Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome (IBS) goes by many names. Some people call this condition nervous stomach. Others call it irritable bowel, irritable colon, or spastic colon. The condition most often occurs in people in their late teens to early forties. Women suffer from IBS more often than men, and it might affect more than one family member.

What is IBS?

IBS is a common though uncomfortable disorder of the colon or lower bowel. While the basic cause of IBS is unknown, researchers have found that the colon muscle in people with IBS contracts more readily than in people without IBS. Also, patients with IBS have a lower tolerance for pain. A number of factors can trigger IBS, including certain foods, medicines, and emotional stress. Some research has suggested that excess bacteria in the GI tract may contribute to symptoms.

The good news is that IBS is not a life-threatening condition. IBS does not make a person more likely to develop other colon conditions, such as colitis, Crohn's disease, or colon cancer. Yet, IBS can be frustrating because it can come and go throughout life.

What are the symptoms of IBS?

Some people think of IBS as the gut's response to stress in the world. Symptoms include:

• Abdominal pains or cramps, usually in the lower half of the abdomen
• Excess gas
• Harder or looser bowel movements than usual
• Diarrhea, constipation, or an alternating pattern between the two

Because these symptoms can happen over and over, a person with IBS can feel stressed or saddened by his or her condition. These feelings often become less severe as the person gains control over IBS.

Who treats IBS?

If you are having symptoms and think you may have irritable bowel syndrome (IBS), you should talk to your primary care physician or another healthcare provider. Your doctor may treat you or may refer you to a gastroenterologist.

A gastroenterologist is a physician who specializes in the diagnosis and treatment of diseases of the digestive system. These diseases include, among others: IBS, colorectal cancer, liver disease, swallowing and esophageal disorders, and pancreas disorders.

In some cases of IBS, the symptoms may not respond to the medical treatment prescribed by the doctor. In these cases, the patient may be referred for psychosocial therapies. Some patients may improve with counseling and alternative treatments such as hypnosis and biofeedback.

How can my healthcare provider help?

Your healthcare provider can:

• Make sure there is no other cause for your symptoms
• Order blood tests or X-rays if needed
• Offer appropriate medicines
• Suggest dietary therapies
• Answer any questions you have about stress and other IBS triggers
• Advise you about calcium supplements, if needed
• Offer support as you gain control over IBS

How is IBS diagnosed?

When you see your doctor about irritable bowel syndrome (IBS), he or she will take your medical history and perform a physical examination. Depending on your symptoms, your doctor may want to run certain tests in order to make a diagnosis, including blood tests and stool samples. These tests are usually normal, but they rule out other diseases which may mimic IBS.

Depending on the symptoms and other pertinent factors in the medical history, your doctor may perform a procedure called flexible sigmoidoscopy. Flexible sigmoidoscopy is a routine outpatient procedure in which the inside of the lower large intestine is examined.

Flexible sigmoidoscopies are commonly used to evaluate bowel disorders, rectal bleeding, or polyps (benign growths). During the procedure, a physician uses a sigmoidoscope (a long, flexible instrument about 1/2 inch in diameter) to view the lining of the rectum and lower portion of the colon. The sigmoidoscope is inserted through the rectum and advanced to the descending colon.

Another option for examining the colon is a colonoscopy. Colonoscopy is also an outpatient procedure, similar to a sigmoidoscopy, in which the entire colon is examined with a colonoscope. If necessary during a colonoscopy, small amounts of tissue can be removed for analysis (biopsy) and polyps can be identified and removed. In many cases, colonoscopy allows accurate diagnosis and treatment without the need for a major operation.

How can I gain control over IBS?

Nearly all people with IBS can be helped, but no one treatment works for everyone. Usually, with a few basic changes in diet and activities, IBS will improve over time. Here are some steps you can take to help you reduce symptoms of IBS:

• Avoid caffeine (found in coffee, teas, and sodas)
• Minimize lactose-containing foods. Lactose is the sugar found in milk products
• Increase fiber in your diet (found in fruits, vegetables, grains, and nuts)
• Drink three to four glasses of water per day.
• Don't smoke.
• Learn to relax, either by getting more exercise or by reducing stress in your life.

Try limiting how much milk you consume. (Women should get 1,500 milligrams of calcium per day. If you have IBS and are concerned about your calcium intake, you can try other sources of calcium. These sources include broccoli, spinach, turnip greens, tofu, yogurt, sardines and salmon with bones, calcium-fortified breads, calcium supplements, and some calcium carbonate antacid tablets).

Keep a record of foods you eat so you can figure out which foods bring on bouts of IBS. Common food triggers of IBS are red peppers, green onions, wheat, and milk.

You can also ask a nutritionist for samples of healthy diets to follow.