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Irritable Bowel Syndrome (IBS)

What is Irritable Bowel Syndrome?

Irritable Bowel Syndrome (IBS) is a condition in which the bowels (colon and small intestine) do not function properly. There is an important distinction between a syndrome and a disease.

In short, a set of symptoms that do not point to a specific disease is a syndrome. This is important because diseases are diagnosed health conditions. They have characteristics like causes, treatments and methods that allow a physician to diagnose and treat the causes of the symptoms. When a doctor finds a true impairment of the function of a system in the body, that is a disease. But when a physician is told of certain symptoms, yet there is no diagnosis of an actual disease, that is referred to as a syndrome. And in the case of a syndrome, until an underlying disease is determined, treatment can be very difficult.

Classifying your IBS

IBS is often classified into four subtypes based on a person's usual stool consistency. These subtypes are important because they affect the types of treatment that are most likely to improve the person's symptoms.

The four subtypes of IBS are:

  • IBS with constipation (IBS-C)
    • hard or lumpy stools at least 25% of the time
    • loose or watery stools less than 25% of the time
  • IBS with diarrhea (IBS-D)
    • loose or watery stools at least 25% of the time
    • hard or lumpy stools less than 25% of the time
  • Mixed IBS (IBS-M)
    • hard or lumpy stools at least 25% of the time
    • loose or watery stools at least 25% of the time
  • Unsubtyped IBS (IBS-U)
    • hard or lumpy stools less than 25% of the time
    • loose or watery stools less than 25% of the time

Source - nih.gov

Other names for IBS

Over the years, IBS has had a few different names:

  • spastic colon
  • nervous colon
  • colitis

Eventually doctors realized that these were each manifestations of the same syndrome, and thus named it accordingly.

Symptoms of Irritable Bowel Syndrome

Some symptoms that could be indicative of IBS include:

  • a change in the frequency of bowel movements
  • a change in the appearance and or texture of your stools
  • pain or discomfort that goes away after one or more bowel movements
  • diarrhea, constipation or incomplete bowel movements
  • bloating
  • passing mucus in your bowel movements

If a person experiences one or more of these symptoms multiple times during a month, especially if over multiple months, his/her physician should be consulted.

Causes of IBS

It may be that the cause of IBS is both physical and mental:

  • Motility – slower movement of food causes constipation, whereas faster motility can cause diarrhea
  • Infections – bacterial gastroenteritis may irritate the lining of the stomach and intestines
  • Too much bacteria in the small intestine
  • Genetics and family history
  • The brain – nerves in the stomach control a lot of the actions of digestions
  • Diet
  • Coffee and alcohol, as well as foods that are rich in carbohydrates and fat, may also contribute.

Diagnosis of IBS

  • Colonoscopy – visually examine the colon and intestine
  • Flexible Sigmoidoscopy – examine the colon and rectum
  • Stool sample tests – check for blood and or parasites
  • Lower GI series – an x-ray of the large intestine

Treatment of IBS

  • A change in diet and eating habits
  • Avoiding foods that do, or may, trigger an attack, such as:
    • fatty foods
    • certain dairy products
    • alcohol and caffeine
    • artificial sweeteners
    • foods that cause gas or bloating, like beans, and cabbage
  • Probiotics may be introduced to aid in digestion

Also, an individual's mental health can also be a factor. This is referred to as a mind-gut connection. Relieving stress and anxiety are important when dealing with irritable bowel syndrome.

The subject of mental health always brings with it the stigma of mental illness, but IBS is not a mental illness, and it is not some imagined illness. Stress and anxiety cause the human body to operate differently. Counseling can provide you with tools to control stress and anxiety, and should be seriously considered.

Diet and IBS

A person's diet and nutrition will need to be modified to see what is triggering his/her symptoms. In general, the following suggestions may make IBS sufferers less prone to attacks, but they will need to experiment to see what makes them feel better:

  • don't eat big meals; smaller portions are easier on the digestive system
  • eat more often, and eat less
  • eat balanced meals; that is, vegetables, fruits, cereals, and some meat
  • if constipated, more dietary fiber should be added to one's diet; but add it slowly, as fiber may be a trigger for symptoms

IBS Medications

Some medications that are often suggested or prescribed include:

  • Fiber supplements and laxatives which help relieve constipation
  • Loperamide which helps control diarrhea
  • Antispasmodics which help relieve abdominal pain
  • Lubisprostone and Linaclotide which aid in relieving abdominal pain due to constipation
  • Antidepressants

Points to remember about IBS

  • IBS is not a disease. You cannot take a pill that will make it go away.
  • People with IBS respond differently to different treatments. Some get better simply by modifying their diet. Some need to learn to control stress. Some may even need medication.
  • Modifying one's diet may contribute a lot to feeling better.
  • Controlling IBS takes time. Patience is important.