Irritable Bowel Syndrome
The walls of the intestines are lined with muscles that contract and relax in a coordinated rhythm to squeeze food through the intestines.
In irritable bowel syndrome (IBS), also called functional bowel syndrome, irritable colon, spastic bowel, and spastic colon, the contractions become too strong or long lasting, moving food along too quickly or too slowly. It is a very common disease, affecting as many as 20 percent of Americans.
Symptoms of IBS may include:
- Abdominal pain
- Mucus in the stool
It occasionally may cause depression. Since these symptoms may result from more serious disorders, you should discuss them with your WellStar physician.
Causes and Prevention
The root causes of IBS are unknown, but triggers include pressure on your intestines and certain foods, medications, or stresses.
- Many people find that certain foods trigger IBS symptoms. However, IBS-like symptoms after consuming dairy products may result from lactose intolerance.
- Most people with IBS find that symptoms are aggravated by stress.
- Many women find that symptoms are more pronounced around their menstrual periods.
- Other illnesses, like acute infectious diarrhea, can trigger IBS.
IBS begins before age 35 in half of those who contract it. About twice as many women as men have it, and people with a family history of IBS are at increased risk.
Diagnosis of IBS is often a process of eliminating other, more serious possible causes of your symptoms. Researchers have developed the Rome criteria for functional gastrointestinal disorders. Your WellStar physician will assess how well you fit these criteria, and the other possible causes will be eliminated by tests for those conditions.
Since the causes of IBS are unknown, treatments seek to ameliorate its symptoms. In most cases, symptoms can be controlled by changing your diet and learning to manage stress. Some treatments are:
- Gradually increase fiber intake, and note whether your symptoms improve or get worse. Some people are helped by reducing dietary fiber and taking a fiber supplement, like Metamucil® or Citrucel.®
- Don't eat foods that seem to cause problems
- Eat about the same quantity and at about the time every day. If you have diarrhea, eating more, smaller meals may help. If you are constipated, perhaps larger, high-fiber meals will help food along.
- Reduce dairy product consumption
- Drink plenty of liquids, especially water, and consume less caffeine and alcohol
- Regular exercise helps improve mood and stimulates normal intestinal contraction.
- Use medications with caution and with the lowest dosages that help.
For more severe cases, your WellStar physician may recommend:
- A fiber supplement, like Metamucil® or Citrucel®
- An anti-diarrheal medication, like Immodium®
- Eliminating gassy foods like carbonated beverages, and raw fruits and vegetables
- Anticholinergic medications, which relieve intestinal spasms
- If symptoms include depression, antidepressants may provide relief, as well as calm the intestines.
- Counseling may help relieve stress.
There are two medications specifically for IBS:
- Alosetron (Lotronex®) inhibits nervous actions to relax the colon, useful for treating IBS with diarrhea (IBS-D) . It has potentially serious side effects, and should be used only by women who have not responded to other treatments. It is not approved for use by men.
- Lubiprostone (Amitiza®) increases fluid secretion in the small intestine, helping stool passage, to treat IBS with constipation (IBS-C). It also has side effects, and is approved only for women over 18.