Irritable bowel syndrome
Irritable bowel syndrome
Irritable bowel syndrome (IBS) is a common disorder that affects your large intestine (colon). Irritable bowel syndrome commonly causes cramping, abdominal pain, bloating gas, diarrhea and constipation. Despite these uncomfortable signs and symptoms, IBS doesn't cause permanent damage to your colon.
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 or 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.
The signs and symptoms of irritable bowel syndrome can vary widely from person to person and often resemble those of other diseases. Among the most common are:
Like many people, you may have only mild signs and symptoms of irritable bowel syndrome. However, sometimes these problems can be disabling. In some cases, you may have severe signs and symptoms that don't respond well to medical treatment. Because symptoms of irritable bowel syndrome can occur with other more serious diseases, it's best to discuss these symptoms with your doctor.
For most people, IBS is a chronic condition, although there will likely be times when the signs and symptoms are worse and times when they improve or even disappear completely.
When to see a doctor
Your doctor may be able to help you find ways to relieve symptoms as well as rule out other more-serious colon conditions, such as ulcerative colitis and Crohn's disease, which are forms of inflammatory bowel disease.
It's not known exactly what causes irritable bowel syndrome. The walls of the intestines are lined with layers of muscle that contract and relax in a coordinated rhythm as they move food from your stomach through your intestinal tract to your rectum. If you have irritable bowel syndrome, the contractions may be stronger and last longer than normal. Food is forced through your intestines more quickly, causing gas, bloating and diarrhea.
In some cases, the opposite occurs. Food passage slows, and stools become hard and dry. Abnormalities in your nervous system or colon also may play a role, causing you to experience greater than normal discomfort when your intestinal wall stretches from gas.
There are a number of other factors that may play a role in IBS. For example, people with IBS may have abnormal serotonin levels. Serotonin is a chemical messenger that's normally associated with brain function, but it also plays a role in normal digestive system function. It's also possible that people with IBS don't have the right balance of good bacteria in the intestine.
Triggers affect some people, not others
Many people have occasional signs and symptoms of irritable bowel syndrome. However, you're more likely to have IBS if you:
IBS isn't associated with any serious conditions, such as colon cancer. But, diarrhea and constipation, both signs of irritable bowel syndrome, can aggravate or even cause hemorrhoids.
The impact of IBS on your overall quality of life may be its most significant complication. IBS might limit your ability to:
These effects of IBS may cause you to feel you're not living life to the fullest, leading to discouragement or even depression.
Preparing for your appointment
Make an appointment with your doctor if you have symptoms of IBS. After an initial evaluation, your doctor may refer you to a specialist in digestive disorders (gastroenterologist) for more extensive testing.
Here's some information to help you prepare for your appointment and what to expect from your doctor.
What you can do
For IBS, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask additional questions during your appointment.
What to expect from your doctor
What you can do in the meantime
Tests and diagnosis
A diagnosis of irritable bowel syndrome depends largely on a complete medical history and physical exam.
Criteria for making a diagnosis
The most important symptom is:
You also must have at least two of the following:
Your doctor will likely assess how you fit these criteria, as well as whether you have any other signs or symptoms that might suggest another, more-serious condition. Some red flag signs and symptoms that might prompt your doctor to do additional testing include:
If you have these red flag signs or symptoms, you'll need additional testing to further assess your condition.
If you fit the IBS criteria and don't have any red flag signs or symptoms, your doctor may suggest a course of treatment without doing additional testing. But if you don't respond to that treatment, you'll likely require more tests.
Treatments and drugs
Because it's not clear what causes irritable bowel syndrome, treatment focuses on the relief of symptoms so that you can live as normally as possible.
In most cases, you can successfully control mild signs and symptoms of irritable bowel syndrome by learning to manage stress and making changes in your diet and lifestyle. But if your problems are moderate or severe, you may need to do more. Your doctor may suggest:
Medication specifically for IBS
Lifestyle and home remedies
In many cases, simple changes in your diet and lifestyle can provide relief from irritable bowel syndrome. Although your body may not respond immediately to these changes, your goal is to find long-term, not temporary, solutions:
The following nontraditional therapies may help relieve symptoms of irritable bowel syndrome:
Coping and support
Living with irritable bowel syndrome presents daily challenges. IBS may be painful or embarrassing and can seriously affect the quality of your life. These suggestions may help you cope more easily:
Anyone may experience digestive upset from worry or anxiety. But if you have irritable bowel syndrome, stress-related problems such as abdominal pain and diarrhea tend to occur with greater frequency and intensity. Finding ways to deal with stress may be helpful in preventing or alleviating symptoms:
Last Updated: 2011-07-29
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