What is irritable bowel syndrome (IBS)?

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• irritable bowel syndrome (IBS)
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Irritable bowel syndrome, or irritable bowel disease, is a long-term gastrointestinal disorder. It causes abdominal pain, bloating, mucous in stools, irregular bowel habits, and alternating diarrhea and constipation.

Irritable bowel syndrome (IBS) or irritable bowel disease (IBD), is also known as spastic colitis, mucus colitis, and nervous colon. It is a chronic, or long-term, condition, but symptoms tend to change over the years.

IBS can cause persistent discomfort, but most people will not experience severe complications.

Symptoms often improve as individuals learn to manage the condition. Severe and persistent severe symptoms are rare. Fast facts on irritable bowel syndrome

Here are some key points about irritable bowel syndrome.

• IBS can cause discomfort, but it does not usually lead to serious complications.
• Currently, there is no cure for IBS.
• Dietary and emotional factors can play a key role in IBS.
• Reducing alcohol intake can ease symptoms.
• Excluding foods that cause gas can also improve symptoms.

IBS can lead to discomfort and abdominal pain.

The most common symptoms experienced by people with IBS are:

• changes in bowel habits
• abdominal pain and cramping, which often lessen after using the bathroom
• a feeling that the bowels are not fully emptied after using the bathroom
• excess gas
• passing of mucus from the back passage, or rectum
• a sudden urgent need to use the bathroom
• swelling or bloating of the abdomen
• frequent urination
• halitosis, or bad breath
• headache
• joint or muscle pain
• persistent fatigue
• pain with sex (for females) or sexual dysfunction
• irregular menses
• foods that cause flatulence, such as beans, celery, onions, carrots, raisins, bananas, apricots, prunes, brussel sprouts, pretzels, and bagels
• dairy products
• sugar-free gum
• some candies
• products with caffeine in them, maybe due to lactose (sugar), sorbitol, or caffeine intolerance, rather than IBS
• diet
• environmental factors, such as stress
• genetic factors
• hormones
• digestive organs being excessively sensitive to pain
• an unusual response to infection
• a malfunction in the muscles used to move food through the body
• an inability of the central nervous system (CNS) to control the digestive system properly
• consuming more oat-based foods to reduce gas or bloating
• not skipping meals and eating at the same time every day
• eating slowly
• limiting alcohol intake
• avoiding carbonated sugary beverages, such as soda
• limiting intake of certain fruits and vegetables
• limiting tea and coffee intake to three cups per day
• drinking enough fluids, at least eight cups of fluid per day for most people

It may help to avoid or limit the intake of resistant starch, commonly found in processed or recooked foods and in some legumes. Resistant starch is not broken down in the digestive tract and counts as a component of dietary fiber.
Anxiety and stress

The following may help reduce or relieve symptoms:

• relaxation techniques, including exercises or meditation
• some specific physical activities, such as Tai Chi or yoga
• regular physical exercise
• stress counseling or cognitive behavioral therapy (CBT)

Medications

The following medications are used for IBS symptoms:

• Antispasmodic medications reduce abdominal cramping and pain by relaxing the muscles in the gut.
• Bulk-forming laxatives can help relieve constipation. These can be purchased over-the-counter or online, although they should be used with caution.
• Antimotility medications for diarrhea include loperamide, which slows down the contractions of the intestinal muscles. Loperamide may be purchased online.
• Tricyclic antidepressant (TCAs) often help to reduce abdominal pain and cramping.

Medications specific to IBS treatment include:

alosetron (Lotronex) for severe diarrhea-predominant IBS in women
lubiprostone (Amitiza) for constipation-predominant IBS in women

These are usually the last line of treatment, when other lifestyle or therapeutic interventions have failed, and symptoms remain severe.
Psychological therapy

Some psychological techniques can be useful:

Psychodynamic interpersonal therapy (PIT), where the therapist helps the patient explore their past to find out whether anything may have affected them unconsciously.
Hypnotherapy can help alter the unconscious mind's attitude to symptoms.
Cognitive behavioral therapy (CBT) fosters strategies for reacting differently to the condition through relaxation techniques and a positive attitude.

Exercise can help reduce symptoms in some people.
Diagnosis

IBS is uncomfortable, but it generally does not have serious medical implications.

No specific imaging or laboratory test can diagnose IBS.

Diagnosis involves ruling out conditions that produce IBS-like symptoms and then following a procedure to categorize the symptoms.

There are 3 main types of IBS:

• IBS with constipation (IBS-C): There is stomach pain, discomfort, bloating, infrequent or delayed bowel movements, or hard or lumpy stools.
• IIBS with diarrhea (IBS-D): There is stomach pain, discomfort, an urgent need to go to the toilet, very frequent bowel movements, or watery or loose stools.
• IIBS with alternating stool pattern (IBS-A): There is both constipation and diarrhea.

Many people experience different types of IBS as time goes by.

The doctor can often diagnose IBS by asking about symptoms, for example:

• Have there been any changes in your bowel habits, such as diarrhea or constipation?
• Is there any pain or discomfort in your abdomen?
• How often do you feel bloated?

A blood test may help rule out other possible conditions, including:

• lactose intolerance
• small intestinal bacterial overgrowth
• celiac disease

If specific signs or symptoms suggest another condition, further testing may be required.

These could be:

• anemia
• localized swelling in the rectum and abdomen
• weight loss (unexplained)
• abdominal pain at night
• progressively worsening symptoms
• significant blood in the stool
• family history of inflammatory bowel disease, colorectal cancer, or celiac disease

Patients with a history of ovarian cancer may require further testing, as will patients over the age of 60 whose change in bowel habits have persisted for longer than 6 weeks.

Risk factors

The following groups of people are more likely to have IBS:

Younger adults: IBS affects people of all ages, but diagnosis usually occurs before the age of 45 years, often at 20 to 30 years.

Gender: It is more likely to affect women.

Family history: If a close relative has or has had IBS, there may be a higher chance of developing it. However, there is no clear link.

Environment: Ongoing research is investigating whether the family-history risk of IBS is linked to genes, a shared family environment, or both.