing your diet based on your specific triggers.

The potential benefits? You may experience reduced bloating, less gas, and more stable bowel movements.

Here are some practical tips to consider if you’re thinking about trying a low FODMAP diet for your IBS-M:

  1. Educate yourself: Learning which foods are high or low in FODMAPs is crucial. There are many resources available, like the Monash University FODMAP app, that can guide you through the process.
  2. Get professional guidance: Working with a registered dietitian who specializes in the low FODMAP diet can make a world of difference. They can help you navigate the complexities of the diet and ensure you’re meeting your nutritional needs.
  3. Give it time: It can take a few weeks on the diet to see noticeable improvements. Be patient and trust the process.
  4. Reintroduce systematically: Don’t skip the reintroduction phase. This is where you’ll identify your personal FODMAP triggers, allowing you to personalize your diet for the long term.

It’s important to note that the low FODMAP diet is not a long-term solution for IBS-M. It’s a tool for managing symptoms while you work on other aspects of your gut health. If you’re considering this diet, it’s always best to consult with a healthcare professional to ensure it’s right for you.

When to See a Doctor for IBS-M

You’ve been managing your IBS-M symptoms like a pro, but there may come a time when you need to call in the experts. Here are some key situations to keep in mind:

  1. New or Worsening Symptoms: If your symptoms take an unexpected turn or become more severe, it’s time for a consult.
  2. Weight Loss or Nutritional Deficiencies: Unintended weight loss or difficulty getting essential nutrients may indicate a need for medical intervention.
  3. Blood in Stool: This is a red flag. Whether it’s bright red or tarry black, it’s a sign you should reach out to your healthcare provider.
  4. Fever: A fever can signal an underlying infection or inflammation that requires prompt medical attention.
  5. Disrupted Daily Life: If your symptoms significantly impact your quality of life—making it difficult to work, socialize, or sleep—it’s time to seek guidance.
  6. Age over 50: While IBS-M typically starts earlier in life, new or changing symptoms after age 50 may require closer examination.
  7. Family History of Digestive Diseases: Let your doctor know if conditions like inflammatory bowel disease or colon cancer run in your family.

Remember, your doctor is your partner in managing your IBS-M. They can help tailor a treatment plan, suggest targeted dietary changes, and rule out other conditions with similar symptoms. If in doubt, it’s always better to err on the side of caution and reach out to a healthcare professional.

IBS-M Subtype Final Thoughts

Managing IBS-M, a complex subtype of irritable bowel syndrome, requires a multi-faceted approach tailored to each individual’s unique symptoms and triggers.

By tracking symptoms, making targeted diet modifications, incorporating stress reduction techniques, and considering medications or complementary therapies, individuals can find relief and regain control over their gut health.

Written and Medically Reviewed By

  • Kelly Chow

    Kelly first experienced IBS symptoms at the age of 24 with major-to-severe symptoms. She underwent all types of tests and experimented with many treatments before finally finding ways to manage her symptoms. Kelly has written and shared ebooks and Gluten-Free diet plans that she has used to live life like she did before IBS.

  • Julie Guider, M.D.

    Dr. Julie Guider earned her medical degree from Louisiana State University School of Medicine. She completed residency in internal medicine at the University of Virginia. She completed her general gastroenterology and advanced endoscopy fellowships at University of Texas-Houston. She is a member of several national GI societies including the AGA, ACG, and ASGE as well as state and local medical societies.