Anybody can get diarrhea sometimes. The same goes for constipation. But if you get both of them often, you may have a type of irritable bowel syndrome (IBS). Specifically, you may have IBS-A, the “alternating” kind.
- IBS-D (diarrhea)
- IBS-C (constipation)
- IBS-A (alternating), also known as A-IBS and IBS-M (mixed type)
It’s called “alternating” because you go back and forth between diarrhea and constipation, sometimes pretty quickly. And some studies have found that people with this type tend to have more belly pain or discomfort than those who have IBS-C or D.
The difference between occasional digestive issues and IBS is that, with IBS, discomfort and bowel troubles are common and go on for months.
What Causes IBS-A?
Doctors don’t really know what causes the condition. It may happen for a number of reasons, which could be different from person to person. Some possible reasons behind it include:
- Your genes
- The way your brain and your digestive tract signal each other
- Psychological factors, like stress or past trauma
- Your diet
- Gut bacteria
Getting a Diagnosis
There are no tests that can tell for sure whether you have IBS-A. It’s tough for doctors to diagnose any type of the condition. They generally rely on the symptoms you describe and their experience treating IBS to make a diagnosis.
Your doctor may ask about your diet, symptoms, lifestyle, if others in your family have digestive problems, and medications you take. She might ask you if you’ve had trauma, such as physical or sexual abuse, in the past. Don’t be alarmed by questions that may seem very personal. Your doctor is trying to find out if emotional stress could be a reason for your constipation and diarrhea.
Your doctor may check your blood pressure, listen to your heart, and touch your belly. If you have IBS, these things should be normal (although your belly may feel tender). But it will help her rule out other conditions that may be causing your symptoms.
Your doctor may order a few common tests, such as:
- Basic blood tests, including a complete blood count, to rule out other diseases
- A blood test for celiac disease (when your body can’t digest gluten)
- If your main symptom is diarrhea, your doctor may test your stool for parasites and more.
If you have any “red flag” issues such as weight loss, fever, bleeding, or a family history of digestive diseases (including colon cancer), you may need a colonoscopy. For this test, the doctor looks inside your large intestine using a tool with a tiny camera.
Treatment for IBS-A
There is no cure for IBS, so the goal of treatment is to ease your symptoms so you feel better and can tackle your daily activities. When constipation is a major problem, as it often is with IBS-A, your doctor may suggest you take a fiber supplement.
Prescription medications may also be part of your treatment. They may include drugs for constipation, diarrhea, pain, and depression or anxiety. However, drug treatment is often a challenge with IBS-A. That’s because medication for diarrhea can make constipation worse, and vice-versa. The best medications for IBS-A may be those that have only a short-term effect.
Living With IBS-A
For some, medications can be an important part of getting IBS-A under control. But there’s more you can do to feel better -- physically and mentally -- with this condition.
You may need to try some diet changes to find out which foods make you feel better and which ones make your symptoms worse. For example, if gas is a problem, see if you feel better by avoiding foods that can cause it, such as:
- Brussels sprouts
If you have any new symptoms, tell your doctor. Worrying about them isn’t going to help your body or mind. If something changes, go straight to your doctor to find out what it may mean.