Irritable Bowel Syndrome

What is irritable bowel syndrome (IBS)?

Irritable bowel syndrome (IBS) is a condition where one’s body can’t comsume certain foods. Symptoms include: gas, cramps, bloating, constipation, and diarrhea. IBS can cause a great deal of discomfort and distress.While there is no cure or real solution available for individuals that have this condition, there are steps you can take to limit or manage the symptoms and distress. IBS is usually caused by poor dieting and stress.

It believed that close to 40% of the American public has some degree of IBS. It occurs more often in women than in men, and it begins before the age of 35 in most cases.

What are the symptoms of IBS?

Abdominal pain, bloating, and discomfort are the main symptoms of IBS. However, symptoms and severity of symptoms can vary from person to person. Some people have constipation, which means hard, difficult-to-pass, or infrequent bowel movements, while others with IBS experience diarrhea, which is frequent, loose, watery, stools. People with diarrhea frequently feel an urgent and uncontrollable need to have a bowel movement. Other people with IBS alternate between constipation and diarrhea. Sometimes people find that their symptoms subside for a few months and then return, while others report a constant worsening of symptoms over time.

What causes IBS?

Researchers have yet to discover any specific cause for IBS. One theory is that people who suffer from IBS have a colon, or large intestine, that is particularly sensitive and reactive to certain foods and stress. The immune system, which fights infection, may also be involved. It is also believed that poor dieting and the consumption of pasteurized foods, fast food and other foods that are hard to decompose in one’s body can lead to IBS. Further, high stress levels seem to also be related to causing symptoms.

Other reasons for causes of IBS:

Recent research has reported that serotonin is linked with normal gastrointestinal (GI) functioning. Serotonin is a neurotransmitter, or chemical, that delivers messages from one part of your body to another. Ninety-five percent of the serotonin in your body is located in the GI tract, and the other 5 percent is found in the brain. Cells that line the inside of the bowel work as transporters and carry the serotonin out of the GI tract. People with IBS, however, have diminished receptor activity, causing abnormal levels of serotonin to exist in the GI tract. As a result, they experience problems with bowel movement, motility, and sensation—having more sensitive pain receptors in their GI tract.

Researchers have reported that IBS may be caused by a bacterial infection in the gastrointestinal tract. Studies show that people who have had gastroenteritis sometimes develop IBS, otherwise called post-infectious IBS.

Researchers have also found very mild celiac disease in some people with symptoms similar to IBS. People with celiac disease cannot digest gluten, a substance found in wheat, rye, and barley. People with celiac disease cannot eat these foods without becoming very sick because their immune system responds by damaging the small intestine. A blood test can determine whether celiac disease may be present.

How is IBS diagnosed?

If you think you have IBS, you should consult your physician as a first step. There is no specific test that can be taken to diagnose IBS. One’s physician will look at an individual’s full history and look at symptoms related to certain foods one consumes. Some diagnostic tests may be performed to rule out other problems; this may include: stool sample testing, blood tests, and x rays. Typically, a doctor will perform a sigmoidoscopy, or colonoscopy, which allows the doctor to look inside the colon. This is done by inserting a small, flexible tube with a camera on the end of it through the anus. The camera then transfers the images of your colon onto a large screen for the doctor to see better.

If your test results are negative, the doctor may diagnose IBS based on your symptoms, including how often you have had abdominal pain or discomfort during the past year, when the pain starts and stops in relation to bowel function, and how your bowel frequency and stool consistency have changed. Many doctors refer to a list of specific symptoms that must be present to make a diagnosis of IBS.

The following have been associated with a worsening of IBS symptoms:

  • Large meals
  • Bloating from gas in the colon
  • Medicines, especially penicillin and antibiotics
  • Wheat, rye, barley, chocolate, milk products, or alcohol
  • Drinks with caffeine, such as coffee, tea, or colas
  • Stress, conflict, or emotional upsets

What is the treatment for IBS?

There are no proven cures currently available this condition. The best way to handle the condition is to avoid the foods that give you the most discomfort, try to limit your stress and one may try to take certain supplements which can help manage the discomfort.

Medications to try:

Symptoms relief products:

Pepto Bismol, Pepsid AC, Imodium, Tums are over the counter medications you can take to help reduce the discomfort. These medications won’t help reduce symptoms long term, but they will help mediate the symptoms.

Pro Biotics, herbs, fiber and enzymes are supplements which can help reduce discomfort and have been proven to help improve one’s digestives system overall. These supplements can be found at any nutritional supplement store.

Medications may affect people differently, and no one medication or combination of medications will work for everyone with IBS. You will need to work with your doctor to find the best combination of medicine, diet, counseling, and support to control your symptoms.

How does stress affect IBS?

Stress—feeling mentally or emotionally tense, troubled, angry, or overwhelmed—can stimulate colon spasms in people with IBS. The colon has many nerves that connect it to the brain. Like the heart and the lungs, the colon is partly controlled by the autonomic nervous system, which responds to stress. These nerves control the normal contractions of the colon and cause abdominal discomfort at stressful times. People often experience cramps or “butterflies” when they are nervous or upset. In people with IBS, the colon can be overly responsive to even slight conflict or stress. Stress makes the mind more aware of the sensations that arise in the colon, making the person perceive these sensations as unpleasant.

Some evidence suggests that IBS is affected by the immune system, which fights infection in the body. The immune system is affected by stress. For all these reasons, stress management is an important part of treatment for IBS. Stress management options include

  • Stress reduction (relaxation) training and relaxation therapies such as meditation
  • Counseling and support
  • Regular exercise such as walking or yoga
  • Changes to the stressful situations in your life
  • Adequate sleep

What does the colon do?

The colon, which is about 5 feet long, connects the small intestine to the rectum and anus. The major function of the colon is to absorb water, nutrients, and salts from the partially digested food that enters from the small intestine. Two pints of liquid matter enter the colon from the small intestine each day. Stool volume is a third of a pint. The difference between the amount of fluid entering the colon from the small intestine and the amount of stool in the colon is what the colon absorbs each day.

Colon motility—the contraction of the colon muscles and the movement of its contents—is controlled by nerves, hormones, and impulses in the colon muscles. These contractions move the contents inside the colon toward the rectum. During this passage, water and nutrients are absorbed into the body, and what is left over is stool. A few times each day contractions push the stool down the colon, resulting in a bowel movement. However, if the muscles of the colon, sphincters, and pelvis do not contract in the right way, the contents inside the colon do not move correctly, resulting in abdominal pain, cramps, constipation, a sense of incomplete stool movement, or diarrhea.

Can changes in diet help IBS?

For many people, careful eating reduces IBS symptoms. Before changing your diet, keep a journal noting the foods that seem to cause distress. Then discuss your findings with your doctor. You may want to consult a registered dietitian who can help you make changes to your diet. For instance, if dairy products cause your symptoms to flare up, you can try eating less of those foods. You might be able to tolerate yogurt better than other dairy products because it contains bacteria that supply the enzyme needed to digest lactose, the sugar found in milk products. Dairy products are an important source of calcium and other nutrients. If you need to avoid dairy products, be sure to get adequate nutrients in the foods you substitute, or take supplements.

In many cases, dietary fiber may lessen IBS symptoms, particularly constipation. However, it may not help with lowering pain or decreasing diarrhea. Whole grain breads and cereals, fruits, and vegetables are good sources of fiber. High-fiber diets keep the colon mildly distended, which may help prevent spasms. Some forms of fiber keep water in the stool, thereby preventing hard stools that are difficult to pass. Doctors usually recommend a diet with enough fiber to produce soft, painless bowel movements. High-fiber diets may cause gas and bloating, although some people report that these symptoms go away within a few weeks. (For information about diets for people with celiac disease, please see the NIDDK’s Celiac Disease fact sheet.) Increasing fiber intake by 2 to 3 grams per day will help reduce the risk of increased gas and bloating.

Drinking six to eight glasses of plain water a day is important, especially if you have diarrhea. Drinking carbonated beverages, such as sodas, may result in gas and cause discomfort. Chewing gum and eating too quickly can lead to swallowing air, which also leads to gas.

Large meals can cause cramping and diarrhea, so eating smaller meals more often, or eating smaller portions, may help IBS symptoms. Eating meals that are low in fat and high in carbohydrates such as pasta, rice, whole-grain breads and cereals (unless you have celiac disease), fruits, and vegetables may help.

Other websites to view:

American Gastroenterological Association 

Disclaimer: No medical doctor has reviewed the contents of this website/ blog. This website/blog was development for the purpose of providing a central place for lactose intolerant individuals to come to share basic information and personal insight. It is advised that you check with your physician or medical advisor before acting upon anything learned from this site.