Irritable Bowel Syndrome (IBS)

Irritable Bowel Syndrome (IBS) affects the large intestine (colon) and can cause bloating, abdominal cramping and a change in bowel habits. Some patients with IBS have constipation while others have diarrhea. Some people go back and forth between the two. Although IBS is uncomfortable, it does not harm the colon.

IBS is common and more frequently affects women than men. No one knows the exact cause of IBS, but most people can control symptoms with a change in diet, medicine and stress management.

Symptoms of IBS:

  • Pain or cramping in the abdominal area
  • Diarrhea
  • Constipation
  • Mucus in the stool
  • Flatulence
  • Uncomfortable bloating

Risk Factors of IBS

  • Being female—more women are diagnosed with IBS than men.
  • Family history—People with a close relative, such as a parent or brother or sister, with IBS are at higher risk for IBS. It is unclear as to whether the risk results more from shared genetics or a common environment.
  • Being under 35 years of age—At least half of all people who are diagnosed with IBS are under 35 years of age.

Even though IBS is not harmful, it can be confused with other conditions. IBS symptoms may be similar to other diseases such as Crohn’s disease, ulcerative colitis or even colon cancer. It is imperative that you see a doctor if you have significant changes in your bowel habits because IBS symptoms could be an indication of a more serious problem.

Tests to Diagnose IBS

There are no physical signs to diagnose IBS, so diagnosis usually occurs by a process of elimination. To be diagnosed with IBS, the most important symptom is abdominal pain that lasts at least 12 weeks (not necessarily consecutive). Other criteria include mucus in the stool, bloating, bowel straining and urgency, and changes in the stool.

If a diagnosis of IBS seems fairly certain, a doctor may recommend treatment without any testing. If there are any reasons for concern, however, a doctor may recommend one or more of the following procedures.

  • Colonoscopy—A test that examines the lining of the entire colon to check for polyps, inflammation and abnormalities.
  • Flexible sigmoidoscopy—A procedure that uses a flexible tube to examine the the lower part of the colon.
  • Computerized tomography (CT) scan—this test will show a cross-section of the internal organs and help diagnose other issues.
  • Lactose intolerance tests—if lactase is not present in the body to break down milk sugar, you may exhibit some of the same symptoms as IBS such as cramping, bloating, constipation or diarrhea. This test can help differentiate between lactose intolerance and IBS.
  • Blood test—Celiac disease, an allergic reaction to gluten, can have similar symptoms to IBS. A blood test can help exclude celiac disease.

Treatment for IBS

There is no cure for IBS, so the goal is to manage the symptoms.

  • Controlling the diet—some people discover that certain foods will trigger IBS symptoms. Common triggers include alcohol, chocolate, carbonated beverages, certain fruits or vegetables or milk. Keeping a food journal and recording foods that cause constipation or diarrhea can be helpful.
  • Stress management—like many other diseases and conditions, stress can make IBS worse. Planning ahead, making lists, meditating, taking time to relax, and avoiding stressful situations can prevent aggravation of symptoms.
  • Fiber supplements—Taking fiber supplements can help control constipation.
  • Anti-diarrheal medications
  • Anticholinergic medications—these drugs can help control painful intestinal spasms.

Medication for IBS

  • Alosetron (Lotronex)—this medication was approved by the FDA, removed from the market, and now is approved again with restrictions. Alosetron helps relax the colon and slow down the bowels. It is only used when diarrhea is the prominent symptoms, and usually used when all other treatments have failed.
  • Lubiprostone (Amitiza)—this drug increases fluids in the small intestine to help move the stool. It is generally only prescribed for patients with severe constipation when other treatments have been ineffective.