Worry about dying is a frequent reason people with IBS seek medical care, so researchers have looked closely at what happens to people with IBS over decades.[2] The results are reassuring. UK guidelines state plainly that IBS is not associated with an increased risk of cancer or death, while also stressing that it affects quality of life as much as organic gut diseases such as inflammatory bowel disease (IBD).[1] Both halves of that sentence matter.
Does IBS shorten your life?
No. Three very different studies have reached the same conclusion:
- Sweden, nationwide. Researchers compared 45,524 people with IBS who'd had a bowel biopsy with more than 217,000 matched people from the general population and with their own siblings. After adjusting for other factors, IBS was not linked to a higher risk of death, and the authors concluded that IBS doesn't seem to increase the risk of dying.[2]
- Minnesota, community. Among 3,933 residents followed for more than 30,000 person-years, reporting IBS symptoms had no significant link with survival.[3]
- Minnesota, 29 years. In 112 people diagnosed with IBS at the Mayo Clinic in the early 1960s and followed for a median of 29 years, survival was no different from what was expected for the general population.[4]
Can IBS turn into something worse?
IBS doesn't turn into cancer, and it doesn't damage the bowel: colonoscopy in people with IBS finds very little.[1] What does happen, occasionally, is that someone diagnosed with IBS turns out to have had another condition all along:
- In a Danish study of 57,851 people with IBS, colon cancer risk was more than eight times higher than expected in the first three months after diagnosis, then fell below expected levels 1 to 10 years later. The authors put the early spike down to diagnostic confusion between overlapping symptoms.[5]
- In a UK study, people diagnosed with IBS were later diagnosed with celiac disease, IBD or colorectal cancer somewhat more often than people without IBS (3.7% vs 1.7% over 15 years), with the excess peaking in the six months after diagnosis. After five years their colorectal cancer risk was no higher than in the general population, though a small excess of celiac disease and IBD persisted.[6]
- A systematic review found that fewer than 5% of people with IBS were given a different, organic diagnosis once initial tests were normal.[7]
The takeaway: a confident IBS diagnosis is very stable, but symptoms that change or new warning signs deserve a fresh look. See IBS or colon cancer? and IBS vs IBD.
Is IBS serious?
For quality of life, yes. IBS isn't dangerous, but it can be disabling:
- In an international survey of 1,966 people with IBS who used patient information websites, respondents restricted their activities on an average of 73 days a year. To be symptom-free they said they would give up 25% of their remaining life, and 14% would accept a 1 in 1,000 risk of death.[8] People who seek out such websites may have more severe symptoms than average.
- In a Swedish study of 525 patients, 24% of those in work reported missing work because of IBS, and 87% said it reduced their productivity while at work.[9]
US guidelines call IBS a chronic, often debilitating disorder that greatly affects quality of life.[10] Taking it seriously means getting a diagnosis and effective treatment; see How is IBS treated?
Are there any real risks with IBS?
The avoidable risks come mostly from care, not from IBS itself. UK guidelines warn that people with IBS are more likely to have unnecessary operations, including gallbladder, appendix and womb removal, and to be prescribed opioid painkillers inappropriately. They recommend avoiding these harms, along with unproven tests and treatments promoted for profit.[1] If surgery or strong painkillers are suggested for IBS-type pain, it's reasonable to ask whether IBS has been considered as the explanation.
When to see a doctor
IBS doesn't cause the following, so see a doctor promptly if you notice any of them:[11][10]
- blood in your stool, or black, tarry stools
- unintentional weight loss
- anemia
- fever
- pain or diarrhea that wakes you at night
- a lump in your abdomen
- a family history of bowel cancer, IBD or celiac disease
- symptoms that start after about age 50
Keeping a record of your symptoms, stool types and any changes makes these conversations easier. IBS Clue can export a PDF report of your diary to share with your doctor. For more detail, see IBS red flags.