Table of Contents
Last updated on March 25th, 2025 at 12:47 am
Written By Reagan Hughes, Dietetic Intern, Reviewed By Shena Jaramillo, MS, RD
IBS is common in eating disorders as normal digestion function and enzymatic processes are severely impaired.
IBS stands for irritable bowel syndrome which is a gastrointestinal disorder characterized by a cluster of symptoms that affect your digestive system and a specific illness or disease is not present.
There are several reasons eating disorders and IBS co-occur including:
- Delayed gastric emptying
- Disruption of the gut-brain axis
- Hormonal changes
- Purging
- Laxative abuse
- Stress and anxiety
This article explores some of the symptoms common with IBS in eating disorders, How IBS may contribute to eating disorders and/or recovery, and strategies to manage your IBS in ed recovery.
Symptoms of IBS Common With Eating Disorders
Most of us experience issues with our digestive system from time to time. If you experience these symptoms frequently and/or regularly, this could be an indication of IBS.
Some of the most common IBS symptoms include:
- Abdominal pain or cramps (usually related to passing a bowel movement)
- Excess gas and bloating
- Diarrhea, constipation, or alternating between the two
- Changes in the appearance of bowel movements
- Variations in how regularly you have a bowel movement
- Mucus in your stool
Types of IBS Common With Food Restriction
Understanding the type of IBS you have can help you to tailor treatment for relief. Based on your most predominant symptoms, your IBS can be categorized into one of the following:
- IBS-D: Mostly diarrhea (loose, watery poop) and abdominal discomfort
- IBS-C: Mostly constipation (hard, lumpy poop) and abdominal discomfort
- IBS-M: Alternating diarrhea and constipation with abdominal discomfort
Causes of non-eating disorder-related IBS
The exact cause of IBS is not well understood, but researchers believe it is related to various interactions between our immune system, hormones, and nervous system.
Researchers have identified the various IBS triggers:
- The specific types of foods you eat and possible intolerances/allergies
- How you eat (i.e. eating too quickly or with distractions)
- Stress, trauma or anxiety
- Visceral hypersensitivity, meaning the nerves in your digestive tract are extra sensitive
- Changes in the gut microbiome (i.e. bacterial overgrowth)
- Hormonal changes
- Genetics
- Severe infection
An eating disorder typically exacerbates all the symptoms listed above. Anyone with an IBS diagnosis should be assessed for an eating disorder.
IBS and eating disorders:
An ED places you at a greater risk of developing IBS. Having IBS places you at a greater risk of developing an ED or disordered eating patterns. There is an undeniable connection between the two, but no cut-and-dry answer to explain the relationship.
One area of research that is clear is that our mental health can tremendously impact our physical health, especially our gastrointestinal system.
An ED can cause immense psychological stress. This can lead to disruption in the gut-brain axis. IBS and ED are both associated with a disruption of the gut-brain axis.
Here’s are some ways that your eating disorder and/or IBS disrupts the gut-brain axis:
- Stress/anxiety can trigger stress responses which tell your brain to release stress hormones. These hormones can turn on pain signals in the gut, increasing the sensitivity, speed, and “leakiness” of your gut.
- Strong emotions trigger the release of hormones. These hormones can impact your rate of digestion, potentially contributing to diarrhea or constipation.
- Changes in the gut microbiome
Nutrient Deficiencies With IBS and EDs
Food restriction related to an eating disorder can place you at a greater risk for developing nutrient deficiencies.
Common nutrient deficiencies experienced in an eating disorder include but are not limited to:
- Zinc
- Copper
- Selenium
- Vitamin D
- B-vitamins
Nutrient deficiencies impact how our gut operates. If you are deficient in a nutrient, your gut may not be working as efficiently as it could, resulting in gastrointestinal symptoms.
Can IBS cause an eating disorder
Sometimes it is difficult to know whether an eating disorder triggers IBS symptoms or vice versa.
Dietary modifications are one of the most successful ways to manage IBS symptoms. However, you may self-impose a diet that is way too restrictive because you’re afraid of having IBS symptoms.
IBS protocol is often tricky to follow, and a healthcare provider may try to give you a list of foods to avoid without any follow-through on how to properly do an elimination diet and reintroduce foods. This can cause excessive food restriction even if the intentions are good.
Dietary changes with IBS That can trigger an eating disorder include:
- Extremely restrictive diets prescribed by healthcare providers
- Not keeping a food log to determine what your triggers are during treatment
- Not having proper guidance with a food elimination protocol
- Unintentionally undernourishing because you’re not sure what to eat
- Undernourishing because you’re sick of eating the same food types
- Poor meal and snack planning due to limited food selection
- Having many fear foods because you’re not sure what causes IBS
- Having co-existing conditions like ADHD and forgetting to eat
Managing IBS with an ED
Managing both IBS and an ED is a difficult balance, requiring a thoughtful approach. Here are a few suggestions:
Seek professional help
- Consult with healthcare providers who specialize in both IBS and eating disorders
- Have a therapist, dietitian, and pcp on your healthcare team
- Follow up with your healthcare team regularly for support in managing both IBS and eating disorder symptoms
Establish Regular Eating Patterns
Irregular eating patterns can exacerbate both IBS symptoms and eating disorder behaviors.
- Aim to eat regular meals and snacks throughout the day
- Use an eating disorder meal plan to determine your nutrient needs
- Avoid restrictive diets
Use Elimination Diets With Caution
IBS is often the result of an eating disorder. So as much as possible, it is important to work through normalizing meals and snacks before taking out any foods that can cause IBS symptoms.
Common diet protocols used in treating IBS are much too restrictive for someone with an eating disorder and will exacerbate eating disorder symptoms.
However, not all IBS symptoms are caused by an eating disorder and the possibility of food sensitivities and allergies should not be ruled out in ED recovery.
A skilled ed dietitian can help you to:
- Create a modified elimination diet that tests one food at a time
- Keep track of foods that might be a trigger
- Assess similar foods that may be causing IBS symptoms
In eating disorder recovery, every food will likely appear to be an IBS trigger. Really honing in on single food items to test out repeatedly can help you to manage IBS symptoms while still working on your eating disorder recovery.
Identify Triggers
Identifying your triggers for IBS will be a big defense in alleviating symptoms.
To help identify triggers:
- Keep a food journal
- Log your stress/anxiety levels
- Low hunger/fullness before and after a meal
- Keep track of your bathroom habits
Manage Stress
Stress can exacerbate both IBS and eating disorder symptoms.
Some tools you can use to manage stress include:
- Speaking with a metal health expert
- Yoga
- Deep breathing exercises
- Meal support
- Gardening or outdoor activities
Manage The GI Symptoms
GI symptoms can be incredibly uncomfortable. It can make recovering from an eating disorder and improving IBS symptoms feel impossible. As you weight restore in your eating disorder, there are things that you can do to help manage IBS symptoms.
Some things that might help with IBS symptoms in ED recovery include:
- Make some of your calories liquid calories
- Use heading pads to manage GI pain
- Practice good bathroom habits (sit on the toilet at the same time daily, elevate your feet)
- Stop laxative abuse if you are engaging in this
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