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Information on Irritable Bowel Syndrome Symptoms, Causes & Treatment
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What Is Irritable Bowel Syndrome?
Irritable bowel syndrome (IBS) is a common
disorder of the intestines that leads to crampy pain, gassiness, bloating,
and changes in bowel habits. Some people with IBS have constipation
(difficult or infrequent bowel movements); others have diarrhea (frequent
loose stools, often with an urgent need to move the bowels); and some
people experience both. Sometimes the person with IBS has a crampy urge to
move the bowels but cannot do so.
Through the years, IBS has been called by many names--colitis, mucous
colitis, spastic colon, spastic bowel, and functional bowel disease. Most
of these terms are inaccurate. Colitis, for instance, means inflammation
of the large intestine (colon). IBS, however, does not cause inflammation
and should not be confused with another disorder, ulcerative colitis.
The cause of irritable bowel syndrome is not known, and as yet there is no cure. Doctors
call it a functional disorder because there is no sign of disease when the
colon is examined. Irritable bowel syndrome causes a great deal of discomfort and distress, but
it does not cause permanent harm to the intestines and does not lead to
intestinal bleeding of the bowel or to a serious disease such as cancer.
Often IBS is just a mild annoyance, but for some people it can be
disabling. They may be unable to go to social events, to go out to a job,
or to travel even short distances. Most people with IBS, however, are able
to control their symptoms through medications prescribed by their
physicians, diet, and stress management.
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What Causes Irritable Bowel Syndrome?
The colon, which is about 6 feet long, connects
the small intestine with the rectum and anus. The major function of the
colon is to absorb water and salts from digestive products that enter from
the small intestine. Two quarts of liquid matter enter the colon from the
small intestine each day. This material may remain there for several days
until most of the fluid and salts are absorbed into the body. The stool
then passes through the colon by a pattern of movements to the left side
of the colon, where it is stored until a bowel movement occurs.
 Colon
motility (contraction of intestinal muscles and movement of its contents)
is controlled by nerves and hormones and by electrical activity in the
colon muscle. The electrical activity serves as a "pacemaker" similar to
the mechanism that controls heart function.
Movements of the colon propel the contents slowly back and forth but
mainly toward the rectum. A few times each day strong muscle contractions
move down the colon pushing fecal material ahead of them. Some of these
strong contractions result in a bowel movement.
Because doctors have been unable to find organic causes, irritable bowel syndrome often
has been thought to be caused by emotional conflict or stress. While
stress may worsen irritable bowel syndrome symptoms, research suggests that other factors also
are important. Researchers have found that the colon muscle of a person
with IBS begins to spasm after only mild stimulation. The person with IBS
seems to have a colon that is more sensitive and reactive than usual, so
it responds strongly to stimuli that would not bother most people.
Ordinary events such as eating and distention from gas or other
material in the colon can cause the colon to overreact in the person with
IBS. Certain medicines and foods may trigger spasms in some people.
Sometimes the spasm delays the passage of stool, leading to constipation.
Chocolate, milk products, or large amounts of alcohol are frequent
offenders. Caffeine causes loose stools in many people, but it is more
likely to affect those with IBS. Researchers also have found that women
may have more symptoms of irritable bowel syndrome during their menstrual periods, suggesting
that reproductive hormones can increase irritable bowel syndrome symptoms.
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What Are the Symptoms of Irritable Bowel Syndrome?
If you are concerned about IBS, it is important
to realize that normal bowel function varies from person to person. Normal
bowel movements range from as many as three stools a day to as few as
three a week. A normal movement is one that is formed but not hard,
contains no blood, and is passed without cramps or pain.
People with IBS, on the other hand, usually have crampy abdominal pain
with painful constipation or diarrhea. In some people, constipation and
diarrhea alternate. Sometimes people with IBS pass mucus with their bowel
movements. Bleeding, fever, weight loss, and persistent severe pain are
not symptoms of irritable bowel syndrome but may indicate other problems.
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How Is Irritable Bowel Syndrome Diagnosed?
IBS usually is diagnosed after doctors exclude
the presence of disease. To get to that point, the doctor will take a
complete medical history that includes a careful description of symptoms.
A physical examination and laboratory tests will be done. A stool sample
will be tested for evidence of bleeding. The doctor also may do diagnostic
procedures such as x-rays or endoscopy (viewing the colon through a
flexible tube inserted through the anus) to find out if there is disease.
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Irritable Bowel Syndrome Diet & Stress
The potential for abnormal function of the colon
is always present in people with IBS, but a trigger also must be present
to cause symptoms. The most likely culprits seem to be diet and emotional
stress. Many people report that their symptoms occur following a meal or
when they are under stress. No one is sure why this happens, but
scientists have some clues.
Eating causes contractions of the colon. Normally, this response may
cause an urge to have a bowel movement within 30 to 60 minutes after a
meal. In people with IBS, the urge may come sooner with cramps and
diarrhea.
The strength of the response is often related to the number of calories
in a meal and especially the amount of fat in a meal. Fat in any form
(animal or vegetable) is a strong stimulus of colonic contractions after a
meal. Many foods contain fat, especially meats of all kinds, poultry skin,
whole milk, cream, cheese, butter, vegetable oil, margarine, shortening,
avocados, and whipped toppings.
Stress also stimulates colonic spasm in people with IBS. This process
is not completely understood, but scientists point out that the colon is
controlled partly by the nervous system. Stress reduction (relaxation)
training or counseling and support help relieve symptoms of irritable bowel syndrome in some
people. However, doctors are quick to note that this does not mean IBS is
the result of a personality disorder. IBS is at least partly a disorder of
colon motility.
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How Does a Good Diet Help Irritable Bowel Syndrome?
For many people, eating a proper diet lessens irritable bowel syndrome
symptoms. Before changing your diet, it is a good idea to keep a
journal noting which foods seem to cause distress. Discuss your findings
with your doctor. You also may want to consult a registered dietitian, who
can help you make changes in your diet for irritable bowel syndrome.
For instance, if dairy products
cause your symptoms to flare up, you can try eating less of those foods.
Yogurt might be tolerated better because it contains organisms that supply
lactase, the enzyme needed to digest lactose, the sugar found in milk
products. Because dairy products are an important source of calcium and
other nutrients that your body needs, be sure to get adequate nutrients in
the foods that you substitute.
Dietary fiber may lessen symptoms of irritable bowel syndrome in many cases. Whole grain breads
and cereals, beans, fruits, and vegetables are good sources of fiber.
Consult your doctor before using an over-the-counter fiber supplement.
High-fiber diets keep the colon mildly distended, which may help to
prevent spasms from developing. Some forms of fiber also keep water in the
stools, thereby preventing hard stools that are difficult to pass. Doctors
usually recommend that you eat just enough fiber so that you have soft,
easily passed, and painless bowel movements. High-fiber diets may cause
gas and bloating, but within a few weeks, these symptoms often go away as
your body adjusts to the new diet for irritable bowel syndrome .
Large meals can cause cramping and diarrhea in people with IBS.
Symptoms may be eased if you eat smaller meals more often or just eat
smaller portions. This should help, especially if your meals are low in
fat and high in carbohydrates such as pasta, rice, whole-grain breads and
cereals, fruits, and vegetables.
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Can Medicines Relieve Irritable Bowel Syndrome Symptoms?
Your doctor may prescribe fiber supplements or
occasional laxatives if you are constipated. Some doctors prescribe drugs
that control colon muscle spasms, drugs that slow the movement of food
through the digestive system, tranquilizers, or antidepressant drugs, all
of which may relieve symptoms of irritable bowel syndrome.
It is important to follow the physician's instructions when taking irritable
bowel syndrome medications--particularly laxatives, which can be habit forming
if not used carefully.
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Is IBS Linked to Other Diseases?
IBS has not been shown to lead to any serious,
organic diseases. No link has been established between IBS and
inflammatory bowel diseases such as Crohn's disease or ulcerative colitis.
IBS does not lead to cancer. Some patients have a more severe form of IBS,
and the pain and diarrhea may cause them to withdraw from normal
activities. These patients need to work with their physicians to find the
best combination of medicine, diet, counseling, and support to control
their symptoms of irritable bowel syndrome.
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