To Your Health: Irritable bowel syndrome is common disorder
By Dr. Robert Kaiser June 19, 2012 2:10PM
Dr. Kaiser is a board-certified gastroenterologist on staff at Ingalls Memorial Hospital. | Supplied Photo
Updated: July 21, 2012 6:15AM
Irritable bowel syndrome, or IBS, is the most common gastrointestinal disorder in the United States, causing discomfort and misery for about one in six Americans.
Patients with this condition suffer symptoms that can include painful bloating, constipation, diarrhea or an alternating pattern of both. Embarrassed by their symptoms, many patients try to avoid social interactions.
For years, the cause of IBS was not clearly understood, but a recent Cedars-Sinai study has linked an overgrowth of bacteria in the gut to IBS. Treatments for IBS have always focused on trying to alleviate the symptoms, but this recent study shows that targeted antibiotics may also be a successful treatment for IBS.
Fortunately, unlike more serious intestinal diseases such as ulcerative colitis and Crohn’s disease, IBS doesn’t cause inflammation or changes in bowel tissue or increase your risk of colorectal cancer. In many cases, you can control IBS by managing your diet, lifestyle and stress.
The signs and symptoms of IBS vary widely from person to person and often resemble those of other diseases. The most common symptoms include abdominal pain or cramping, a bloated feeling, gas or flatulence, diarrhea or constipation (sometimes alternating) and mucus in the stool.
Many people have only mild symptoms, while others may be more severe. Because IBS symptoms can occur with more serious conditions such as an infection or colon cancer, it’s best to discuss them with a doctor.
Many people find that their symptoms worsen when they eat certain foods. For example, chocolate, milk and alcohol might cause constipation or diarrhea. Carbonated beverages and some fruits and vegetables may lead to bloating and discomfort in some people with IBS.
For many people with IBS, stressful events such as a change in their daily routine can aggravate symptoms. What’s more, many researchers believe that hormonal changes play a role in IBS, and many women find that symptoms are worse during or around their menstrual periods.
In general, you’re more likely to have IBS if you are young, female and have a family history. IBS symptoms first appear before the age of 35 for about half of all those with the disorder. More women than men are diagnosed with IBS; and studies have shown that people who have a first-degree relative such as a parent or sibling with IBS are at increased risk.
While IBS isn’t associated with any serious conditions such as colon cancer, diarrhea and constipation can aggravate or even cause hemorrhoids. The most significant complication may be the impact of IBS on your overall quality of life.
Many with the disorder have difficulty coping with symptoms away from home that may cause them to avoid social engagements. And the physical discomfort of IBS may make sexual activity unappealing or even painful. These effects can lead to discouragement or even depression.
Making a diagnosis
A complete medical history and physical exam are required before a diagnosis of IBS can be made. In general, you must have certain signs and symptoms before a doctor diagnoses irritable bowel syndrome.
The most important symptom is abdominal pain and discomfort lasting at least 12 weeks, though they don’t have to occur consecutively.
Patients must also have at least two of the following signs: a change in the frequency or consistency of your stool; straining, urgency or a feeling that you can’t empty your bowels completely; mucus in the stool; and bloating or abdominal distension.
Red flags that might prompt your doctor to do additional testing include new onset of IBS after age 50, weight loss, rectal bleeding, fever, nausea or recurrent vomiting, abdominal pain (especially if it’s not relieved by a bowel movement) and diarrhea that is persistent or awakens you from sleep.
Because there are no physical signs to definitively diagnose irritable bowel syndrome, diagnosis often involves a process of elimination. If you fit the IBS criteria and don’t have any red flags, your doctor may suggest treatment without doing additional testing. If you don’t respond to treatment, you may undergo a flexible sigmoidoscopy, colonoscopy, lactose intolerance tests or blood tests to rule out other causes for your symptoms.
The goal of IBS treatment is to relieve symptoms.
Lifestyle changes can help in some cases of IBS. For example, regular exercise and improved sleep habits may reduce anxiety and help relieve bowel symptoms.
Dietary changes can be helpful, too, although no specific diet can be recommended, because the condition differs from one person to another. The following changes may help:
Avoid foods and drinks that stimulate the intestines such as caffeine, tea or colas.
Avoid large meals.
Increase fiber in the diet. This may improve constipation but make bloating worse.
Talk with your doctor before taking over-the-counter medications. No single medication will work for everyone. Medications your doctor might try include:
Anticholinergic medications (dicyclomine, propantheline, belladonna and hyoscyamine) taken about a half-hour before eating to control intestine muscle spasms
Bisacodyl to treat constipation
Loperamide to treat diarrhea
Low doses of tricyclic antidepressants to help relieve intestinal pain
Lubiprostone for constipation symptoms
Rifaximin, an antibiotic
Counseling or therapy may also help in cases of severe anxiety or depression.
While IBS may be a lifelong condition, symptoms can be relieved and improved through treatment, and it does not cause permanent harm to the intestines or lead to cancer.
Call your doctor if you have symptoms of IBS or if you notice a change in your bowel habits that does not go away.
More information is at Ingalls Care Connection at (800) 221-2199.
Dr. Kaiser is a board-certified gastroenterologist on staff at Ingalls Memorial Hospital.