Irritable bowel syndrome, also known as IBS or spastic colon, is a disorder of the gastrointestinal tract. IBS is not a disease, but a functional disorder. Although, unlike Crohn‘s disease and ulcerative colitis, it is not a form of inflammatory bowel disease, it causes very uncomfortable, and sometimes embarrassing, symptoms that require long-term management.
Causes of IBS
The precise causes of IBS are unknown. It is believed that the nerves and muscles in the bowels of patients with IBS are overly sensitive, contracting or relaxing to an abnormal degree, resulting in cramping or pain. These muscles may force food to pass quickly through the intestines resulting in gas, bloating and diarrhea, or slow peristalsis, resulting in constipation. It is thought that these muscles may be reacting to stimulants such as certain foods or environmental factors.
Risk Factors for IBS
There are several risk factors for IBS. These include:
- Being female
- Being under the age of 45
- Having a family history of the condition
- Being under severe stress
- Having psychiatric symptoms, especially those related to abuse
There is speculation that hormones play a role in the development of IBS and that this is the reason the condition is more common in perimenopausal women.
Symptoms of IBS
The symptoms of IBS can be particularly discomforting because they vary and often appear without known triggers. These symptoms include:
- Abdominal pain or cramping
- Abdominal distention (bloating)
- Flatulence (gas)
- Alternating episodes of diarrhea or constipation
- Mucus in the stool
These symptoms are common and many people experience mild variations of them on a fairly regular basis. Because these symptoms may occur for a number of reasons, it is important to consult with a physician to determine whether they result from IBS or indicate a more serious condition.
Diagnosis of IBS
IBS can be difficult to diagnose. A complete medical history is taken and a physical exam is performed. Researchers have developed a diagnostic tool, known as the Rome Criteria, a set of criteria, based on symptoms that signal IBS. These criteria include the following:
- Regular abdominal pain or discomfort for 12 weeks
- A difference in the frequency or consistency of stool
- A feeling that the bowels have not been completely emptied
- Reduction of pain level following a bowel movement
- Ongoing symptoms for a minimum of 6 months
Inflammatory bowel disease and other gastrointestinal problems are ruled out through one or more of the following diagnostic tests:
- Test for lactose intolerance
- Blood tests
- Barium X-ray
- Colonoscopy
- Sigmoidoscopy
- CT scan
IBS is typically diagnosed by the prevalence of the gastrointestinal symptoms described over an extended period of time in the absence of evidence of more serious illness.
Treatment of IBS
Once IBS has been diagnosed, it can usually be treated with simple lifestyle changes. Since the cause of IBS is unknown and there is no cure, treatment usually focuses on relieving symptoms. Managing stress and making dietary changes may be sufficient to control mild symptoms. Different foods may act as triggers for different people, but some foods are common culprits. Patients are normally advised to cut back on fatty foods, dairy products, chocolate, alcohol and caffeine.
While lifestyle changes may help to curb symptoms, patients may still be troubled, occasionally or even frequently, by gastrointestinal discomfort. Several medications are helpful in dealing with IBS symptoms, including fiber supplements, laxatives, antispasmodics, antibiotics, anti-diarrheals and antidepressants.
Dealing with stress is one of the primary ways to reduce symptoms of IBS. Regular exercise, meditation, counseling and deep breathing can all help to keep stress at a minimum and reduce IBS flare-ups. While IBS is a common condition, it is important to discuss the disorder with a doctor to determine the best individual method of treatment.