Irritable Bowel Syndrome

What is Irritable Bowel Syndrome?
Irritable bowel syndrome (IBS) is a common disorder that may affect over 15 percent of the general population. It is sometimes referred to as spastic colon, spastic colitis, mucous colitis or nervous stomach. IBS should not be confused with other diseases of the bowel such as ulcerative colitis or Crohn's disease.  IBS is a functional disorder where the function of the bowels may be abnormal but no structural abnormalities exist.

What are the symptoms of IBS?
People with IBS may experience abdominal pain and changes in bowel habits - either diarrhea, constipation, or both at different times. Symptoms associated with IBS include abdominal cramps, fullness or bloating, abnormal stool consistency, passage of mucous, urgency or a feeling of incomplete bowel movements.

What causes IBS?
The symptoms of IBS seem to occur as a result of abnormal functioning or communication between the nervous system and the muscles of the bowel. This  abnormal regulation may cause the bowel to be "irritated" or more sensitive. The muscles in the bowel wall may contract too forcefully or too weakly, too slowly or rapidly at certain times. Although there is no physical obstruction, a patient may perceive cramps or functional blockage.

What role does stress play in IBS?
IBS is not caused by stress. It is not a psychological or psychiatric disorder, however emotional stress may contribute to IBS. Many people may experience nausea or diarrhea when nervous or anxious. While we may not be able to control the effect stress has on our intestines, reducing the sources of stress in our lives may help to alleviate the symptoms of IBS.

How can I tell if the problem is IBS and not something else?
A careful medical history and physical examination by a colon and rectal surgeon or other physician are essential to exclude more serious disorders. Tests may include blood tests, stool tests, visual inspection of the inside of the colon with flexible sigmoidoscopy or colonoscopy, and x-ray studies. Fever, anemia, rectal bleeding and unexplained weight loss are not symptoms of IBS and need to be evaluated by your physician.

How is IBS treated?
Understanding that IBS is not a serious or life-threatening condition may relieve anxiety and stress, which often contribute to the problem. Stress reduction, use of behavioral therapy, biofeedback, relaxation or pain management techniques can help relieve the symptoms of IBS in some individuals. Use of a diary may help to identify certain foods or other factors that cause symptoms.

Mild to moderate symptoms can often be managed by dietary changes. Your physician may recommend avoiding meals that are too large or high in fatty or fried foods. Caffeine or alcohol may also cause cramps or diarrhea. Some types of sugar, such as sorbitol commonly used as a low calorie sweetener and fructose, found naturally in honey and some fruits may be poorly absorbed by the gut and cause cramping and diarrhea. Gas producing foods such as beans, cabbage, cauliflower, broccoli, brussel sprouts and onions may cause bloating and increased discomfort in people with IBS.

Increasing dietary fiber may help to improve IBS symptoms. Soluble fiber such as that found in citrus fruits, flaxseeds and legumes may help soften stool and lessen the severity of cramps. Insoluble fiber such as cellulose, cereals and bran can absorb water as it moves through the digestive tract and lessen diarrhea. In some people too much fiber can cause discomfort. Adding fiber to the diet gradually with adequate amounts of liquids may eliminate the discomfort.

Individuals with moderate to severe IBS may benefit from prescribed medication. Medications can help to control the symptoms of IBS but they do not cure the condition. Medications act directly on the intestinal muscles to help the contractions return to normal. Antidepressants in low doses have been shown to be helpful in some with IBS.