Are Diabetes and IBS Connected?

Both irritable bowel syndrome (IBS) and diabetes can cause painful or uncomfortable gastrointestinal (GI) symptoms. In fact, one peer reviewed paper suggests that roughly 75% of people with diabetes experience GI symptoms, many of which can overlap with the symptoms of IBS. 

Though one condition does not cause the other, some people can be affected by both IBS and diabetes at the same time. In this article, you’ll learn more about the connection between the two conditions and how dietary changes can help you to manage both.  

Nourish offers personalized nutrition counseling to help you customize your diet to meet your diabetes needs. If you’re ready to take the next step in your health, consider booking a virtual appointment with a registered dietitian.

What is IBS?

IBS is one of the most commonly diagnosed diseases that affect the digestive tract. An estimated 12% of the U.S. population have the condition. It is also known as IBC colitis, spastic colon, nervous colon, and spastic bowel.

IBS is defined by a group of symptoms that can occur together but don’t cause any visible signs of damage or disease to the gastrointestinal system. Common symptoms of IBS include:

• Diarrhea.
• Constipation.
• Pain in the stomach.
• Changes in bowel movements.
• Bloating.
• Whitish mucus in your stool.
• Feeling like you haven’t finished a bowel movement.

If you’re experiencing symptoms of IBS, it’s important to reach out to your healthcare provider. The diagnosis can sometimes involve several steps, including a review of your symptoms, health and family histories, a physical exam, and certain lab tests. 

Are IBS and Diabetes Connected?

At first glance, it might not seem that IBS, a condition that affects the digestive system, and diabetes, a metabolic disease, have anything in common. But both connections can affect the GI tract and cause similar symptoms.

Over time, diabetes can affect the structure and function of the colon, which can cause GI symptoms, including constipation, diarrhea, and stomach pain. According to one article published in American Family Physician, GI complications of diabetes have become more common as the rate of diabetes has increased in recent years.

Overlapping symptoms of IBS and diabetes can include:

• Constipation.
• Diarrhea.
• Stomach pain.
• Bloating.

Both IBS and diabetes can occur at the same time. But, importantly, one condition does not cause the other. 

Managing IBS with Diabetes

If you’ve been diagnosed with IBS, there are several treatment suggestions your healthcare provider can make that won’t affect your diabetes treatment. Common treatment strategies for IBS include:

• Dietary changes.
• Lifestyle changes (including increasing physical activity and reducing stress).
• Medicines.
• Probiotics.
• Mental health therapy.

Diarrhea

There are three different types of IBS that are differentiated from one another based on your symptoms. One of the three types of IBS is called IBS with diarrhea, or IBS-D. If you have IBS-D, your GI symptoms most often involve loose or watery stools.

Treatment of IBS-D may differ from treatment of IBS with constipation (IBS-C) or IBS with mixed bowel habits (if you experience both diarrhea and constipation), including when it comes to recommended dietary changes.

If you have IBS-D, recommended treatment options will include:

• Antimotility agents: These medicines help to slow down the digestive process and reduce the loss of fluid and electrolytes. 

• Probiotics: Research on the effectiveness of probiotics when treating IBS-D is mixed, but data from one study following people with IBS for 4 weeks found that treatment with the probiotic Bifidobacterium infantis may help to alleviate diarrhea symptoms and improve overall bowel movements.  

• Dietary changes: Unfortunately, there isn’t enough data to definitively prove that one diet is effective at treating IBS or IBS-D. However, data suggests that certain modifications can help to alleviate symptoms in some people, including a diet low in FODMAPs. FODMAPs refer to short-chain carbohydrates found in foods that can worsen GI symptoms in some people. According to the American College of Gastroenterology (ACG), more research is needed to determine the effectiveness of a low FODMAP diet on treating IBS. However, because data suggests that the diet is relatively safe and does not cause adverse side effects, the ACG recommends a limited trial of a low FODMAP diet in people with IBS (including IBS-D) to see if it helps to improve symptoms. The ACG also recommends using soluble fiber, rather than insoluble fiber, may be used to treat IBS symptoms. One study found that a gluten-free diet may help treat symptoms of IBS-D, but given the lack of strong evidence this method is not recommended by the ACG.

Constipation

Many of the dietary modifications recommended by the ACG are the same for the treatment of IBS-D and IBS with constipation (or IBS-C). However, the recommended medications are different:

• Fiber supplements: If increasing your intake of soluble fiber from foods doesn’t help to increase the frequency and consistency of your bowel movements, you may consider adding a fiber supplement into your diet.

• Laxatives: Some laxatives may help to increase the frequency of your bowel movements, including products that contain polyethylene glycol (PEG), like Miralax. However, not all laxatives are safe for long-term use. Consult with your healthcare provider about which laxatives are safest to use for IBS and for how long they recommend using the product.  

• Medications used to relieve constipation: These medications include lubiprostone (Amitiza), linaclotide (Linzess), and plecanatide (Trulance). All three are available by prescription only and will require a prior consultation with your healthcare provider or pharmacist.

Food Choices for IBS and Diabetes

More research is needed to determine which dietary modifications are most effective at treating or relieving IBS. However, recommendations from the ACG may also support dietary changes recommended for the management of diabetes:

• Increase in soluble fiber intake: The ACG recommends increasing your intake of soluble fiber to treat IBS symptoms. Soluble fiber helps to draw water to the digestive tract and slow digestion. Foods that are high in soluble fiber include oat bran, barley, nuts, seeds, beans, lentils, peas, and some fruits (including apples, strawberries, and citrus) and many vegetables.

• Try a low FODMAP diet: You may consider working with a healthcare provider or registered dietitian to try a limited FODMAP diet to see whether or not it helps to alleviate your symptoms. There are many foods that are low in FODMAPs, including bell peppers, bok choy, blueberries, kiwi, meat, poultry, almond milk, eggs, peanuts, and flours made from corn, potato, rice, oats, quinoa, or spelt.

If you’re interested in making changes to your diet that may benefit your IBS and diabetes treatment, Nourish can connect you with a registered dietitian specialized in chronic disease management. Consider booking a virtual appointment today.

Does IBS Affect Blood Sugar?

There is no conclusive evidence that IBS affects blood sugar levels in people with diabetes. However, it is possible to have both IBS and blood sugar issues.

Diabetes and Bowels

Diabetes can affect the structure and function of the bowels and research shows that people with diabetes are at a higher risk of certain bowel disorders, including:

• Chronic constipation.
• Enteropathic diarrhea. 
• Colorectal cancer.
• Inflammatory bowel disease (IBD).
• Microscopic colitis. 
• Clostridium difficile colitis. 

Takeaway

IBS and diabetes can cause similar GI symptoms, like diarrhea, constipation, stomach pain, and bloating. Although one condition doesn’t directly cause the other, it is possible to have both IBS and diabetes at the same time. Certain dietary changes can help to manage both conditions, but you should consider working with a registered dietitian or another healthcare professional to incorporate these changes and determine whether or not they help to alleviate your symptoms. If you have diabetes and are experiencing GI distress, it’s important to speak with your provider to determine the cause of your symptoms, as people with diabetes are at higher risk of developing certain GI disorders.

Managing Diabetes with an RD

Understanding which foods may benefit your diabetes and other chronic conditions can seem overwhelming. Working with a diabetes nutritionist can help you identify foods that will satisfy your tastes and support your overall health.

Book an appointment with Nourish and see a registered dietitian through your insurance.