Types of Irritable Bowel Syndrome (IBS): How to Know Which One You Have

Irritable bowel syndrome (IBS) affects up to 10% of people worldwide, and up to 15% of people in the U.S. While IBS is common, it’s not a one-size-fits-all disorder. The symptoms and treatments can vary widely from one person to the next. In fact, there are four different types of IBS that have very different features. 

If you’re one of the many people with IBS, understanding your subtype can help. It may provide clues to everything from triggers to the best treatments for you. And it may make living with IBS easier.

What is IBS?

IBS is a gastrointestinal (GI) disorder that typically causes abdominal pain and changes in your stool. For a diagnosis of IBS, you must have had abdominal pain and symptoms for at least 6 months. Your symptoms should also occur at least 1 day a week over a 3-month period.

Typically, you’ll have two or more of the following symptoms:

• Abdominal pain related to a bowel movement

• A change in how often you have bowel movements

• A change in how your stools look

If you have IBS, it’s important to find out what subtype you have. To figure out your subtype, you should look at your bowel habits when you’re not taking stool softeners or laxatives. That’s because these medications can change your natural pattern of bowel movements.

Quiz: Do I Have IBS?

What are the different types of IBS?

Different types of IBS are based on the symptoms you display most during a flare. The types don’t categorize all of your stools — just when your stools are abnormal. We’ll go over the IBS types here.

1. IBS-D (diarrhea)

If you have IBS and more than ¼ of your bowel movements are loose or watery, you have IBS-D. IBS-D is the most common type of IBS.

People with IBS-D tend to report a lower quality of life than those with other types of IBS. Diarrhea symptoms of IBS-D may be so severe that they negatively affect:

• Daily activities

• Body image

• Relationships 

Conditions like lactose intolerance and inflammatory bowel disease (IBD) may mimic IBS-D. Your primary care provider can do further testing to make the correct diagnosis.

2. IBS-C (constipation)

If you have this type, at least ¼ of your stools are hard or lumpy. Constipation is the main complaint. Many factors can contribute to constipation. So your primary care provider will likely recommend GC-C agonists or run tests to make sure there isn’t another cause for your symptoms. Some people who treat their IBS-C daily with prescription medications experience constipation relief in about 1 week and symptom improvement over the next 3 months.

People with IBS-C can also struggle with other symptoms as a result of severe stool changes. There may be higher rates of depression and anxiety in those with IBS-C than in other IBS types.

3. IBS-M (mixed diarrhea and constipation)

This IBS type has symptoms that alternate between constipation and diarrhea. With IBS-M, your stools are both loose ¼ of the time and hard to pass ¼ of the time. 

Another feature that seems unique to IBS-M is how long symptoms last. Most people with this type of IBS have symptoms that last for just a few days. In other types, symptoms can sometimes last a bit longer. 

What are the treatments for IBS types?

Treatment for IBS will vary from person to person. It can also depend on symptoms and the type of IBS you have. Many times, IBS treatment uses several approaches. Successful management of IBS symptoms often includes dietary changes, exercise, and medications.

Dietary changes

Dietary changes are one of the first-choice treatments for all types of IBS. Your digestive healthcare specialist may recommend a diet with foods low in FODMAPs (fermentable oligo-di-monosaccharides and polyols).  

Low-FODMAP foods are easier to digest, and they’re less likely to cause bloating and IBS flares. On the other hand, high-FODMAP foods can cause excess gas, which can worsen IBS.  

Researchers estimate that for 3 in 10 people with IBS, a low-FODMAPs diet alone will not improve IBS symptoms. But most people find a low-FODMAPs diet helpful.  

Some examples of low-FODMAP foods include:

• Gluten-free bread and crackers

• Lactose-free milk (like soy and almond milk)

• Eggs

• Nuts

• Some fruits (like pineapple, banana, and strawberries)

• Certain vegetables (like spinach, cucumber, and eggplant )

Some high-FODMAP foods you may want to avoid with IBS include:

• Rice

• Some fruits (like apples, pears, and mango)

• Certain vegetables (like onions, cauliflower, and asparagus)

• Milk products

• Legumes (like lentils and chickpeas)

Dietary recommendations may sometimes differ based on the IBS type. For example, foods and drinks with a lot of caffeine can have a laxative-like effect in some people. This means it may cause or worsen diarrhea. If you have IBS-D or IBS-M and your symptoms are worse after having caffeine, you may want to avoid it.  

Exercise

Regular exercise may also decrease flares of IBS. One small study found that increasing moderate exercise for 12 weeks can improve IBS symptoms. This can include exercises like walking, cycling, and aerobics.

High-intensity exercise, like running, may cause GI upset. This could worsen symptoms of IBS-D. Modifying your diet or intensity of exercise may help.

Yoga may also decrease symptoms of IBS. And it may improve symptoms of constipation in IBS-C and IBS-M.

Medications

Medications for IBS usually focus on specific IBS symptoms that occur during flares. That’s one reason it’s useful to understand your IBS type. It will help in targeting your treatment options. 

For IBS types with diarrhea, treatment often aims to reduce bowel irritability. 

Common medications may include:

• Loperamide

• Alosetron

• Rifaximin  

For IBS-C, treatments to loosen and soften stool may help. Medications, like lubiprostone, are common to treat symptoms of constipation.

Probiotics are a common treatment for all types of IBS. They tend to improve bloating and gas associated with IBS, but not diarrhea or constipation.

When to see a doctor

It’s a good idea to see a digestive healthcare specialist if you have persistent abdominal pain, changes in your stool, or other symptoms of IBS. They can help to figure out if your symptoms are due to IBS and give you the correct diagnosis and IBS type. 

You should also let your digestive healthcare specialist know if you have IBS and your symptoms aren’t improving with your current treatment plan. They can help to suggest dietary, exercise, or medication changes based on your IBS type.

Why trust our experts?

Written by:

Stephanie Reese, DO, MS

Dr. Reese is board-certified in family medicine and resides in Savannah, Georgia. She received her undergraduate degree from the Florida Institute of Technology and master’s in hematology/immunology from Long Island University.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Our editorial standards

Meet our experts