Get the inside tract on IBS

Irritable Bowel Syndrome (IBS) is one of the leading cause of absence from work . . .

Irritable Bowel Syndrome (IBS) is the most commonly diagnosed gastrointestinal condition. It’s the second leading cause of absence from work (behind the common cold) and affects one in five Americans.

Symptoms and causes

The primary symptoms of IBS are abdominal pain and altered bowel habits. In Western countries including the U.S., women are twice as likely as men to be diagnosed with IBS.

• Abdominal pain can be crampy and vary in intensity. Pain may be worsened by eating or emotional stress. Having a bowel movement often relieves the pain. Abdominal pain is often the most troubling symptom to IBS patients and has been the most difficult symptom to treat.
• After pain, changes in bowel habits are the second most frequent IBS symptom. This can include diarrhea, constipation, or alternating diarrhea and constipation.

IBS has been linked to Small Intestinal Bacterial Overgrowth (SIBO). Abnormal contractions of the colon (“spastic colon”) may also be a cause. Stress and anxiety are seen in many of the patients who seek medical help for IBS, but they are probably not the root cause.

Many patients with IBS have food intolerances, raising the possibility that it is food allergies or food sensitivity. But the most important trigger for IBS is now believed to be food poisoning. If you had recent travel and developed diarrhea or ate food you think caused illness, try to determine if that is when your IBS started.

Diagnosis and treatment

There is no diagnostic test for IBS. However, the constellation of symptoms including abdominal discomfort and irregular bowel habits are very typical of IBS. In the absence of blood in the stool, weight loss, or anemia, the condition is likely IBS.

It’s important to rule out other diseases. Over the age of 50, a colonoscopy is important for all people as part of routine screening for colon cancer. In addition, it’s recommended that a blood test for celiac disease be performed in all people with suspected IBS. While Crohn’s disease and ulcerative colitis are rare, these should at least be considered in someone with new onset symptoms.

There are a number of different treatments for IBS and often a combination of long-term treatment is used.

• Keep a record of your symptoms and identify factors that might affect your symptoms
• Reduce foods that cause gas such as beans, cabbage, brussel sprouts, cauliflower and broccoli, and increase daily fiber either with food or with a bulk fiber supplement. Lactose intolerance is common and can aggravate IBS or cause symptoms that mimic IBS.
• Several classes of medicine are used to relieve symptoms. Ask your doctor for details.
• Regular exercise, massage, and prayerful meditation help relieve stress.

Most people with IBS find that symptoms improve as they learn to control their condition. Only a small number of people with irritable bowel syndrome have disabling signs and symptoms.

Fortunately, unlike more-serious intestinal diseases such as ulcerative colitis and Crohn’s disease, irritable bowel syndrome doesn’t cause inflammation, changes in bowel tissue, or increase your risk of colorectal cancer. In many cases, you can control irritable bowel syndrome by managing your diet, lifestyle and stress.

If you would like an appointment with a gastroenterologist for your digestive issues, please contact us today.

SUSAN LOCKE, MD, is Healthnetwork Foundation’s medical director. Mark Pimental, MD, gastroenterologist at Cedars-Sinai Medical Center, also contributed information for this article.

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