Irritable bowel syndrome (IBS) refers to a common
disorder of the lower intestinal tract. It involves abdominal pain and
abnormal bowel movements. Emotional stress often makes the symptoms worse.
It is not the same as inflammatory bowel
disease (IBD), which includes Crohn's disease and ulcerative colitis.
IBS involves a combination of abdominal pain
and constipation, diarrhea, or an alternating pattern of these problems.
In IBS the intestinal nervous system becomes
hypervigilant, with a lower tolerance for stretching and movement of the
intestine, and a tendency for spasm of the intestinal muscles develops. There is no problem with the structure of
It is not clear why patients develop IBS, but
in some instances, it occurs after an intestinal infection. This is called
postinfectious IBS. There may also be other triggers.
IBS can occur at any age, but it often begins
in adolescence or early adulthood. It is more common in women. The condition
is the most common intestinal complaint for which patients are referred to a
Symptoms range from mild to severe. Most
people have mild symptoms. IBS symptoms may be worse in patients who also
have stress or mood disorders, such as anxiety and depression. However, it is
important to understand that these conditions do not cause IBS.
Symptoms may include:
Abdominal fullness, gas, bloating
Abdominal pain that:
Comes and goes
Is reduced or goes away after a bowel movement
Occurs after meals
Chronic and frequent constipation, usually
accompanied by pain
Chronic and frequent diarrhea, usually
accompanied by pain
Loss of appetite
Exams and Tests
Most of the time, your doctor can diagnose IBS
with few or no tests. Tests usually reveal no problems. Some experts
recommend a trial of a lactose-free diet for possible lactase deficiency.
Some patients may need an endoscopy, especially
if symptoms begin later in life. Younger patients with persistent diarrhea
may need this test to look for inflammatory bowel diseases that can cause
similar symptoms, such as Crohn's disease or ulcerative colitis. You may need
additional tests if you have blood in your stool, weight loss, signs of
anemia, or you have recently traveled.
Patients over age 50 should be screened for
The goal of treatment is to relieve symptoms.
Lifestyle changes can be helpful in some people
with IBS. For example, regular exercise, improved sleep habits, and stress
reduction techniques may reduce anxiety and help relieve bowel symptoms.
Dietary changes can be helpful. However, no
specific diet can be recommended for IBS in general, because the condition
differs from one person to another. Increasing dietary fiber and avoiding
foods and drinks that stimulate the intestines (such as caffeine, fatty
foods, acidic foods, andbroccoli/cauliflower/brussel sprouts) may help some
Other possible treatments may include:
Fiber supplements or other medications to
improve bowel movements
Probiotics (trying to restore a healthy
balance of bacteria in the gut)
Medications for intestinal spasm
Counseling in cases of severe anxiety or
Antidiarrheal medications for those whose main
symptom is diarrhea
Low-dose antidepressants to help relieve
Irritable bowel syndrome may
be a lifelong condition for some people, but symptoms can usually be improved
or relieved through treatment. IBS
does not increase the risk of cancer, ulcerative colitis or Crohn’s disease.
© A.D.A.M., Inc. and Elsevier Inc. - www.mdconsult.com. Modified by Michael Margolin, MD