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What are the four types of IBS?

That's right, there are four subtypes of IBS. Figure out which you have with Salvo Health

Published:

July 6, 2022

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Published:

May 2, 2024

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At its core, irritable bowel syndrome (IBS) involves the large intestine. Gas, bloating, cramping, abdominal pain, and stool issues are all characteristic symptoms of IBS. (Though you might experience some more than others.) Depending on your symptoms, you might have a specific type of IBS, or even multiple types of IBS.

Wait... there are multiple types of IBS?

That’s right, there are four subtypes of IBS, which are distinguished by different symptom patterns. Don’t worry: Once you find out what type of IBS you have, you’re that much closer to effectively managing your symptoms.

We’ll cover:

  • Things to know about IBS and IBS types
  • How do I figure out my IBS type?
  • IBS-C: Constipation
  • IBS-D: Diarrhea
  • IBS-M: Mixed
  • IBS-U: Unclassified
  • Why does knowing my IBS type help?

Things to know about IBS and IBS types

Researchers don’t yet know exactly why IBS can take the various forms it does, but experts have identified four main IBS types. It is possible for someone to have different types at different times or to switch back and forth between types. It’s also possible for someone to experience additional symptoms that fall outside what’s considered normal for any particular type. As you probably know, IBS does not always play by hard and fast rules.

It can be tough to trace IBS back to any one specific cause. Regardless of the type you have, there may be no particular reason for why your IBS has developed the way it has. IBS severity can be related to problems in the way the gut and the brain communicate with each other, to hyper-attuned nerves and muscles within the digestive tract, or to changes in the gut microbiome, among other factors.

A few things to note about IBS:

  • It is generally a chronic condition, which can require long-term management and treatment
  • Though it can be very disruptive and uncomfortable, and can definitely have an impact on your life, IBS does not cause injury or long-term damage to the digestive system. It is not a precursor to cancer or other life-threatening conditions.
  • All types of IBS may include abdominal discomfort, bloating, excess gas, and other kinds of digestive discomfort.

How do I figure out my IBS Type?

There’s no way around it: to determine your IBS type, you’ll need to pay close attention to your poop. Here are a few strategies to get started:

  • Keep a journal of your bowel movements as a record.
  • Take note of any foods that seem to cause irregular bowel movements.
  • Record if your IBS feels worse when you feel particularly anxious, depressed, or stressed.

Having a month’s worth of stool records helps establish your particular IBS pattern, which can inform your treatment. For more detail, refer to the Rome IV criteria for IBS.

Stool types you may notice include:

Constipation:

  • Small, hard and nubbly, like pebbles or kibble (constipation)
  • Bumpy and long but dry, with lumps on the surface (mild constipation)

Normal:

  • Long, with cracked or rounded surfaces
  • Long, soft, and smooth

Diarrhea:

  • Small, soft individual blobs like gum-drops (more fiber needed)
  • Mushy and indeterminate (mild diarrhea) or downright liquid

As you keep your stool journal, you may also want to track your stress levels (a 1-10 scale is a convenient way to do this). Once you have at least a month’s worth of record-keeping, compare your symptoms to the IBS types described below.

IBS-C: Constipation

You may have IBS-C if more than 25% of your stools are the constipated type (hard and dry or lumpy) and if you do not typically have any diarrhea. Other constipation-type symptoms with IBS-C can include needing to strain or push hard to get poop out, or spending a lot of extra time on the toilet due to a feeling of incomplete or unsatisfying bowel movements. Sometimes the constipation can be so severe, people will use manual maneuvers such as massaging the lower abdomen or perineum, or even using a finger to remove impacted stool from the rectum.

IBS-D: Diarrhea

With IBS-D, your stool may be extremely loose, mushy, or even liquid for more than a quarter of your bowel movements. You may need to constantly run to the bathroom, sometimes even up to 10 times a day.

When your bowel movements can be that sudden and unpredictable, you may be reluctant to leave the house or to get very far from a toilet. You may even consider underwear liners or light diapers to avoid any accidents or emergencies, and you may find yourself avoiding certain social situations, which can be a major challenge for IBS sufferers.

IBS-M: Mixed

As its name implies, IBS-M can involve both constipation and diarrhea, sometimes alternating between the two. If you have IBS-M, you’ll notice loose bowel movements or diarrhea at least 25% of the time, but you’ll also have constipation at least 25% of the time as well. It can be taxing, to say the least, to experience such fluctuating symptoms.

IBS-Unclassified

If you don’t notice any predominant pattern in your bowel movements, you may fall into the category of IBS-U. It’s possible for IBS-U not to cause a specific kind of stool pattern, but for you to still have abdominal pain, bloating, gas and other indicators of IBS. You may not have normal bowel movements, but they may not clearly fall into either constipation or diarrhea types. The disorder is not always clear-cut, but may still have a significant impact on you.

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How does knowing my IBS type help?

More information about your potential IBS type can help guide both you and your health providers. You will probably want to discuss your symptoms and any prior testing with your physician for confirmation and treatment recommendations. You can also consider certain changes that could help reduce your IBS symptoms.

Going back to your stool journal, see what else you notice in terms of related stress or certain foods. Things that worsen your symptoms are called triggers, and many triggers can be reduced or avoided to help with symptoms.

The following suggestions are only that: ideas for where to start. As you explore different ways to control and manage IBS according to your type, you will develop a personal IBS strategy. Your health care providers can help tailor an IBS plan that is right for your IBS type, including specific medications and diet recommendations. The following suggestions may also be helpful:

For symptoms related to constipation

  • Drink more liquid
  • Eat more fiber-rich foods, like leafy greens, legumes, and whole grains
  • Be sure to exercise regularly, since movement can help move stool along

For symptoms related to diarrhea

  • See whether more probiotics reduce symptoms
  • See if cutting out wheat products (gluten) or lactose helps with symptoms
  • Try relaxation techniques such as mindfulness meditation, deep breathing, or other mind-body therapies.

For IBS symptoms in general

  • See if you can lower stress here and there
  • Might therapy help? (if you have anxiety or depression, for example)
  • Practice regular exercise, including a mix of cardio, low-impact resistance training, and controlled movement like tai chi or yoga  
  • Steer clear of foods that seem to trigger your symptoms. Consider avoiding high FODMAP foods

How Salvo Health can help

Salvo Health is a digital healthcare company, creating an on-app virtual clinic experience that is low-cost and radically accessible for those living with IBS, GERD, SIBO or chronic gut issues.

When you download our app and become a member with Salvo Health, you get immediate access to a coordinated Salvo Health Care Team, including a certified gastro-specialist and certified health coach. Your Care Team will communicate with your async via the app, create custom Care Plan based on your symptoms, and check in with you regularly to guide your gut health journey. Daily tasks, notifications, quizzes, and helpful articles can also keep you on track when managing your IBS!

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