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What is irritable bowel syndrome (IBS)?

Irritable bowel syndrome is a disorder characterized most commonly by cramping, abdominal pain, bloating, constipation, and diarrhea. IBS causes a great deal of discomfort and distress, but it does not permanently harm the intestines and does not lead to a serious disease, such as cancer. Most people can control their symptoms with diet, stress management, and prescribed medications. For some people, however, IBS can be disabling. They may be unable to work, attend social events, or even travel short distances.

As many as 20 percent of the adult population, or one in five Americans, have symptoms of IBS, making it one of the most common disorders diagnosed by doctors. It occurs more often in women than in men, and it begins before the age of 35 in about 50 percent of people.

 

What are the symptoms of IBS?

Abdominal pain, bloating, and discomfort are the main symptoms of IBS. However, symptoms can vary from person to person. Some people have constipation, which means hard, difficult-­‐to-­‐pass, or infrequent bowel movements. Often these people report straining and cramping when trying to have a bowel movement but cannot eliminate any stool, or they are able to eliminate only a small amount. If they are able to have a bowel movement, it may have mucus in it, which is a fluid that moistens and protect passages in the digestive system. Some people with IBS experience diarrhea, which is frequent, loose, watery, stools. People with diarrhea frequently feel an urgent and uncontrollable need to have a bowel movement. Other people with IBS alternate between constipation and diarrhea. Sometimes people find that their symptoms subside for a few months and then return, while others report a constant worsening of symptoms over time.

 

What is the treatment for IBS?

Unfortunately, many people suffer from IBS for a long time before seeking medical treatment. Up to 70 percent of people suffering from IBS are not receiving medical care for their symptoms. No cure has been found for IBS, but many options are available to treat the symptoms. The doctor will prescribe the best treatments for a person’s particular symptoms and encourage the person to manage stress and make dietary changes.

Medications are an important part of relieving symptoms. The doctor may suggest fiber supplements or laxatives for constipation or medicines to decrease diarrhea

With any medication, even over–the–counter medications such as laxatives and fiber supplements, it is important to follow the doctor’s instructions. Some people report a worsening in abdominal bloating and gas from increased fiber intake, and laxatives can be habit forming if they are used too frequently.

Medications affect people differently, and no one medication or combination of medications will work for everyone with IBS. Working with the doctor to find the best combination of medicine, diet, counseling, and support to control symptoms may be helpful.

 

How does stress affect IBS?

Stress—feeling mentally or emotionally tense, troubled, angry, or overwhelmed—can stimulate colon spasms in people with IBS. The colon has many nerves that connect it to the brain. Like the heart and the lungs, the colon is partly controlled by the autonomic nervous system, which responds to stress. These nerves control  the normal contractions of the colon and cause abdominal discomfort at stressful times. People often experience cramps or “butterflies” when they are nervous or upset. In people with IBS, the colon can be overly responsive to even slight conflict or stress. Stress makes the mind more aware of the sensations that arise in the colon, making the person perceive these sensations as unpleasant.

Some evidence suggests that IBS is affected by the immune system, which fights infection in the body. The immune system is affected by stress.

For all these reasons, stress management is an important part of treatment for IBS.

Stress management options include:

  • stress reduction training and relaxation therapies such as meditation
  • counseling and support
  • regular exercise such as walking or yoga
  • changes to the stressful situations in a person’s life
  • adequate sleep

 

Points to Remember

  • IBS is a disorder that interferes with the normal functions of the colon. The symptoms are crampy abdominal pain, bloating,  constipation, and diarrhea.
  • IBS is a common disorder found more often in women than men.
  • People with IBS have colons that are more sensitive and reactive to things that might not bother other people, such as stress, large meals, gas, medicines, certain foods, caffeine, or alcohol.
  • IBS is diagnosed by its signs and symptoms and by the absence of other diseases.
  • Most people can control their symptoms by taking medicines such as laxatives, antidiarrhea medicines, antispasmodics, or antidepressants; reducing stress; and changing their diet.
  • IBS does not harm the intestines and does not lead to cancer. It is not related to Crohn’s disease or ulcerative colitis.

 

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Suburban Gastroenterology