Irritable bowel syndrome (IBS) can be challenging to manage. No one knows exactly what causes the abdominal discomfort and pain.

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IBS triggers are not always consistent and can even vary for the same person. For instance, you may eat a salad one day and feel fine, but the next day, the greens can cause an attack. For another person, milk is an occasional culprit, says gastroenterologist Christine Lee, MD.

Stress, anxiety, travel, new medications, and negative emotions also can make your IBS symptoms worse. That’s why it’s so important to find ways to relax, whether with yoga, relaxation techniques or meditation — or even by making more drastic life or job changes if needed.

Doctors diagnose IBS when someone has three or more bouts of unexplained abdominal discomfort and pain (such as bloating, cramping and diarrhea) for at least three months in a row with clear periods of no symptoms in between bouts. Your doctor may order a blood test, stool samples and a colonoscopy to exclude other possible diagnosis.

If you think you have IBS or you’re struggling to manage your condition, gastroenterologists can help you avoid common mistakes and find effective ways to manage your disease.

You have chronic stomachaches, but you may figure there’s no reason to see a doctor.

They will say things like ‘that’s just my stomach’ or ‘everyone in my family has stomach issues.’ However, there are many strategies to deal with IBS, from medication, to diets, to behavior therapy.

Some people think an IBS diagnosis only partially explains their stomach and abdominal aches. They worry that something more serious is going on.

However, unless symptoms change drastically or a person begins to lose weight, becomes malnourished or has other worrisome symptoms, additional testing usually isn’t unnecessary.

Patients often say, “I know something is inflamed in my GI tract” and they request repeated procedures. However, in IBS, there is no identifiable inflammation, unlike inflammatory bowel disease.

Rather than seeking various procedures, it’s better to focus on what is causing your symptoms.

Because IBS symptoms are sometimes all over the board — from constipation and diarrhea to gas and cramping — work closely with your doctor to find a treatment plan that addresses them.

“Find out what is causing the gas/abdominal bloating symptoms, then treat the root of the problem instead of just treating the symptom, such as treating gas by taking Gas-X,” she says.

Elimination diets, done in consultation with a doctor, can sometimes help ease chronic pain associated with the neck and lower back, fibromyalgia and other chronic conditions. Foods typically eliminated include gluten, dairy, sugar and packaged and processed foods.

Be careful about “fad” diets or extreme or self-imposed elimination diets, which have not been shown to help those with IBS in the long term.

“In fact, some of these diets are so restrictive that it is very difficult to adhere to long term, and can actually cause insensitivities down the road, as well as vitamin and nutritional deficiencies,” says Dr. Lee.

If you do have IBS, the best diet to try is a low-FODMAP diet. FODMAPs — fermentable oligosaccharides, disaccharides, monosaccharides and polyols saccharides — are carbohydrates that may not digest or absorb well in your intestines.

Following a low-FODMAP diet means limiting servings of milk (and other foods that contain lactose), fruits, broccoli (and other cruciferous vegetables) and legumes or beans.

“Some people will improve with certain diets, and a prime example is a low-FODMAP diet,” she says.

If that diet doesn’t work, try other healthy diets and find what works for you.

While researchers continue to search for a cure for IBS, these tips can help you manage your condition right now. If you continue to struggle, talk to your doctor.