Irritable Bowel Syndrome (IBS)

What is IBS?

Affecting between 25 and 45 million people in the United States of all ages, irritable bowel syndrome (IBS) is a chronic disorder that affects the large intestine. It is characterized by abdominal discomfort, pain and altered bowel movements.

The walls of the intestines are lined with muscles that relax and contract in a pattern, helping food from the stomach to the rectum. In those with IBS, the contractions and relaxation periods may be drawn out, causing bloating, diarrhea and gas. In some cases, the opposite may apply, with weak contractions slowing the progression of food through the gastrointestinal tract and resulting in hard, dry stool.

What causes IBS?

While the precise cause of IBS is unknown, it is proposed that symptoms may be the result of a disruption in communication between the brain, nervous system and digestive system.

IBS Triggers

While not all patients with IBS react to the same stimuli, common triggers include:

  • Foods: Eating certain foods, such as carbonated beverages, chocolate and alcohol, may trigger more aggressive forms of the symptoms of IBS. Certain fruits and vegetables have also been known to play a part, including beans, cabbage and cauliflower.
  • Stress: The majority of those living with IBS find that their symptoms worsen over during periods of extreme stress. It should be noted, however, that although symptoms may be aggravated by stress, stress is not a cause of IBS.
  • Hormones: As it has been shown that women are more likely to have IBS, many believe that hormones contribute to the condition. In addition, women often find that their IBS symptoms worsen during menstruation.
  • Additional factors: In some cases, other illnesses such as acute gastroenteritis or bacteria overgrowth may trigger IBS flare-ups.

Whom does IBS affect?

Those who are more likely to have IBS include:

  • 50 and under: IBS is more likely to occur in patients under 50, but may affect older patients as well.
  • Females: Twice as many women as men have reported having this condition. Overall, two out of three IBS patients are female.
  • Family history: Research has shown that those who have a family member with IBS have a greater risk of having it as well. It is also suggested that genetics or shared factors within a family may be related.

Do I have IBS?

Symptoms of IBS

The symptoms of IBS may vary widely from person to person and can mimic symptoms of other diseases. Common symptoms of IBS include:

  • Abdominal pain/cramping
  • Bloating
  • Diarrhea (also known as IBS-D), constipation, or alternating bouts of both
  • Gas
  • Mucus in stool

Diagnosing IBS

Because there are no physical symptoms to aid in a concrete diagnosis of IBS, determining if a patient has IBS becomes a process of eliminating other conditions with the same symptoms.

After taking a complete medical history and conducting a thorough exam, a physician may use two sets of criteria to determine IBS after other conditions have been ruled out.

  • Rome III criteria: According to these criteria, a conclusion of IBS is reached when abdominal pain and discomfort have been present three times a month in the past three months and accompanied by two or more of the following: improvement of symptoms with defecation, altered frequency of stool or altered consistency of stool.
  • Manning criteria: This set of criteria focuses on pain relief following defecation, incomplete bowel movements, mucus present in the stool and stool inconsistency. The more of these symptoms that are present, the more likely it is that a patient has IBS.

Additional Diagnostic Testing

Diagnostic imaging tests may also be recommended by your physician to further rule out other causes for your symptoms. Tests that may be conducted include:

What are the treatment options for IBS?

As there is no clear cause of IBS, treatments are focused on relieving symptoms for comfort. In the majority of cases, mild symptoms of IBS may be controlled through stress management as well as diet and lifestyle changes. In addition, adequate sleep and water intake may be recommended.

Dietary changes may include the removal of:

  • Foods containing gluten
  • FODMAP carbohydrates including fructose, fructans and lactose
  • Gassy foods, such as broccoli, cauliflower and cabbage

Suggested medications for management of IBS symptoms may include:

  • Anti-diarrheal medications
  • Antibiotics
  • Anticholinergic and antispasmodic medications
  • Fiber supplements

For more information on irritable bowel syndrome or to schedule an appointment, contact us today.