Irritable Bowel Syndrome
Irritable bowel syndrome (IBS)is a chronic gastrointestinal disorder of unknown cause. Common symptoms include abdominal cramping or pain, bloating and gassiness, and altered bowel habits.Irritablebowel syndromehas been called spastic colon, functional bowel disease, and mucous colitis. However, IBS is not a true "colitis." The term colitis refers to a separate condition known as inflammatory bowel disease (IBD).
Irritable bowel syndromeis not contagious, inherited, or cancerous. However,IBS often disrupts daily living activities. Nineteen percent of respondents in a survey of married or cohabiting people with IBS stated that they had difficulties in their personal relationships, and 45% stated that IBS interfered with their sex life.
Irritable Bowel Syndrome Causes
The cause ofirritable bowel syndromeis currently unknown. IBS is thought to result from an interplay of abnormal gastrointestinal (GI) tract movements, increased awareness of normal bodily functions, and a change in the nervous system communication between the brain and the GI tract. Abnormal movements of the colon, whether too fast or too slow, are seen in some, but not all, people who have IBS.
Irritable bowel syndrome has also developed after episodes of gastroenteritis.
It has been suggested that IBS is caused by dietary allergies or food sensitivities, but this has never been proven.
Symptoms of irritable bowel syndrome may worsen during periods of stress or menses, but these factors are unlikely to be the cause that leads to development of IBS.
Irritable Bowel Syndrome Symptoms
Irritable bowel syndrome affects each person differently. The hallmark of IBS is abdominal discomfort or pain. The following symptoms are also common:
- Abdominal cramping and pain that are relieved after bowel movements
- Alternating periods of diarrhea and constipation
- Change in the stool frequency or consistency
- Gassiness (flatulence)
- Passing mucus from the rectum
- Abdominal distension
The following are not symptoms or characteristics of IBS:
- Blood in stools or urine
- Vomiting (rare, though may occasionally accompany nausea)
- Pain or diarrhea that interrupts sleep
Exams and Tests
Irritable bowel syndrome can be a very difficult diagnosis to make. IBS is called a diagnosis of exclusion, which means that a doctor considers many other alternatives first, perhaps performing tests to rule out other problems. Some of these tests may include laboratory studies, imaging studies(such as a CT scan or small intestinal x-rays), or a lower GI endoscopy (colonoscopy). An endoscopy is a procedure in which a flexible tube with a tiny camera on one end is passed into the GI tract while the patient is under conscious sedation.
- A combination of history, physical examination, and selected tests are used to help diagnose irritable bowel syndrome.
- No single blood test or x-ray study confirms a diagnosis of IBS.
- Irritable Bowel Syndrome Treatment
- Self-Care at Home
- Many people have already modified their diets before seeing a doctor. Temporarily avoiding dairy products may help assess whether symptoms of lactose intolerance are mimicking those of irritable bowel syndrome. Persons who avoid dairy products should exercise and consider taking calcium supplements.
Certain foods, such as cruciferous vegetables (cauliflower, broccoli, cabbage, brussels sprouts) and legumes (beans) may worsen bloating and gassiness.
Most people with irritable bowel syndrome have problems only occasionally. A few may experience long-lasting problems and require prescription medications.
- A common treatment for IBS is the addition of fiber to the diet. This theoretically expands the inside of the digestive tract, reducing the chance it will spasm as it transmits and digests food. Fiber also promotes regular bowel movements, which helps reduce constipation. Fiber should be added gradually, because it may initially worsen bloating and gassiness.
- Stress may cause IBS "flares." Doctors may offer specific advice on reducing stress. Regularly eating balanced meals and exercising may help reduce stress and problems associated with irritable bowel syndrome.
- Smoking may worsen symptoms of IBS, which gives smokers another good reason to quit.
- Since many patients with irritable bowel syndrome report food intolerances, a food diary may help identify foods that seem to make IBS worse.
- Antispasmodic medicines, such as dicyclomine and hyoscyamine, are sometimes used to treat symptoms of irritable bowel syndrome. Antispasmodic medicines help slow the action of the digestive tract and reduce the chance of spasms. However, they may have some side effects and thus are not for everyone. Other treatment plans are available, depending on symptoms and condition.
- Antidiarrheal medicines, such as loperamide , a kaolin/pectin preparation, and diphenoxylate/atropine are sometimes used when diarrhea is a major feature of IBS. Do not take these on a long-term basis without first consulting a doctor.
- Antidepressants may be very effective in smaller doses than those typically used to treat depression. Imipramine, amitriptyline , nortriptyline, and desipramine are some commonly used medicines that may alleviate irritable bowel syndrome symptoms. Some other antidepressants are more commonly prescribed when depression and IBS coexist.
- The following newer medications are typically reserved for patients with symptoms that do not improve with the above treatments:
- Tegaserod is used for the short-term treatment of women with irritable bowel syndrome when constipation is the main symptom. Tegaserod stimulates the digestive tract to maintain movement, decreasing the risk of developing constipation. The drug is taken twice daily 30 minutes before the morning and evening meal for 4-6 weeks. In individuals who respond, an additional 4-6 weeks of therapy may be considered. A doctor should be contacted immediately if new or sudden worsening of abdominal pain or diarrhea occurs.
- Maintaining good physical fitness improves bowel function and helps reduce stress.
- Stopping smoking is important for overall good health.
- Avoiding coffee, gas-producing foods, and spicy foods may help.
- Reducing or eliminating alcohol consumption may help.