Irritable bowel syndrome (IBS) is a chronic condition that causes abdominal pain and altered bowel movements. IBS often occurs in early adulthood and is more common in women than men. The exact cause of IBS remains unknown.
Symptoms of IBS:
-Abdominal pain with cramping, usually related to a bowel movement
-Diarrhea, constipation or both
-Mucus in bowel movements
-Gas and bloating
Abdominal pain in IBS is typically described as cramping, and having a bowel movement can alleviate the pain. Many people with IBS describe frequent episodes of gas, bloating and belching.
Changes in bowel habits are also typical and include diarrhea, constipation or alternating diarrhea and constipation. Diarrhea usually occurs in the daytime, often after meals and associated with urgency. It is very uncommon to experience diarrhea during the night with IBS. One-half of people with IBS notice a mucus discharge with diarrhea.
Constipation with IBS can be intermittent. Stools are often pellet-shaped and associated with a sensation of incomplete emptying.
There is no single diagnostic test for IBS. Your health care team will obtain your medical history and perform a physical exam, blood and stool tests. Additional tests to evaluate the colon such as sigmoidoscopy or colonoscopy may be performed based on your age, family history of gastrointestinal diseases and especially if other symptoms are present.
There are multiple treatments for IBS to reduce symptoms and abdominal pain. Many people with IBS note some foods will worsen symptoms. It is important to work with your health care team and a nutritionist to safely eliminate or limit foods that worsen symptoms and avoid any nutritional deficiencies that can occur. Many clinicians recommend avoiding lactose as lactose intolerance is common and causes symptoms similar to IBS. Other foods are known to cause gas and bloating, such as cruciferous vegetables (cabbage, broccoli, and brussels sprouts), and legumes (beans). A nutritionist can also assist with a diet called "low-FODMAP" (fermentable oligosaccharides, disaccharides, monosaccharides and polyols). These are carbohydrates that can be difficult to digest and limiting these foods can help some people with IBS.
Increasing dietary fiber is known to relieve symptoms of IBS. Often this requires a fiber supplement such as psyllium or methylcellulose. Fiber supplements should be started at a low dose and gradually increased over several weeks to reduce excess gas that can occur.
Stress and anxiety can worsen the symptoms of IBS. Review this with your health care team as some people benefit from formal counseling. Many people find regular exercise to be helpful and it is known to assist in regulating bowel movements.
A variety of medications can be used to treat IBS and these are very effective over time. Your treatment plan will depend on if you have IBS with diarrhea or constipation.
New research is evaluating the use of "good" bacteria such as probiotics in the treatment of IBS, and stool tests that measure the bacteria in the intestine indicate the microbes in people with IBS may differ from those without IBS.