Irritable Bowel Syndrome (IBS) Symptoms Beyond the Gut

Updated on April 06, 2021

Medically reviewed by Robert Burakoff, MD

Many people with irritable bowel syndrome (IBS) report symptoms not directly related to the bowel—symptoms healthcare providers call extra-intestinal symptoms. You may experience these in other parts of the digestive system or elsewhere in your body.

That means, along with IBS symptoms, you may also be dealing with puzzling, chronic symptoms that can be uncomfortable and have a major impact on your life.

woman nauseous in the bathroom — Halfpoint / Getty Images

GI Symptoms

The main IBS symptoms are related to your digestive system. This includes:

Diarrhea
Constipation
Abdominal pain

You may also experience symptoms elsewhere in the body, including some related to digestion, but not the bowel. The most common are:

Nausea
Heartburn
Reflux

Non-GI Symptoms

The physical symptoms of IBS that are completely separate from the digestive tract can be harder to wrap your head around.

According to researchers at the University of North Carolina, the most commonly reported non-gastrointestinal symptoms associated with IBS are:

Headache
Back pain
Frequent urination
Fatigue
Bad breath or a bad taste in the mouth

Other reported symptoms include:

Sleep difficulties
Muscle aches
Cold, clammy, or trembling hands
Heart palpitations
Dizziness
Pain during menstruation or intercourse

Effects

People with IBS often have their extra-intestinal symptoms minimized or dismissed by healthcare providers—even by their own friends and family. People with IBS report hearing things like:

That's not supposed to happen. Other people don't have those symptoms.
It's not cancer. It won't kill you.
It's in your head.
If you're not responding to medical treatment, you must be misdiagnosed.
If you don't have preexisting mental health issues, your problem isn't psychological. See a doctor.
You must be doing something wrong.
You must be misdiagnosed.
Live with it.

Causes

Theories abound as to why IBS increases your risk of these extra-intestinal symptoms. The wide variety of reported physical problems makes it challenging to find a common, underlying explanation.

It may be a combination of factors—including those yet to be uncovered—that contribute to the problem of extra-intestinal symptoms. The debate on this subject is ongoing and includes two main areas of inquiry.

Underlying Biological Cause

In the search for a unifying biological factor, researchers are looking at several systems that may be dysregulated or dysfunctional, including:

The nervous system, including the role of neurotransmitters
The body's innate pain regulation systems
The immune system

Psychological Factors

Research into the role of psychological factors as possible contributors to extra-intestinal symptoms has pinpointed two possibilities. IBS patients may be more likely to:

Experience emotions as physical symptoms
Have a tendency to be hyper-aware of bodily sensations

Other Theories

Some people theorize that food sensitivities may be the underlying cause of the various ailments experienced by people who have IBS.

Along the same lines is the theory that increased intestinal permeability (leaky gut syndrome) is playing a part. At this point, there is not enough research to make any firm conclusions.

Treatments

The high frequency of extra-intestinal symptoms in IBS suggests that this is a problem that needs to receive proper attention from the medical establishment.

The strength of the healthcare provider-patient relationship appears to have a beneficial effect on patient outcomes, particularly in IBS. Your healthcare provider needs to take your health concerns seriously and work to develop an effective treatment plan that addresses all of your physical complaints.

Focusing on interventions that address the body as a whole might prove helpful. This includes dietary modifications, herbal supplements, antidepressants, and brain/gut interventions such as cognitive behavioral therapy (CBT) or hypnotherapy.

IBS Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Download PDF

You can educate yourself about red-flag digestive symptoms to ease the anxiety that something more serious is being missed.

A Word From Verywell

If you're touched by IBS, you may want to consider advocating for and donating to research aimed at understanding the possible underlying causes of, and effective treatment for, these puzzling extra-intestinal physical complaints.

Meanwhile, work closely with your healthcare team to find ways to manage all of your symptoms so you can feel better and enjoy your life.

5 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of irritable bowel syndrome.
Palsson OS, Whitehead WE. IBS - Beyond the bowel: The meaning of co-existing medical problems. UNC Center for Functional GI & Motility Disorders.
Barbara G, Cremon C, Carini G, et al. The immune system in irritable bowel syndrome. J Neurogastroenterol Motil. 2011;17(4):349–359. doi:10.5056/jnm.2011.17.4.349
Muscatello MR, Bruno A, Mento C, Pandolfo G, Zoccali RA. Personality traits and emotional patterns in irritable bowel syndrome. World J Gastroenterol. 2016;22(28):6402–6415. doi:10.3748/wjg.v22.i28.6402
Gecse K, Róka R, Séra T, et al. Leaky gut in patients with diarrhea-predominant irritable bowel syndrome and inactive ulcerative colitis. Digestion. 2012;85(1):40-6. doi:10.1159/000333083

By Barbara Bolen, PhD
Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome.

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