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Irritable Bowel Syndrome (IBS)

What is it?

Irritable bowel syndrome (IBS) is a disorder of the gastrointestinal tract that causes abdominal pain, constipation, or diarrhea. It is also known as irritable colon or spastic colon.

Who gets it?

IBS affects women as much as three times more often than men. As many as 30% of Americans suffer from IBS at some time in their lives. In a majority of cases, symptoms appear before age 35. You will be more likely to have IBS if you have other family members with it.

What causes it?

The cause of IBS is not known, but it seems that the gastrointestinal tract in people with IBS is extra sensitive to stimuli. During an episode of IBS, the gastrointestinal tract may contract strongly and more frequently, causing too much movement. These contractions cause food and fecal material to move rapidly through the small intestine, which causes diarrhea. Or, the gastrointestinal tract may not contract enough, causing undigested material to move slowly through the colon. This causes constipation. IBS can be caused by stress, diet, drugs, or hormones. The types of foods that trigger an attack of IBS vary from person to person, but some common triggers include chocolate, milk products, fatty foods, caffeine, and large amounts of alcohol. IBS symptoms may get worse during menstruation, so some researchers believe that female reproductive hormones are another trigger. Muscle movement in the colon is controlled by the nervous system, so stress and depression may also cause the spasms associated with IBS.

What are the symptoms?

The main symptoms of IBS are diarrhea, constipation, and strong abdominal cramps. Other symptoms can include gas, bloating, nausea, an overwhelming and uncontrollable urge to have a bowel movement, mucus in the bowel movements, and the feeling that the bowels have not emptied even after a bowel movement. Symptoms can range from mild to severe. For many, the symptoms of IBS come on suddenly, usually after a meal, and are relieved by a bowel movement. Symptoms rarely wake a person during sleep.

How is it diagnosed?

To diagnose IBS, your physician will take a complete medical history, examine your abdomen, and perhaps perform a rectal exam. You will be diagnosed with IBS if you have had continuous or recurring symptoms for at least three months and other possible conditions, such as Crohn’s disease or ulcerative colitis, are ruled out. There is no specific diagnostic test for IBS, but tests to rule out other causes include the examination of a stool sample for blood or intestinal parasites, blood tests, abdominal x-rays, and barium enema x-ray, a procedure in which a barium liquid is passed into the colon through the rectum before x-rays are taken. Your doctor may also order an colonoscopy or sigmoidoscopy, procedures in which a thin, flexible tube equipped with a tiny camera is inserted through the anus to provide a view of the inside of the colon. A person with IBS will have no sign of any disease of the colon. If your doctor suspects your symptoms are caused by lactose intolerance, he or she may ask you to try a lactose-free diet for a few weeks. Most cases of IBS are classified as mild. About a quarter of the cases are moderate, meaning they occasionally interrupt daily activities. Only a small percentage are so severe that they interfere with daily life and cause psychological problems.

What is the treatment?

Treatment for IBS varies. If you are able to identify the foods or types of stress that cause your symptoms, avoiding these foods or situations will relieve the symptoms. Most treatments for IBS focus on diet. In general, a low fat, high fiber diet is effective in treating mild cases of IBS. If you have problems with bloating and gas, you should avoid foods that aggravate these conditions, such as beans and cabbage. The artificial sweetener sorbitol, as well as fructose, may also aggravate diarrhea. If you have IBS and are lactose intolerant, you should avoid dairy products. Eating more fiber, such as bran, may help with both constipation and diarrhea. Dietary changes may be supplemented by drugs that treat diarrhea and constipation, and psychotherapy, especially where stress and depression are contributors. Your doctor may recommend that you keep a diary of your food intake, emotional state, and occurrences of IBS for a few weeks to help identify triggers. Severe IBS is usually treated with a combination of dietary changes, psychotherapy, and medication, including antidepressants. Stress management techniques such as yoga, biofeedback, yoga, and meditation may also help with symptoms. Some people find relief in herbal remedies; however, you should consult with your doctor about methods and doses.

Self-care tips

With knowledge and treatment, you can lead a normal life with IBS. It causes no lasting damage to the colon and it cannot cause other bowel diseases or cancer. You may have IBS all your life, or the symptoms may gradually go away. You can help relieve symptoms by following a healthy diet, getting plenty of exercise, drinking enough water each day, learning stress management techniques, and avoiding the foods that can cause flare-ups for you.
 


This information has been designed as a comprehensive and quick reference guide written by our health care reviewers.  The health information written by our authors is intended to be a supplement to the care provided by your physician.  It is not intended nor implied to be a substitute for professional medical advice. 

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This page was last updated on October 31, 2006
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