What is Irritable Bowel Syndrome?

Irritable bowel syndrome (IBS) is a syndrome, not a disease. A syndrome is a constellation of symptoms we put a label on in order to aid understanding. With IBS, these symptoms include discomfort in the form of cramping, bloating, abdominal pain, constipation and diarrhea. The good news is that IBS does not permanently harm the intestines or lead to more serious disease, such as cancer. Also, most people can control the symptoms with a combination of diet, stress management and medication.

For some, however, IBS can be disabling, preventing them from going to work, taking in a movie or even traveling short distances.

One in five adults has symptoms of IBS, making it one of the most common disorders. It occurs more often in women and begins before the age of 35 for half of its sufferers.

How is IBS diagnosed?

There is no specific test for IBS. It’s usually diagnosed by ruling out other diseases through stool sample testing, blood tests and X-rays. Typically, we will perform a sigmoidoscopy or colonoscopy to get a look inside the colon. If your test results are negative, IBS may be diagnosed based upon your symptoms, including how often you’ve had abdominal pain or discomfort during the past year, when the pain starts and stops in relation to bowel function, and how your bowel frequency and stool consistency have changed. Bleeding, fever, weight loss and persistent severe pain are not symptoms of IBS and may indicate other problems such as inflammation, or rarely, cancer.

What is the treatment for IBS?

No cure has been found for IBS, but many options are available to treat you, depending on your symptoms.

In addition to diet and stress management, medications are often used to relieve the symptoms of IBS. We may suggest fiber supplements or laxatives for constipation or medicines such as antidiarrheals to decrease diarrhea. We may also prescribe an antispasmodic to help control colon muscle spasms and reduce abdominal pain. Working together, we can find the best combination of medicine, diet, counseling, and support to control your symptoms.

What causes IBS?

The simple answer is…we don’t know. Researchers have yet to discover a specific cause for IBS. One theory is that people who suffer from IBS have a colon that’s particularly sensitive and reacts to certain foods and stress. The immune system, which fights infection, also may be involved.

In addition, recent research has found that serotonin may play a role. Serotonin is a neurotransmitter, or chemical, that delivers messages from one part of your body to another and 95% of your body’s serotonin is located in the gastrointestinal (GI) tract. It helps with normal GI functioning. Cells that line the inside of the bowel work as transporters, carrying the serotonin out of the GI tract. People with IBS, however, have abnormal levels of serotonin in their GI tract. As a result, they experience problems with bowel movement, motility and sensation — having more sensitive pain receptors in their GI tract.

Other research has reported that IBS may be caused by a bacterial infection in the gastrointestinal tract. Studies show that people who have had gastroenteritis sometimes develop IBS, otherwise called post-infectious IBS.

Can changes in diet help IBS?

For many people, careful eating will reduce IBS symptoms. Before changing your diet, keep a journal making note of the foods that cause distress. Then discuss your findings with us. We may want to consult a registered dietitian to help you make changes to your diet.

In many cases, dietary fiber may lessen IBS symptoms, particularly constipation. We usually recommend a diet with enough fiber to produce soft, painless bowel movements.

Drinking 6-8 glasses of plain water a day is important, especially if you have diarrhea. Drinking carbonated beverages, such as sodas, can result in gas and cause discomfort. Chewing gum and eating too quickly can lead to swallowing air, which may increase abdominal bloating.

Large meals can cause cramping and diarrhea, so eating smaller meals more often, or eating smaller portions, may also help IBS symptoms.