What Is Irritable Bowel Syndrome (IBS)?
IBS treatment depends on severity of symptoms
IBS treatment depends on severity of symptoms
On TV commercials, people with irritable bowel syndrome or IBS are seen discussing their symptoms: cramping, diarrhea or constipation and bloating, to name a few.
But if you have IBS, you don’t need to be reminded of these troublesome symptoms. Chances are you know them all too well already. What you’re looking for is long-term relief.
“The symptoms of irritable bowel syndrome can be very uncomfortable or even painful, and profoundly affect your quality of life,” says Edward Paredez, MD, a gastroenterologist at Scripps Memorial Hospital La Jolla.
“Fortunately, IBS does not cause damage to the digestive tract. But if you are showing signs and symptoms of IBS and they are interfering with your quality of life, you should see your doctor.”
A primary care physician may first diagnose IBS and refer a patient to a gastroenterologist for additional treatment.
Who gets IBS — and why?
IBS is a common health issue. It affects about 12 percent of people in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Women are more likely than men to develop IBS. It is more common in people who are younger than 50, according to the NIDDK, which is part of the National Institutes of Health.
What causes IBS?
IBS is a disorder of the bowel or large intestine. It is not the same as inflammatory bowel disease (IBD), which is more serious and includes Crohn’s disease and ulcerative colitis. Rather, IBS is a problem with how the bowel functions. With IBS, the nerves and muscles in the bowel are much more sensitive than normal. They may overreact to foods that are not a problem for people with regular bowel movements.
Symptoms of IBS
People with IBS may experience one or more symptoms, including:
- Abdominal pain
- Cramping
- Excess gas
- Bloating (or swelling) of the belly
- Change in bowel movement (diarrhea or constipation)
Some people with IBS may have a straining feeling during a bowel movement, or a change in frequency or a sense that their bowel movement is not complete. Sometimes, there will be mucus in the stool.
“If you’ve experienced any of these symptoms for a prolonged period, make an appointment to see your doctor for an evaluation,” Dr. Paredez says. “If you notice blood in your stool or develop a fever in addition to other symptoms, call your doctor right away. These may be signs of a more serious problem that needs immediate attention.”
Your physician will discuss your symptoms with you and may do a physical exam and other tests, including stool sampling tests, to rule out or treat other possible causes, such as hypothyroidism, Crohn’s disease, ulcerative colitis or anxiety disorder.
There is no known definitive cure for IBS. But a number of treatments can help the bowel function more normally and greatly relieve or get rid of IBS symptoms. Knowing your trigger points usually helps.
What are IBS triggers?
There are several possible causes of IBS symptoms. One of the most common is food. Among the most common triggers are dairy products, such as milk, cheese and ice cream. Caffeine, carbonated drinks, chocolate, alcohol, and foods with a high fat content are also know triggers.
The size of a meal can also make a difference. Large meals may cause an increase in IBS symptoms as the bowel struggles to digest all that food.
Psychological factors also may play a role. “Some people with irritable bowel syndrome find that their symptoms become more pronounced when they are upset, anxious or under stress,” Dr. Paredez says. "While these emotions in themselves won’t cause IBS, they can make it worse.”
Hormones can affect IBS as well. Some women may notice more symptoms during their menstrual periods.
There is also a subtype of IBS associated with a period of time after you experience acute bacterial gastroenteritis or traveler’s diarrhea.
In addition, there is ongoing research in the rapidly expanding fields of intestinal microbiome and in the basic science of intestinal permeability which has been referred to in lay terms as “leaky gut”.
Treatment for IBS
There is no specific diet for IBS. But eliminating troublesome foods can sometimes make a significant difference in IBS symptoms.
“There has been significant focus on avoidance of trigger foods and specific diets, such as the low-FODMAP diet,” Dr. Paredez says.
“If you have problems with constipation, your doctor can review your diet and lifestyle and may recommend that you add more water or fiber to your diet through food or supplements. Fiber may make stools softer and easier to pass. In addition, certain healthy foods, such as prunes, apples and berries, have laxative properties.
Learning to reduce stress in your life also may reduce IBS symptoms of cramping and abdominal pain. Talk to a counselor or look into methods of stress management, such as yoga, meditation, talking to a friend or family member or even just taking a walk. Your doctor may be able to refer you to a counselor or a stress management program.
Physical exercise can also help decrease stress and may help with IBS symptoms as well.
Depending on your symptoms, your doctor may suggest taking medication. Over-the-counter laxatives can relieve constipation. Anti-spasmodic medications can slow the contractions of the bowel to help with diarrhea and cramping. Prescription medications may be another alternative.
“Often, a combination of treatments works best to relieve IBS symptoms,” says Dr. Paredez says. “Many patients wish to keep treatment plans as natural as possible. Your physician can help you determine the approach that is right for you.”