Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is often described by many names. Some people call this condition “nervous stomach.” Others refer to it as “colitis,” “irritable bowel,” or “spastic colitis.” The condition most commonly occurs in people in their late teens to early forties. Women are more frequently affected by irritable bowel syndrome than men, and it may affect more than one member of a family.

What is irritable bowel syndrome?

Irritable bowel syndrome is a common disorder that affects the large intestine. Although the underlying cause of IBS is unknown, researchers have found that the muscles of the large intestine in individuals with IBS contract more easily than in those without the syndrome. Additionally, patients with IBS have a lower pain threshold. A variety of factors can “trigger” irritable bowel syndrome, including certain foods, medications, and emotional stress. Some studies suggest that an excessive number of bacteria in the gastrointestinal tract may contribute to symptom production.

The good news is that irritable bowel syndrome is not a life-threatening condition. IBS does not make a person more likely to develop other conditions of the large intestine, such as ulcerative colitis, Crohn’s disease, or colorectal cancer. However, IBS can cause frustration because it may lead to episodes of symptoms throughout a person’s life.

What are the symptoms of irritable bowel syndrome?

Some people consider irritable bowel syndrome to be the intestine’s response to stress. Symptoms include:

• Abdominal pain or cramps, usually in the lower half of the abdomen
• Bloating, swelling of the abdomen
• Difficult or more loose bowel movements than usual
• Diarrhea, constipation, or alternating between the two

Because these symptoms can occur repeatedly, a person with irritable bowel syndrome may feel anxious or depressed about their condition. These feelings often lessen when the symptoms of IBS improve.

How is irritable bowel syndrome treated?

If you have symptoms and believe you may have irritable bowel syndrome, you should talk to your doctor. Your doctor may treat you or refer you to a gastroenterologist.

A gastroenterologist is a doctor who specializes in the diagnosis and treatment of diseases of the digestive system. These diseases include, among others: Irritable Bowel Syndrome, colorectal cancer, liver disease, swallowing disorders, conditions of the esophagus, stomach, and pancreatic disorders.

In some cases of irritable bowel syndrome, the symptoms may not respond to treatment prescribed by your doctor. In these instances, the patient may be referred for psychosocial therapy. Some patients may improve with counseling and alternative therapies, such as hypnosis and biofeedback.

How can your doctor help?

Your doctor can:

• Ensure there is no other cause for your symptoms
• Order blood tests or X-rays if necessary
• Prescribe appropriate medications
• Suggest dietary adjustments
• Answer any questions you have regarding stress and irritable bowel syndrome
• Advise you on calcium supplements, if needed
• Support you in gaining control over your irritable bowel syndrome

How is irritable bowel syndrome diagnosed?

When you see your doctor for irritable bowel syndrome, they will take your medical history and perform a clinical examination. Depending on your symptoms, your doctor may recommend certain tests to make the diagnosis, including blood tests and stool samples. These tests are usually normal but rule out other diseases that may mimic Irritable Bowel Syndrome.

Depending on the symptoms and other related factors in your medical history, your doctor may perform a procedure called sigmoidoscopy. Sigmoidoscopy is a common endoscopic examination that looks at the inner part of the lower large intestine.

Sigmoidoscopy is typically used to evaluate lower intestinal disorders, such as rectal bleeding or polyps. During the examination, a doctor uses a sigmoidoscope (a long, flexible tube about 10 mm in diameter) to inspect the inner wall of the rectum and lower part of the large intestine. The sigmoidoscope is inserted through the rectum and advanced into the sigmoid colon.

Another option for examining the large intestine is colonoscopy. Colonoscopy is similar to sigmoidoscopy, where the entire large intestine is examined using a colonoscope. If necessary, during colonoscopy, small amounts of tissue may be removed for analysis (biopsy) and polyps can be identified and removed. In many cases, colonoscopy allows for accurate diagnosis and treatment without the need for surgery.

What is the appropriate treatment?

Nearly all people with irritable bowel syndrome can be helped, but no single treatment works as effectively for everyone. Typically, with a few basic changes to diet and activities, irritable bowel syndrome will improve over time. Here are some steps you can take to help reduce the symptoms of irritable bowel syndrome:

• Avoid caffeine (found in coffee, tea, and soft drinks).
• Minimize foods containing lactose. Lactose is the sugar found in dairy products.
• Increase fiber in your diet (found in fruits, vegetables, grains, and nuts).
• Drink three to four glasses of water a day.
• Do not smoke.
• Learn to relax, whether through more exercise or reducing stress in your life.

Try to limit the amount of milk you consume. (Women should take 1,500 mg of calcium per day. If you have irritable bowel syndrome and are concerned about calcium intake, you can try other sources of calcium. These sources include: broccoli, spinach, yogurt, sardines, salmon with bones, calcium-fortified breads, calcium supplements, and antacid tablets).

Keep a record of the foods you eat so you can identify which foods worsen your Irritable Bowel Syndrome. Common foods that trigger Irritable Bowel Syndrome include red peppers, onions, red wine, wheat, and milk.

You can also discuss with a dietitian about healthy dietary patterns to follow.

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