Why Does Everyone Seem to Have IBS Now?

Credit - Photo-Illustration by TIME; Manusapon Kasosod—Moment RF/Getty Images, Boonchai Eedmakawand—Moment RF/Getty Images, Viorel Kurnosov—iStockphoto/Getty Images

We’re in the midst of a weird cultural moment involving people’s bowel habits. Irritable bowel syndrome (IBS) has been trending on social media, including TikTok videos and posts about the disorder on Instagram, X, and other platforms. Billboards proclaiming that Hot girls have IBS have popped up over the past few years in Los Angeles and other cities.

As a result, a subject that was once unthinkable to discuss socially has been normalized. “It’s definitely a phenomenon,” says gastroenterologist Dr. Roshini Raj, an associate professor of medicine at the NYU Grossman School of Medicine and author of Gut Renovation. “It’s a topic more people are comfortable talking about, and people are paying more attention to how their guts are feeling.”

What is IBS?

A functional GI disorder, IBS is characterized by symptoms like bloating, gas, abdominal pain, cramping, constipation, and/or diarrhea. The syndrome is more common among women—affecting more than twice as many women as men—but men experience it, too.

Thanks to the social-media trend, people may be diagnosing themselves with IBS based on their symptoms, or they may be bringing them to their doctors’ attention.

Read More: Why Gut Health Issues Are More Common in Women

“When people share their stories, awareness [of IBS] increases, and with that exposure, people realize their symptoms aren’t normal,” says Dr. Shabnam Sarker, an assistant professor of medicine in the gastroenterology and hepatology division at Vanderbilt University Medical Center. “And they’re realizing it doesn’t have to be that way.”

Dr. Bryan Curtin, director of the Center for Neurogastroenterology and GI Motility at The Melissa L. Posner Institute for Digestive Health & Liver Disease at Mercy Medical Center in Baltimore, agrees. “The upside of this openness to discussing IBS is that it is less stigmatized and people suffering with these conditions feel less alone and isolated,” he says.

How do you know if you have IBS?

While there’s no structural or biochemical test for IBS, there are specific criteria—called the ROME IV Criteria—that are essential for its diagnosis. These include recurrent abdominal pain at least one day per week in the last three months, along with changes in the frequency and appearance of stools (among other symptoms). Subtypes of IBS include constipation-predominant IBS, diarrhea-predominant IBS, mixed IBS, and unclassified IBS.

In other words, it’s a clinical diagnosis based on someone’s medical history, physical examination, and personal set of symptoms. But because other gastrointestinal disorders—such as celiac disease and inflammatory bowel diseases like Crohn’s disease—can have similar symptoms to IBS, doctors often order tests to rule those out before making an IBS diagnosis.

Beyond the hashtags, the latest research does suggest that IBS is more prevalent—affecting 6.1% of people in the U.S.—than previously thought. Experts estimate that as many as 10-15%of people in the U.S. have IBS, and many of them may be undiagnosed, Raj says.

Why is IBS on the rise?

The digestive system is complicated, and the precise cause of IBS isn’t well understood. It may be related to gut motility or permeability problems, and many experts believe it has to do with the quality of a person’s diet and dysregulation of the gut microbiome: the community of microbes, including bacteria, that naturally live in the gastrointestinal tract.

The uptick also could be related to stress. “IBS is a brain-gut axis disorder,” explains Sarker. “The gut has a lot of nerves, and the way the nerves are firing affects [gut] movement, pain, and bloating. Psychological stressors play a big role in IBS, and there’s been a lot more stress since the pandemic.”

Read More: Green Tea Is Even Better For You Than You Think

The increase in IBS prevalence also could be related to COVID-19 because “viral illnesses can induce disorders of the gastrointestinal system,” says Dr. Darren Brenner, a gastroenterologist and professor of medicine and surgery at the Northwestern University Feinberg School of Medicine. Indeed, a 2023 review of studies on the subject found that COVID-19 infection was associated with new IBS diagnoses; this was especially true among women and people with depression or anxiety.

While IBS isn’t life-threatening, it can be a miserable experience and negatively affect someone’s quality of life. “With IBS, a lot of people change their behavior to work around their symptoms,” Sarker says. This may lead them to decline invitations to parties or other social events because they’re worried about having a flare-up. Or, it may spur them to avoid physical activity for the same reason.

How to find relief

One of the drawbacks to the IBS social-media sensation: Some of the information being shared isn’t correct, research has found. Another possible downside? If people with GI symptoms start doom-scrolling, their anxiety and hypervigilance can get ramped up, which could worsen their symptoms. They also might be seduced by online products that promise to eliminate bloating that may not actually work.

Because the symptoms and severity of IBS can vary among people, there isn’t a one-size-fits-all approach to treating it. “The nice thing is because we have so many things in our armamentarium, people can choose their treatment,” says Brenner. “There is no cure for this disorder, and the symptoms wax and wane, but we have multiple modalities that can improve symptoms and quality of life.”

Read More: What’s So Great About Cottage Cheese?

These include dietary modifications such as increasing fiber and water intake and avoiding possible trigger foods like gluten and dairy. “Keeping a food diary can help people identify triggers for IBS,” says Sarker.

Other treatments may include botanical preparations (like peppermint oil, which can reduce intestinal spasms), neuromodulators (such as some antidepressants), antibiotics, or medications that influence gut motility. Mind-body approaches—such as cognitive behavioral therapy, meditation, and gut-directed hypnosis—can also be beneficial because “the gut-mind condition is very real and even more pronounced in someone with irritable bowel syndrome,” says Raj.

Getting plenty of sleep and regular exercise is also beneficial for managing IBS. Many people with IBS rely on a combination of therapeutic strategies to treat the condition.

“There’s no definitive cure for IBS,” says Sarker. “But we can manage this and get you to where your quality of life is much better.”

Contact us at letters@time.com.