Irritable bowel syndrome (IBS) is classified as a functional gastrointestinal disorder. This is because when tests such as a colonoscopy are done, the colon shows no evidence of disease such as ulcers or inflammation. Therefore, IBS is typically diagnosed only after all other possible digestive disorders and diseases have been ruled out.
IBS is often misdiagnosed or misnamed as colitis, mucous colitis, spastic colon, irritable bowel disease, or spastic colon. These misnomers persist, even though IBS is now an increasingly recognized and treatable condition. Affecting 25 to 55 million people in the United States, IBS results in 2.5 to 3.5 million yearly visits to physicians. Twenty to 40 percent of all visits to gastroenterologists are due to symptoms of irritable bowel.
Muscles in the bowel normally contract a few times a day, moving feces along and ultimately resulting in a bowel movement. It is believed that in a person with IBS, these muscles are exceptionally sensitive to stimuli, or triggers. While they would not normally affect others, triggers such as food or stress can provoke a strong response in a person with an irritable bowel. A person who does not have IBS may have no trouble eating a salad or drinking coffee, but a person with IBS may exhibit symptoms such as pain, bloating, and diarrhea.
Symptoms
The symptoms of IBS can include:
- Gas.
- Pain.
- Bloating.
- Nausea.
- Vomiting.
- Mucus in the stool.
- Constipation.
- Diarrhea.
Cramps are often relieved by a bowel movement, but some people with IBS may have cramps and be unable to pass anything. The severity of IBS symptoms vary and may be described as anything from a mild annoyance to debilitating. Blood in the stool, fever, weight loss, vomiting bile, and persistent pain are not symptoms of IBS and may be the result of some other problem.
Diet
Many people with IBS describe that symptoms frequently occur shortly after, or even during, meals. Fatty foods, alcohol, caffeine and gas-producing foods (such as broccoli or beans) have regularly been identified as causing IBS attacks. However, it can be difficult for some people to track down which particular foods can trigger their IBS.
Further complicating the issue, not every person with IBS will have symptoms after eating the same foods. The range of triggers is unique to each individual, although there are many common elements among people with IBS. Symptoms can also be intermittent. Something that was fine to eat last week may start causing symptoms today.
Keeping a food and symptom diary is a good way to trace foods that lead to IBS attacks. Starting with a bland diet of "safe foods" and gradually adding a new food each day can also help in the search for specific food triggers. The food diary can then be discussed with a doctor or dietician for help in treatment.Fiber
For constipation, a doctor may prescribe laxatives or fiber supplements such as Metamucil. Fiber supplements help with both constipation and diarrhea. They bulk up the stool in cases of diarrhea, and also make it easier to pass in the case of constipation. Laxatives can be habit-forming, and should be used under the close supervision of a physician.
Treatment
Treatment for IBS can include changes to diet, lifestyle, stress reduction, and medications. Often, a combination of two or more of the above will help to provide the most relief. There is still much that is not understood about IBS, so it may take some time, and some experimentation with different therapies, to achieve good results.
Medications
Anti-spasmodic drugs or tranquilizers may be prescribed to stop the over sensitivity of the muscles in the bowel. Stopping the spasms in the bowel can reduce pain and the feeling of urgency. Anti-diarrhea medications may also be used to slow down frequent, watery stools.
Lifestyle Changes
Smaller portions at mealtimes may help to prevent bloating and cramping. Instead of three large meals every day, five smaller meals may also help in reducing symptoms. Eating a healthy diet, drinking plenty of water, and getting daily exercise are also helpful in reducing IBS symptoms. These changes can also contribute to an overall healthy lifestyle.Stress Reduction
Relaxation training, in addition to medical therapy, can also help to reduce symptoms.It is important to note that stress is not the cause of IBS, but as with any disease or disorder, stress can cause the symptoms of IBS to worsen. IBS is not believed to lead to ulcerative colitis, Crohn's disease or cancer.
The Future
The good news about IBS is that it is increasingly being seen under a new light. People with this common disorder can discuss symptoms with health care professionals without being told "it's all in your head".In the last 20 years, much research has been done to discover more about IBS and other gastrointestinal disorders. Treatment for IBS is better now than ever, but more research and awareness is needed to raise the quality of life for those who suffer with IBS.
Common Trigger Foods
- Alcohol
- Artificial sweeteners
- Artificial fat (Olestra)
- Carbonated beverages
- Coconut milk
- Coffee (even decaffeinated)
- Dairy
- Egg yolks
- Fried Foods
- Oils
- Poultry skin and dark meat
- Red meat
- Shortening
- Solid Chocolate
Sources:
International Foundation for Functional Gastrointestinal Disorders. ”Symptoms of IBS.” International Foundation for Functional Gastrointestinal Disorders. March 2 2007. Apr 18 2007.
The Canadian Society of Intestinal Research. ”Irritable Bowel Syndrome.” The Canadian Society of Intestinal Research. Apr 18 2007.
Hadley SK, Gaarder SM. ”Treatment of Irritable Bowel Syndrome.” Am Fam Physician 15 Dec 2005 72: 2501-6. Apr 18 2007.
