Better Me

Do I Have IBS or Is It All in My Head?

Irritable bowel syndrome (IBS) is one of the most common gastrointestinal conditions in the U.S., yet it can be a taboo topic to talk about with others. Not only can it be quite painful, but it can be very embarrassing too. Because of this, some people may be needlessly suffering alone—even wondering if it’s just in their heads.

“Don’t suffer silently,” said Aravind Sugumar, MD, a gastroenterologist with Banner – University Medicine Digestive Institute in Arizona. “One of the frustrating things about IBS is that it is lacking a single cause. Because some symptoms come and go and there is no definitive test to diagnose it, it is very easy for someone to believe “it’s all in their heads” when it’s not.”

Dr. Sugumar helped shine some light on IBS by answering a few questions you may be asking yourself, so you can stop hiding and start living your life to its fullest.

What is IBS?

IBS is a chronic, quality of life disorder that affects the digestive system. Primary symptoms you may experience include either significant diarrhea or constipation or, in some cases, alternating constipation and diarrhea. Secondary symptoms include bloating, gas, abdominal cramps, pain and nausea.

“What is confusing for some, is that these symptoms may sometimes disappear after the bowels are emptied,” Dr. Sugumar said. “Symptoms can often be overlooked because they aren’t consistent from one person to the other.”

Is IBS a disease?

IBS is a group of symptoms or complaints that affect the entire gut: the colon, small intestine and the esophagus.

Symptoms of IBS may overlap with symptoms of inflammatory bowel disease (IBD) and these are in fact two different diseases with very different prognosis. It is imperative to make sure one does not have IBD by meeting with a gastroenterologist.

“The good news is that IBS diagnosed late or early will have no impact on your mortality or longevity,” Dr. Sugumar said. “But just because it’s not life-threatening doesn’t make it less onerous or life-altering.”

What causes IBS?

While the definitive cause of IBS is not known, Dr. Sugumar said there is a possible connection between genetics, lifestyle habits, stress and environmental factors, but everyone’s causal path can be different.

“The best way to think about this is to envision a Venn Diagram or the Olympic Rings,” he said. “You have all these potential intersecting causes—while one person may be genetically predisposed, they may not suffer from IBS. But combine that predisposition with poor lifestyle habits and increased stress and a person may end up developing IBS. This is why diagnosis can be difficult, because everyone’s path to IBS is unique."

How is it diagnosed?

There are unfortunately no tests to show for sure you have IBS.

“Instead, it is much like a puzzle,” Dr. Sugumar said. “It really requires you to sit down with your doctor and discuss your symptoms, so you can start to put the pieces together.”

What are my treatment options?

“You can arrive at the precipitating causes in many different ways. Hence the treatment is trying to mitigate the precipitating cause,” Dr. Sugumar said. “Treatment can begin once we identify those predominant complaints.”

While there is no cure for IBS, there are things you can do to feel better. Some treatment options may include things like stress reduction techniques, changes to your diet and medication.

Are there any red flag, alarm symptoms I should look out for?

IBS alone won’t lead to a serious disease, but there are “red flags” or “alarm” symptoms to look out for. These signs could mean something more serious is going on.

These include:

While small amounts of bright red blood may be something benign such as a hemorrhoid or small tear, large amounts of dark blood or tarry-colored stools should be cause for concern. See your doctor right away. They can perform medical tests to rule out other diseases.

Do I have IBS, or is just in my head?

“The single most important question I get every day from patients is, “Doctor, is this all in my head?” Dr. Sugumar said. “This statement is obviously a disservice to the patient and the condition. You can’t simply think IBS away; you have to understand it, accept it and then fight it.”

While there is not a magic pill to wipe away IBS, there certainly is a relationship between our brain and belly. While things like stress and anxiety can trigger symptoms for most patients  with IBS, it’s not the case for others. Dr. Sugumar said this is where coping skills may play a role.

“When we talk about that Venn Diagram of IBS, things like stress are only one side of the equation,” he said. “You have some who handle stress well, and others who do not. While you can’t just think it away, research shows that things like therapy and learning coping skills can help ease symptoms for some people."

Do I have IBS?

Do you believe you are suffering from IBS? Don’t suffer alone. Schedule an appointment with your physician or a Banner Health specialist and get on the road to recovery.

To find a Banner Health specialist near you, visit

Gastroenterology Wellness