An Overview of Irritable Bowel Syndrome (IBS)

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Irritable bowel syndrome (IBS) is a functional disorder of the colon (part of the large intestine). Symptoms include crampy abdominal pain, bloating, constipation, and/or diarrhea. The causes aren't well understood, and it is diagnosed based on the symptoms. People with IBS manage their symptoms with diet and lifestyle modifications, and some medications are used as well. However, it is chronic condition that can be controlled but not cured.

Symptoms

When it comes to IBS, there are a number of unpleasant intestinal issues that accompany the issue. While the intensity and severity of symptoms vary from person to person, some of the most predominant symptoms can include:

In some cases, cramps are relieved by a bowel movement; but for some people with IBS, they may have cramps and yet are unable to pass anything. The severity of IBS symptoms varies and could be anywhere 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. If you are experiencing any of these symptoms, you need to see a doctor right away.

IBS does not lead to any organic disease, such as Crohn’s disease or ulcerative colitis, or any type of bowel cancer. It can, however, increase the likelihood of some mental health issues such as depression and anxiety.

Causes

The causes of IBS are still unclear. It may be a combination of problems, and brought on by different factors in each person. As a functional gastrointestinal disorder, it appears to be due to problems in how your brain and gut interact. In a person with IBS, the muscles in the colon that move digested food along are exceptionally sensitive to certain stimuli or triggers. People with IBS may have a difference in gut motility, visceral hypersensitivity, inflammation, and gut bacteria. Sometimes IBS develops after an infection in your digestive tract.

Twice as many women as men have IBS, and it seems to be triggered by hormones related to the menstrual cycle—first being experienced around the time a girl begins to menstruate and resolving after menopause. Many women have flare-up around their menstrual cycle.

Although IBS technically is not caused by stress or strong emotions, some people have their first flare-up of IBS symptoms during a stressful period in their life such as the death of a relative or loss of a job. These stresses aggravate the condition to the point where it becomes more noticeable or bothersome.

IBS tends to run in families, so a genetic predisposition may be at work. Researchers are looking into what genes might lead to an increased risk. This research may also give clues as to what processes in the body are disordered in IBS.

Foods do not cause IBS; but eating certain foods, called "trigger foods" may set off symptoms of diarrhea, bloating, or pain. These may be foods that are generally irritating, such as fried foods or alcohol, or specific food sensitivities.

Diagnosis

IBS is a diagnosis of exclusion, which means that other diseases and infections must be ruled out before it can be diagnosed. For this reason, in 1988, a group of physicians defined criteria to help doctors more accurately diagnose IBS. Known as the Rome Criteria, this set of guidelines outlines symptoms and applies parameters such as frequency and duration.

For instance, the Rome Criteria requires that you have symptoms for at least one day a week in the last three months. It also stipulates that symptoms should have started at least six months prior to your visit. By using the Rome Criteria, doctors can now make a more accurate diagnosis of IBS.

In addition to using the Rome Criteria, physicians often run several tests to ensure that there is no inflammation, infection, or other disease causing the symptoms.

These tests typically include blood tests and fecal occult tests. Other possible testing may include stool cultures, barium enemas, a sigmoidoscopy, and a colonoscopy.

After everything else is ruled out and IBS is diagnosed, patients are typically diagnosed with one of three different types of IBS. These include diarrhea-predominant (IBS-D), constipation-predominant (IBS-C), and alternating constipation and diarrhea, called mixed bowel habits (IBS-M).

Treatment

Typically, the goal of treatment is to lessen troublesome IBS symptoms such as diarrhea, cramping, pain, or constipation. The first step in treatment is lifestyle change, including healthy habits such as exercise, getting enough sleep, reducing stress, and eating a healthy diet. A food diary can help you pinpoint and avoid trigger foods.

There are several different types of medications that may be prescribed by a physician:

  • Antispasmodics: For relief of abdominal pain and cramping
  • Antidiarrheals: To slow down gut motility and relieve diarrhea
  • Antidepressants: For pain reduction and to address any co-existing depression or anxiety symptoms
  • Antibiotics: Specific types may be prescribed that target a possible overgrowth of bacteria in the small intestine (SIBO)
  • IBS-specific medications: These include Amitiza and Linzess for IBS-C and Viberzi for IBS-D.

Be sure to talk to your doctor if you are using or considering any over-the-counter medications or supplements such as laxatives, antidiarrheals, or herbal supplements.

Some people with IBS complement their medical plan with alternative therapies. Two of the most popular are cognitive behavior therapy (CBT) and hypnosis.

Coping

Aside from the pain and discomfort that IBS causes, living with the symptoms on a day-to-day basis can be challenging at times. For instance, you may experience guilt because you have to frequently cancel social engagements, or you may feel lonely and isolated if you feel tethered to your home due to your bathroom issues. Whatever the challenges you face, it is important to look for ways to address these issues in a healthy way.

Many people with IBS practice yoga, meditate, exercise, and eat a diet free from trigger foods. Unfortunately, there is no one diet that will work for all people with IBS, though there are some guidelines that may help.

By incorporating some of these things into their lives, people with IBS are often able to live a happy and productive life in spite of their condition.

A Word From Verywell

When it comes to IBS, the best way to deal with the condition is to learn as much about it as you can. You also should work to foster a partnership with your doctor. Regular communication about what you are experiencing, as well as what works and what doesn't work, will go a long way in improving your situation. Not only will you operate from a position of knowledge, but you also will be able to advocate for yourself and ensure you are getting the best possible care.

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