Irritable Bowel Syndrome

If you have irritable bowel syndrome, or IBS, you might have uncomfortable or painful abdominal symptoms. Constipation, diarrhea, gas and bloating are common IBS symptoms. IBS doesn’t damage your digestive tract or raise your risk for colon cancer. You can often control symptoms through diet and lifestyle changes.

Other names #

• Irritable bowel.

• Irritable colon.

• Spastic colon.

• Nervous stomach, since symptoms often happen when you’re feeling emotional stress, tension and anxiety.

Types #

Often, people with IBS have normal bowel movements some days and abnormal ones on other days. The type of IBS you have depends on the abnormal bowel movements you experience:

• IBS with constipation (IBS-C): Most of your poop is hard and lumpy.

• IBS with diarrhea (IBS-D): Most of your poop is loose and watery.

• IBS with mixed bowel habits (IBS-M): You have both hard and lumpy bowel movements and loose and watery movements on the same day.

Causes #

Researchers don’t exactly know what causes IBS. They think a combination of factors can lead to IBS, including:

• Dysmotility: Problems with how your GI muscles contract and move food through the GI tract.

• Visceral hypersensitivity: Extra-sensitive nerves in the GI tract.

• Brain-gut dysfunction: Miscommunication between nerves in the brain and gut.

Symptoms #

• Abdominal pain or cramps, usually in the lower half of the abdomen.

• Bloating.

• Bowel movements that are harder or looser than usual.

• Diarrhea, constipation or alternating between the two.

• Excess gas.

• Mucus in your poop (may look whitish).

Diagnosis #

If you’ve been having uncomfortable GI symptoms, see your healthcare provider. The first step in diagnosing IBS is a medical history and a physical exam. Your provider will ask you about your symptoms:

• Do you have pain related to bowel movements?

• Do you notice a change in how often you have a bowel movement?

• Has there been a change in how your poop looks?

• How often do you have symptoms?

• When did your symptoms start?

• What medicines do you take?

• Have you been sick or had a stressful event in your life recently?

Depending on your symptoms, you may need other tests to confirm a diagnosis. Blood tests, stool samples and X-rays can help rule out other diseases that mimic IBS.

A flexible sigmoidoscopy can help evaluate bowel disorders, rectal bleeding or polyps. Your provider will:

• Insert a sigmoidoscope, a long, thin, flexible instrument, into the rectum.

• Advance the sigmoidoscope to the colon.

• View the lining of the rectum and lower part of the colon.

Here’s what you can expect during a colonoscopy. Your provider will:

• Insert the colonoscope through the rectum.

• Advance the scope and examine the entire colon.

• Remove small amounts of tissue for a biopsy (if necessary).

• Identify and remove small growths called polyps (if necessary).

• Often, providers can make an accurate diagnosis and even deliver treatment using a colonoscopy. A colonoscopy is a much less invasive procedure compared to an abdominal operation.

Treatment #

Dietary changes #

• Increase fiber in your diet eat more fruits, vegetables, grains and nuts.

• Add supplemental fiber to your diet, such as Metamucil or Citrucel.

• Drink plenty of water — eight 8-ounce glasses per day.

• Avoid caffeine (from coffee, chocolate, teas and sodas).

• Limit cheese and milk. Lactose intolerance is more common in people with IBS. Make sure to get calcium from other sources, such as broccoli, spinach, salmon or supplements.

• Try the low FODMAP diet, an eating plan that can help improve symptoms.

Activity changes #

• Exercise regularly.

• Don’t smoke.

• Try relaxation techniques.

• Eat smaller meals more often.

• Record the foods you eat so you can figure out which foods trigger IBS flare-ups. Common triggers are red peppers, green onions, red wine, wheat and cow’s milk.

Medical changes #

• Your provider may prescribe antidepressant medications if you have depression and anxiety along with significant abdominal pain.

• Other medicines can help with diarrhea, constipation or abdominal pain.

• Probiotics may be an option for you. These good bacteria can help improve symptoms.

• Talk to your provider if your symptoms don’t improve. You may need more tests to see if an underlying condition is causing the symptoms.