by Edward C. Paredez, MD
On television commercials, the women with Irritable Bowel Syndrome (IBS) display their symptoms, clearly written in black ink, across their lower abdomens: cramping, constipation or diarrhea, and bloating, to name a few. But if you experience IBS, you don’t need to see the symptoms in writing. Chances are good that you already know them all too well.
IBS is a disorder of the bowel or large intestine. It is not a disease; rather, it is a problem with how the bowel functions. With IBS, the nerves and muscles in the bowel are much more sensitive than normal; for example, they may overreact to foods that are not a problem for people with regular bowel function.
As a result of this oversensitivity, people with IBS may experience one or more of the symptoms mentioned above, as well as gas and constipation. Often these symptoms can be very uncomfortable or even painful. Fortunately, IBS does not cause damage to the bowel.
IBS is one of the most common ailments affecting adults today. It affects up to 20% of people in the United States and is the reason for 3.6 million doctor visits and 500,000 hospitalizations each year.
There are several possible causes of IBS. One of the most common is food. Among the foods that seem most likely to trigger IBS symptoms are dairy products such as milk, cheese and ice cream, caffeine, carbonated drinks, chocolate, alcohol, and foods with a high fat content.
The size of a meal can make a difference, too — large meals may cause an increase in symptoms as the bowel struggles to digest all that food.
Psychological factors also may play a role. Some people with IBS find that their symptoms become more pronounced when they are upset, anxious or under stress.
While these emotions in themselves won’t cause IBS, they can make it worse. Hormones can affect IBS as well, as some women notice more symptoms during their menstrual periods.
In addition to the symptoms already mentioned, people with IBS may have a “straining” feeling during a bowel movement, a change in frequency of bowel movements or a feeling that the bowel movement is not complete. Sometimes, there will be mucus in the stool.
If you’ve experienced any of these symptoms at least once a month for the past 12 months, make an appointment to see your doctor for an evaluation. If you notice blood in your stool or develop a fever in addition to other symptoms, call your doctor right away, as these may be signs of a more serious problem that needs immediate attention.
During your visit, your physician will discuss your symptoms with you and may do a physical exam and other tests to rule out or treat other possible causes, such as hypothyroidism, Crohn’s disease, ulcerative colitis or anxiety disorder.
There is no “cure” for IBS, but a number of treatments can help the bowel function more normally and greatly relieve or eliminate symptoms. Often, changes in diet that eliminate troublesome foods can make a significant difference in symptoms.
If large meals are a culprit, replacing three large meals with several smaller ones may help. If you have problems with constipation, your doctor may also recommend that you add more fiber to your diet through food or supplements, as fiber makes stools softer and easier to pass.
Learning to reduce stress in your life also may reduce symptoms of cramping and abdominal pain. Talk to a counselor or look into methods of stress management such as yoga, meditation, talking to a friend or family member or even just taking a walk. Your doctor may be able to refer you to a counselor or a stress management program at your local hospital. Physical exercise can also help decrease stress and may help with IBS symptoms as well.
Depending on your symptoms, your doctor may suggest taking medication. Over-the-counter laxatives can relieve constipation, while anti-spasmodic medications slow the contractions of the bowel to help with diarrhea and cramping. Prescription medications may be another alternative.
Often, a combination of treatments works best to relieve IBS symptoms. Your physician can help you determine the best approach.
This Scripps Health and Wellness information was provided by Edward Paredez, MD, a gastroenterologist at Scripps Memorial Hospital La Jolla.