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Is it IBS, or just an upset tummy? Here’s how to tell

irritable bowel syndrome

Stomach pains can hit you at any moment; unfortunately, it usually happens when you least expect it. Whether your stomach pains are caused by food poisoning, irritable bowel syndrome, or just regular stomach aches, it is inconvenient and often embarrassing.

But it is important to understand the cause of your stomach pains; having an upset tummy, though inconvenient, is curable and not long-term. On the other hand, irritable bowel syndrome (IBS) is a chronic condition that, while not curable, is treatable through the management of symptoms.

stomach pains
Stomach pains can sometimes be ambiguous, with causes ranging from food poisoning, lactose intolerance, to irritable bowel syndrome.

What is irritable bowel syndrome (IBS)?

Irritable bowel syndrome, commonly referred to as IBS, is a gastrointestinal disorder that is relatively common, affecting 6-18% of people worldwide [1]. Although IBS comprises a variety of symptoms that affect the gastrointestinal tract, a recent study conducted in 2022 found that it does not increase your risk of gastrointestinal cancer [2].

IBS is a functional gastrointestinal disorder or a disorder of the gut-brain interaction. This means there is a problem with how the gut and brain work together, causing the gastrointestinal tract to be highly sensitive, thus affecting the contraction of the bowel muscle, resulting in bloating, constipation, abdominal pain, and diarrhoea.

The main cause of IBS is still unknown and poorly misunderstood. However, several factors have been linked to the development of IBS. These are:

  • Intestinal muscle contraction: individuals with IBS tend to have altered intestinal muscle contractions.
  • Visceral hypersensitivity: visceral organs, which consist of the organs in your chest, abdomen, and pelvic region, are more sensitive to pain in individuals with IBS. This stems from issues in the nervous system that overreact when the gastrointestinal tract moves and stretches during digestion.
  • Infection: a bacterial or viral infection that causes diarrhoea, also known as gastroenteritis, can cause IBS.
  • Inflammation: one of the persistent issues seen in individuals with IBS.
  • Stress: exposure to stress in the early stages of life can result in numerous IBS symptoms.
Irritable bowel syndrome occurs due to abnormal contractions in the gastrointestinal tract.

What are the symptoms of IBS?

IBS has many symptoms, but it varies from person to person. These symptoms include:

  • Abdominal pain or discomfort
  • Change in appearance of stools
  • Bloating
  • Change in frequency of stools (constipation or diarrhoea)
  • Acid reflux or heartburn
  • Headache
  • Muscle aches and pains

These symptoms come and go for varying durations. For example, bloating or gas tends to disappear after a bowel movement. Therefore, IBS is often misdiagnosed as other conditions, such as an upset tummy or even lactose intolerance.

Differences between IBS and upset tummy

While they may have some similar symptoms, there are a few clear-cut ways to tell if you have IBS or just an upset tummy.

Irritable bowel syndromeUpset tummy
It happens frequently and with greater severity.It occurs rarely, and symptoms are not as severe.
Pain does not wake you up at night.Pain is more severe at night and can wake you up, especially in cases of food poisoning.
Pain may affect the whole gastrointestinal tract.Pain is generalised.
Symptoms usually include constipation, diarrhoea, or both, and lower abdominal pain.Symptoms usually include nausea, vomiting, and upper abdominal pain.
The intestinal lining appears normal.The intestinal lining is inflamed.
There are no known causes, but they have been linked to several factors.It is known to be caused by various bacteria, viruses, food, medication, etc.
irritable bowel syndrome
IBS differs from an upset tummy in various ways, such as pain location – upper abdomen for IBS and lower abdomen for an upset stomach.

How is IBS diagnosed?

If you suspect that you might be experiencing IBS, you should consult with a gastroenterologist who will help you manage your symptoms. IBS is diagnosed if you fulfil the following criteria:

  • Unexplained persistent stomach pains that occur three or more times for at least three months in a row with no sinister symptoms 
  • Pain or discomfort during bowel movements.
  • Change in frequency of bowel movements.
  • Change in appearance of stools.

The following diagnostic tests can be conducted if IBS is suspected:

  • Complete medical history: your gastroenterologist will ask you questions about your medical history, symptoms, foods that trigger your IBS symptoms, family history of IBS, etc.
  • Blood test: this helps to check for anaemia and rule out medical conditions such as coeliac disease.
  • Stool test: also done to rule out infections.
  • Colonoscopy: a colonoscopy is a procedure involving a thin and flexible tube with a camera and light attached at one end, which is inserted into the anus and led up through the rectum and large intestine for a proper examination.
  • Computed tomography scan (CT-scan): a CT-scan is a non-invasive diagnostic imaging tool that uses a combination of X-rays and computer technology to produce cross-sectional, horizontal, or axial images of our body. This helps your gastroenterologist to identify any abnormalities.
  • Gastroscopy: a gastroscopy is a procedure involving a thin and flexible tube with a camera and light attached at one end, which is inserted into the mouth and led down through the oesophagus, into your stomach and your small intestine for a proper examination.
gastroscopy IBS
A gastroscopy can be used to diagnose causes of abdominal pain.

What is the best treatment for IBS?

The best treatment for IBS depends on what works for you; IBS treatment for you may be different from IBS treatment for someone else. Here are some treatment options that you may try to help yourself with IBS:

  • Regular physical activity/exercise
  • Reduce or avoid caffeinated drinks
  • Consume small meals
  • Minimise stress by doing yoga or relaxation techniques
  • Try the low FODMAP diet (a diet plan that restricts carbohydrates)
  • Take probiotics to improve gut bacteria

Your gastroenterologist can prescribe several medications:

  • Antidepressants for patients with depression or anxiety
  • Medications to relieve constipation or diarrhoea
  • Pain medications to alleviate or manage pain

The first line of treatment for IBS would be remedies you can try at home, such as lifestyle changes. However, if severe symptoms persist, medications can be prescribed to help manage them.

In conclusion, IBS is very different from an upset tummy. IBS is a chronic, incurable condition, while an upset stomach is an acute, curable condition. There are no known causes of IBS, but several causes of an upset tummy, such as gastroenteritis, food poisoning, etc. 

So, next time you have any stomach pains, remember when it happens, how frequently it happens, and what the symptoms are. If it happens again within the next few days, weeks, or months, you could be developing IBS. 

If you suspect you have IBS, book an appointment with us today, and we can help you manage your symptoms.


  1. Ami D Sperber, D. D.-Y. (2017). The global prevalence of IBS in adults remains elusive due to the heterogeneity of studies: a Rome Foundation working team literature review. Gut, 1075-1082.
  2. Shanshan Wu, C. Y. (2022). Irritable Bowel Syndrome and Long-Term Risk of Cancer: A Prospective Cohort Study Among 0.5 Million Adults in UK Biobank. The American Journal of Gastroenterology, 785-793.
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