Why IBS in Indian Women Is Often Misdiagnosed

Irritable bowel syndrome (IBS) is one of the most common digestive issues people face worldwide. It causes stomach pain, bloating, gas, constipation, diarrhea, or a mix of these symptoms.

Even though it affects many people, especially women, it is often misdiagnosed or misunderstood. This problem is particularly visible in Indian women, where symptoms get blamed on stress, hormones, or anxiety without proper investigation.

This article explains clearly why this happens, what common treatments fail to help, and what actually works.

What Is IBS? A Simple Explanation

IBS is a functional gut disorder. That means the gut looks normal on tests like ultrasound or endoscopy, but it does not work normally. Symptoms happen because of a complex interaction between the brain and the gut.

This is the “brain-gut axis.” There are no specific blood tests or X-rays that confirm IBS, so doctors use criteria like the Rome criteria based on symptoms instead.

Why Misdiagnosis Happens in Indian Women

1. Overlap with Anxiety and Stress

IBS and anxiety or stress are strongly linked. In research from India, women with IBS were found to have much higher anxiety or depression compared to people without IBS. 

This happens because:

• Symptoms like bloating and pain get worse with stress.

• Doctors sometimes assume women are “emotional” or that stress alone explains gut issues.

But stress is only one piece of the puzzle. In many people, anxiety can be a result of uncomfortable gut symptoms, not the cause. That’s why treating stress alone usually does not fix IBS.

2. Hormonal Changes and Thyroid Imbalance

   
   

Women’s hormones influence digestion. Many women notice gut symptoms flaring around periods, pregnancy, or menopause. Reddit conversations show many women suspect hormones are behind their symptoms, and some see relief when hormone levels are corrected.

Another overlap is with thyroid problems. Both hyperthyroidism (high thyroid activity) and hypothyroidism (low thyroid activity) can cause changes in bowel habits like constipation or diarrhea.

Some people on health forums share stories of being diagnosed with IBS when the real issue was thyroid imbalance.  Research also shows IBS patients have a higher risk of thyroid disease compared with people without IBS.

3. Gender Bias and Diagnostic Delays

   
   

Studies show women often wait longer than men for accurate diagnoses of conditions involving pain and discomfort. Gender bias and assumptions that women’s symptoms are “just hormones” can lead doctors to miss the real cause and diagnose IBS too quickly.

4. Symptom Overlap with Other Conditions

IBS symptoms overlap with other digestive disorders such as small intestinal bacterial overgrowth (SIBO), bile acid malabsorption, endometriosis affecting bowels, or even celiac disease. Because IBS doesn’t show up on standard tests, doctors sometimes diagnose IBS without ruling out these other conditions.

What People Often Try That Might Not Work

1. Overuse of Probiotics

Probiotics are beneficial bacteria that many people take to improve gut health. While some strains like Bifidobacterium and Lactobacillus may help some IBS symptoms, scientific evidence is mixed.

The benefits can vary by strain, dose, and individual gut microbiome.  Probiotics can help reduce bloating and gas for some people, but they don’t work for everyone and may cause more gas in others.

Many people find that despite trying several probiotic brands, there was no improvement, especially for constipation-predominant IBS.  So while probiotics aren’t harmful for most people, they are not a magic fix. They should be used only when targeted to specific symptoms and guided by a clinician.

2. Antispasmodic Medicines

Antispasmodics are another commonly prescribed treatment for IBS pain and cramping. These drugs try to relax the muscles of the gut.

While they may help a subset of people, evidence shows that antispasmodics have limited benefit and do not address the underlying causes of IBS symptoms.

Many patients report that antispasmodics eased some cramping but did little for bloating, constipation, or diarrhea problems.  Because IBS is not a one-size-fits-all condition, relying on medications alone often leads to frustration and repeated doctor visits.

3. What Actually Works for IBS

Rule Out Other Conditions First

Since symptoms overlap, it’s important to check for:

• Thyroid imbalance

• Celiac disease

• SIBO or bacterial overgrowth

• Bile acid malabsorption

• Endometriosis affecting the gut (in women)

Doctors may use blood tests, stool tests, breath tests, or imaging to rule these out before confirming IBS.

Diet First: Trigger Identification and Modification

Food plays a huge role in IBS. Many people report that certain foods made their symptoms worse. Diet approaches that have research support include:

• The low-FODMAP diet reduces fermentable foods that cause gas and bloating for many people.

• Fibre adjustments: soluble fibre like psyllium often helps with constipation and overall gut comfort.

Studies show that 70-80% of symptoms can be managed with changes to diet (15, 16, 17, 18).

Address the Brain-Gut Connection

Evidence shows that gut symptoms and the brain are connected and influence each other. Techniques that help include:

• Mindfulness and stress reduction

• Therapies like gut-directed hypnotherapy

• Cognitive behavioral therapy

  
  

  These approaches improve how the brain processes gut sensations, not just the symptoms themselves.

Lifestyle Factors That Improve IBS

Simple lifestyle habits make a big difference for many people:

• Regular physical activity improves digestion and gut microbiome balance.

• Good sleep and hydration

• Eating slowly and avoiding large, heavy meals

Targeted Medical Support When Needed

In some cases, low-dose neuromodulators or other medications can be helpful when lifestyle and diet changes aren’t enough. This is especially true when anxiety or visceral pain sensitivity contributes to symptoms.

Curious about your gut health? Take our free Gut Health Checker to see where you stand and get personalised tips.

How to Talk to Your Doctor So You Are Not Misdiagnosed

Here are practical questions to ask:

1. Have you ruled out thyroid issues?

Symptoms like constipation and fatigue can come from thyroid imbalance.

2. Could this be SIBO or bile acid malabsorption?

These conditions have symptoms similar to IBS.

3. Is the diet I am on right for my symptoms?

Low-FODMAP or tailored food plans often help.

4. Should we consider stress and hormones as part of a bigger picture?

Stress influences IBS, but it is not the sole cause.

Being your own advocate helps you get proper care sooner.

Conclusion: IBS Is Real and Treatable, but Often Misunderstood

IBS in Indian women is commonly misdiagnosed because symptoms overlap with anxiety, hormones, and other health conditions. Quick fixes like probiotics and antispasmodics may help some people but often fail because they do not address the underlying situation.

The best results come from a comprehensive approach that includes careful diagnosis, personalized diet, stress management, lifestyle changes, and targeted medical support where appropriate.

Your symptoms are real. With the right plan, many people see meaningful improvement and a better quality of life.

Frequently Asked Questions About IBS in Indian Women

1. Why is IBS more common in women than men?

IBS is more commonly reported in women because female hormones affect gut movement, pain sensitivity, and digestion. Estrogen and progesterone can slow or speed up bowel movements, especially around periods, pregnancy, and menopause.

Women also tend to have a more sensitive gut brain connection, which can increase pain and bloating sensations.

2. Can anxiety really cause IBS symptoms?

Anxiety does not directly cause IBS, but it strongly influences gut symptoms. The gut and brain are connected through nerves and hormones.

Stress and anxiety can increase gut sensitivity, slow digestion, or trigger diarrhoea. At the same time, ongoing gut discomfort can increase anxiety. This creates a cycle that needs to be addressed from both sides.

3. Is IBS just a psychological problem?

No. IBS is a real digestive disorder. While stress and emotions affect symptoms, IBS also involves gut motility issues, altered gut bacteria, food sensitivities, and nervous system responses.

IBS, as only psychological, often delays proper treatment and leaves symptoms unresolved.

4. Can thyroid problems be mistaken for IBS?

Yes. Both low thyroid and high thyroid levels can cause symptoms like constipation, diarrhoea, bloating, and fatigue.

Many women are diagnosed with IBS without checking thyroid function properly. Thyroid testing is important when digestive symptoms are ongoing.

5. Do probiotics really help IBS?

Probiotics help some people with IBS but worsen symptoms in others. Certain strains may reduce bloating or gas, while others can increase discomfort.

Probiotics are not a universal solution and should be used only when matched to the right symptoms and gut condition.

6. Why do antispasmodic medicines not work for everyone with IBS?

Antispasmodics relax gut muscles and may reduce cramping temporarily. However, they do not fix the root causes like food triggers, gut sensitivity, or brain gut signaling. This is why many people feel partial or short term relief only.

7. What is the best diet for IBS?

There is no single best diet for everyone with IBS. Many people benefit from a low FODMAP diet, fiber adjustments, or identifying personal trigger foods. Here are 5 foods to avoid with IBS.

Diet needs to be individualized based on whether symptoms are constipation dominant, diarrhea dominant, or mixed.

8. Can IBS be cured permanently?

IBS does not have a single cure, but symptoms can be significantly reduced and well managed. Many people achieve long term relief by combining diet changes, stress management, lifestyle support, and medical guidance when needed.

9. How long does it take to see improvement in IBS symptoms?

   
   

Most people notice improvement within 4 to 8 weeks once the right approach is started. Chronic symptoms may take longer. Therefore, consistency matters more than quick fixes.

10. When should IBS symptoms be investigated further?

Further testing is important if symptoms include unexplained weight loss, anaemia, blood in stools, severe night pain, or if symptoms started suddenly after age 40. These signs may indicate conditions other than IBS.

11. Can children and teenagers have IBS?

Yes. IBS can affect children and teenagers, especially those with anxiety, food sensitivities, or irregular eating habits. Early support helps prevent long-term gut issues and food fear.