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Irritable Bowel Syndrome (IBS) Health Center

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Irritable Bowel Syndrome

Bad Connections

Though it's not known for sure, experts believe that when you have IBS, there's a breakdown in the normal communication between your gut and your brain. Nerves in your GI tract shoot pain signals to the brain when there's nothing really wrong — just a little gas passing through, for instance. Or garbled messages may get sent from the brain to the muscles in the intestines, causing them to overcontract so food is forced through with lightning speed, triggering diarrhea. In other cases, muscle contraction slows almost to a standstill, leading to constipation.

Genes seem partly to blame for these faulty links. Hormones probably play a role, too; women with IBS outnumber men about two to one. What is clear: Though your intestines don't work right when you have IBS, they look perfectly normal if they're checked with X-rays, ultrasounds, or colonoscopies. That's why a battery of tests isn't necessary for a diagnosis — just a good medical history and physical exam — concludes a recent report from the American College of Gastroenterology.

Your symptoms are considered IBS if you have pain with bothersome bowel habits lasting for at least three months. Not every day will be bad. The ups and downs are determined, in good part, by how stressed you are, what you eat, and your menstrual cycle — about 70 percent of women say their IBS gets worse around their periods. Identifying your triggers is a crucial step to reducing flare-ups. But there are also many other ways to help yourself.

Going Natural

There are a number of Rx medications for IBS, but they work only about 30 to 40 percent of the time, says Gerard E. Mullin, M.D., director of Integrative GI Nutrition Services at the Johns Hopkins Hospital in Baltimore. Plus, "some have serious side effects," he adds. No wonder alternative therapies have gained experts' attention — research is finding that they can be highly effective. They're safe to try on your own, either individually or several at once.

Peppermint oil: This works by relaxing the smooth muscle in the intestines, reducing painful spasms. Many IBS sufferers get significant relief from the minty supplements (available in natural foods stores); they're more likely to help if you suffer from diarrhea, but "still worth a try if you have constipation," says Nicholas J. Talley, M.D., Ph.D., professor of medicine at the Mayo Clinic in Jacksonville, FL, and one of the authors of a multicenter review of peppermint oil. The dose found helpful in most studies was about a 0.2 ml gel capsule two to three times a day. It may take a week to feel better, says Dr. Talley, who also notes that if you tend to have frequent heartburn, peppermint oil may make it worse. (If so, simply stop taking.)

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