Irritable Bowel Syndrome: Causes, Symptoms, & Treatments
Irritable bowel syndrome (IBS) is a disorder affecting the gastrointestinal function. IBS causes a range of symptoms such as abdominal pain, diarrhea, and constipation. It affects between 25 and 45 million people in the United States, two-thirds of whom are women. Unfortunately, not all who are affected seek medical treatment. But the pain is real, and the disorder is controllable. If you are experiencing symptoms of IBS, don’t hesitate to contact your physician.
What Is Irritable Bowel Syndrome?
IBS is the most common type of gastrointestinal disorder. It is a chronic condition that affects the functioning of the large intestine (colon) and the small intestine. While stress can make the symptoms worse, IBS isn’t caused by stress. Also, IBS doesn’t make you more susceptible to life-threatening illnesses such as colon cancer. The symptoms can be minor, or they can cause disruption to the emotional, social and professional aspects of a person’s life.
IBS Stages and Types
Experts divide IBS into different categories depending on the bowel symptoms patients experience.
- IBS-D: Abdominal pain and diarrhea
- IBS-C: Abdominal pain and constipation
- IBS-A: Abdominal pain and a mix of diarrhea and constipation
IBS-A sufferers can experience alternating diarrhea and constipation within a short period or extended periods of diarrhea that alternate with long periods of constipation.
Because the disorder is a chronic condition that can range from mild to severe, there are not different identifiable stages of IBS. Most people who have the disorder go through periods when their symptoms are well controlled and times when their symptoms are more pronounced.
Symptoms and Causes
IBS symptoms can be different for each person who has the disorder. The symptoms that are often common to anyone diagnosed with IBS are abdominal pain and cramping, bloating, gas, and mucus in the stool. The way the body responds to IBS can vary, as noted above.
While the exact cause of IBS isn’t known, many factors play a part. IBS symptoms occur due to disruption in how the intestines function. Normally, the muscles that line the walls of the intestines contract and expand in a coordinated way to move food from your stomach through the intestines. If you have IBS, those contractions can be stronger than they should be and last longer, producing diarrhea. Or, they may be weaker and too short, producing constipation.
IBS is now generally viewed as a disorder caused by a breakdown in the communication between the brain and the intestine, but doctors aren’t sure what the cause is. Different things may produce IBS symptoms, but each person can have different triggers, which can include:
- Diet. Different foods can cause or worsen IBS symptoms in different individuals with the syndrome. Types of food that have caused problems for some people include chocolate, fatty foods, fruits, beans, broccoli, and milk to name a few.
- Stress. Stress doesn’t cause IBS, but being under significant stress can make symptoms worse.
- Hormones. Some researchers believe that hormonal changes may play a role because women are twice as likely to have IBS as men.
Prevention and Risks
There is no known way to prevent IBS, but there are ways to control it. See the treatment options listed below for some of these.
Some factors can increase your risk for being diagnosed with IBS:
- Age: The initial diagnosis of IBS is most often made for people under the age of 45, so age is a risk factor.
- Gender: Since more women than men have IBS, being female increases the risk.
- Family history: If you have family members who have IBS, your risk is higher.
- Mental health issues: People who have anxiety or depression are more likely to be diagnosed with IBS. However, not all people with IBS have mental health problems.
Diagnosis and Tests
If you think you may have IBS, you can start by consulting your family doctor, who may refer you to a gastroenterologist. If your family doctor can’t provide a diagnosis, request a referral or seek out a gastroenterologist yourself.
Signs of IBS don’t appear on diagnostic tests. Therefore, IBS is diagnosed based on symptoms rather than test results. This issue can lead some sufferers and doctors to conclude that the problem is “all in your head.” In fact, a survey by the International Foundation for Functional Gastrointestinal Disorders indicated that diagnoses for the 2,000 survey participants were typically made over six years after their symptoms appeared.
It’s important for you to keep in mind that just because there are no specific tests for IBS doesn’t mean that it doesn’t exist. If you have IBS symptoms, there are treatments to make your life much more enjoyable, so don’t hesitate to seek medical care.
Traditionally, a diagnosis of IBS has been a “diagnosis of exclusion.” Doctors would recommend extensive testing to identify the disorders that cause similar symptoms. If all those tests are negative, those disorders would be excluded as possible causes. The final diagnosis would then be IBS.
More recently, researchers have developed criteria that doctors can use to diagnose IBS without the time and expense (or pain for the patient) of following the “diagnosis of exclusion” approach.
- Rome Criteria: These criteria gauge several signs and symptoms that must be noticeable to diagnose IBS. For example, one thing the Rome Criteria look for is whether abdominal pain has lasted at least three days per month for the previous three months, along with a change in the frequency of bowel movements or altered consistency of the stool.
- Manning Criteria: These criteria address whether any pain is relieved after a bowel movement, whether the patient has incomplete bowel movements, whether there is mucus in the stool, or whether there are changes in the consistency of the stool.
Treatment, Procedures, and Medication
Treatment for IBS focuses on relieving symptoms. Your doctor may recommend medications such as Hyoscyamine to reduce spasms in the colon or Alosetron to relax muscles in the colon. Another recommendation might be for over-the-counter anti-diarrheal medications, but long-term use isn’t recommended. Some IBS sufferers find that fiber supplements control constipation. You’ll need to work with your doctor to find the alternatives that are most effective for you.
Healthy Lifestyle Tips
To minimize IBS, try eating at about the same time every day and don’t skip meals. Drink plenty of liquids and exercise regularly. If stress is a factor in your IBS disorder, consider counseling.
Your doctor can’t recommend a particular “IBS diet.” If you notice that food has an effect on your symptoms, keep a diary of the food you eat and your body’s reaction to it. Avoid food that causes or increases IBS symptoms.
If you have the symptoms of IBS, getting the help you need may be a challenge. You may not want to talk about bowel movements and stool consistency. Also, because symptoms may come and go, you may minimize their importance. On the other hand, some doctors have the same issues. Make sure you find a doctor who will listen to you and form a partnership with you to diagnose and manage your IBS.
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