One of the most frustrating things about living with irritable bowel syndrome (IBS) is that there’s no universal playbook for how to manage it. The condition varies from person to person, which means triggers and treatments vary a lot, too.

Julie Khlevner, MD, a pediatric gastroenterologist at NewYork-Presbyterian Morgan Stanley Children’s Hospital, explains that there are actually four subtypes of IBS that are assigned based on the predominant symptoms that a person is experiencing: diarrhea predominant and abdominal discomfort (IBS-D), constipation predominant and abdominal discomfort (IBS-C), both diarrhea and constipation with abdominal discomfort (IBS-mixed) and an undefined subtype (IBS-U) in which a person’s symptoms can vary and don’t fit into any of the other three types.

“IBS is associated with impaired quality of life because of its burdensome symptoms,” Dr. Khlevner says. Because of this, she recommends that people with IBS take a holistic, multidisciplinary approach to treatment. What works to relieve one person’s symptoms may not have any impact on another person’s symptoms, and certain triggers may lead to major digestive discomfort in some people and have no effect on others.

If you’re struggling with IBS — or you think you might have IBS based on symptoms you’ve been experiencing — here are some tips from Dr. Khlevner on how to navigate it.

Make Sure You’re Working with a Team of Healthcare Professionals

Although there are lots of things you can do at home to navigate IBS, Dr. Khlevner stresses how important it is to be working with a multidisciplinary team of providers who specialize in treating it.

“Working with a physician, a dietitian and maybe a behavioral health specialist can really improve quality of life and decrease symptom burden,” Dr. Khlevner says. A physician (likely a gastroenterologist) can help you figure out if you have IBS or if there’s some other cause of your symptoms that could be addressed another way. They can also suggest lifestyle changes and prescribe medications that might help you — Dr. Khlevner says that there are a wide range of possible medications depending on your symptoms, including neuromodulators, antispasmodics, antibiotics and laxatives.

A registered dietitian who specializes in gastrointestinal disorders can be extremely helpful, too. An elimination diet like the low-FODMAP diet can help you identify food triggers and ultimately lessen your uncomfortable IBS symptoms. Dr. Khlevner stresses how important it is to do this under the guidance of a registered dietitian who can assess whether an elimination diet is appropriate for you (based on things like disordered eating history and nutrition status), walk you through the elimination and reintroduction phases so that you get the most out of them and make sure you’re eating a well-balanced and nutritionally complete diet through the process.

Cognitive behavioral therapy is another evidence-based treatment for IBS, and there are psychologists and other mental health therapists who specialize in gastrointestinal disorders. If you’re interested in trying this kind of treatment, Dr. Khlevner recommends searching the Rome Foundation’s directory of licensed therapists who are trained in this area.

Try Cutting Out Caffeine and Alcohol

Caffeine and alcohol are two very common, avoidable triggers for IBS symptoms, Dr. Khlevner says.

“Caffeine can increase the transit time of food in your gut, so for patients with diarrhea predominant symptoms, caffeine can exacerbate those symptoms,” Dr. Khlevner says. “For these people, eliminating caffeine can be life-changing.” Carbonated caffeinated drinks can have the same effect, she says, so if you experience frequent diarrhea, try cutting these things out for a while to see if your symptoms improve.

Alcohol is another common culprit of IBS symptoms. “We know alcohol can worsen symptoms of gastroesophageal reflux and irritate the lining of both your stomach and your esophagus,” Dr. Khlevner says. Try eliminating or cutting back on alcohol — there’s never been a better time to do this, with so many bars serving amazing mocktails and plenty of recipes around — for a while to see if your symptoms improve.

Cook at Home More Often So You Know What’s in Your Food

Different people have different food triggers for IBS. If you’ve worked with a dietitian to figure out your triggers, avoiding these foods (or eating more of certain beneficial foods) can really improve your quality of life, Dr. Khlevner says.

For some people, a high-fiber diet could be really helpful, while eating too much fiber could be uncomfortable for others. Some people may be sensitive to concentrated sugars, while others could see a drastic reduction in symptoms just from cutting out onions and garlic.

You don’t need to cook everything from scratch, but knowing what’s in your food can help you figure out what might be causing your symptoms, and can make it easier to avoid these foods.

Tread Carefully When It Comes to Supplements

Although there are many supplements marketed to people with IBS, Dr. Khlevner says to tread carefully here, and always run any new supplements by your doctor and dietitian. “​​Enteric coated peppermint oil capsules have been shown to be effective for relieving IBS symptoms and it’s quite safe, but you need to take it as a capsule, since the oil can be irritating to the stomach,” she says.

As for probiotics, there are so many things to keep in mind. “Probiotics are live bacteria that have been shown to be effective in patients with IBS, but not every strain is the same,” Dr. Khlevner says. If you want to try a probiotic supplement, ask your doctor to recommend one that contains a strain of bacteria known to help with IBS. And she doesn’t recommend taking these supplements for more than three months, since there’s no research on what they do to the gut microbiome when taken long-term.

Move Your Body Regularly, But Don’t Worry Too Much About When or How

Getting regular physical activity is linked to all kinds of health benefits, so it’s no surprise that moving your body can also help lessen IBS symptoms.

The best news is that you don’t need to force yourself to become a morning workout person or exercise in a way that you don’t like. “There isn’t great evidence for the timing or amount of exercise per day, or even for what type of exercise you should do to help manage IBS symptoms,” Dr. Khlevner says. “You just need to think about having some kind of physical activity in your day, because it can improve bowel function and help food move through your digestive system,” she says.

Work On Your Sleep Hygiene

Lack of sleep can worsen your IBS symptoms, so it’s really important to do everything you can to get enough, Dr. Khlevner says. The exact amount of sleep you need can vary from person to person, but the National Institutes of Health recommend that adults get between seven and nine hours per night.

If you struggle to get adequate shuteye, there are several things you can do to up your chances of a good night sleep. The Centers for Disease Control and Prevention (CDC) lists several habits that can help (called “sleep hygiene”), including establishing a consistent bedtime and wakeup time, sleeping in a dark and quiet room, removing electronic devices from your bedroom (yup, that means not sleeping with your phone on the nightstand), avoiding large meals and alcohol before bedtime and getting some physical activity in during the day.

IBS can be tough to navigate, so don’t lose hope if you haven’t figured out how to manage your symptoms yet.

If you’ve been trying to address your IBS symptoms for a long time with no significant improvement, Dr. Khlevner stresses how important it is to work with a team of qualified healthcare providers who can help you. There are so many different treatments and recommendations out there, she says, and it can take time to figure out which ones work for you.

*This article was written and/or reviewed by an independent registered dietitian nutritionist.

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