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Irritable Bowel Syndrome (IBS) Health Center

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Frequently Asked Questions About Irritable Bowel Syndrome (IBS)

  • What is irritable bowel syndrome (IBS)?
  • Answer:

    Irritable bowel syndrome, also called IBS, is a term used to describe discomfort in the bowel (the colon or large intestine). Symptoms of IBS may include cramping, bloating, gas, mucus in the stool, and changes in bowel habits. Some people with IBS have constipation -- infrequent stools that may be hard, dry, and painful. Others have diarrhea -- frequent loose stools. Some people have alternating constipation and diarrhea. Sometimes, a person with IBS has the urge to move the bowels but cannot do so.

  • Do IBS patients have bloody stools?
  • Answer:

    Sometimes IBS is confused with inflammatory bowel diseases such as ulcerative colitis. But IBS is not a disease and does not cause inflammation, bleeding, damage to the bowel, cancer, or other serious diseases. It is called a functional disorder, which means that there is no sign of disease when the colon is examined, but the bowel doesn't work as it should. The cause of IBS is not known and there is currently no cure.

  • Who gets IBS?
  • Answer:

    IBS is a common problem, affecting up to one in five people. However, estimates of the number of people with IBS vary. The majority of people with IBS (perhaps 75%) are women. IBS often begins in the teen years or young adulthood but can affect people of any age.

  • What are the symptoms of IBS?
  • Answer:

    Symptoms of IBS may include:

    • Stomach cramps
    • Constipation
    • Diarrhea
    • Alternating constipation and diarrhea
    • Feeling that you haven't finished a bowel movement
    • Gas
    • Bloating
    • Mucus in the stool  

    Often, IBS is just a mild annoyance, but for some people it can be disabling. They may be unable to go to social events, work, or travel even short distances. Most people with IBS, however, are able to control their symptoms through diet, stress management, and medication.

  • What causes IBS symptoms?
  • Answer:

    Researchers have found that, for unknown reasons, the colons of people with IBS are more sensitive than usual and react to things that would not bother other people. For example, the muscles of the colon may contract too much after eating. These contractions can cause cramping and diarrhea during or shortly after a meal. The nerves of the colon can be overly sensitive to the stretching of the bowel (because of gas, for example), causing cramping or pain. Diet and stress play a role in IBS for many people, causing symptoms or making them worse.

    In women, IBS symptoms may be worse during their menstrual periods, so hormone changes may be involved. Sometimes, IBS symptoms appear after another illness.

  • How is IBS diagnosed?
  • Answer:

    IBS is usually diagnosed after bowel disease has been ruled out. Your doctor will probably take a complete medical history, do a physical exam, and check for blood in your stool. Other diagnostic tests such as blood tests, X-rays, or a colonoscopy (viewing the colon through a flexible tube inserted through the anus) may be done if needed.

  • How do diet and stress affect IBS?
  • Answer:

    In people with IBS, diet and stress often seem to cause symptoms. Many people report that their symptoms occur after a meal or when they are under stress.

    Eating causes contractions or spasms 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. Contractions may be stronger after a large fatty meal. Many people with IBS learn to avoid certain foods, beverages, and medicines that seem to make their symptoms worse.

    Stress can cause contractions of the colon in people with IBS. The reasons for this are not clear, but scientists point out that the colon is controlled partly by the nervous system. Learning relaxation methods and other ways to reduce stress can be helpful. Counseling and support help relieve IBS symptoms in many people.

  • What foods may cause IBS symptoms?
  • Answer:

    Some foods that may cause symptoms include:

    • Fatty foods like french fries
    • Milk products like cheese or ice cream (especially in people who have trouble digesting lactose, or milk sugar)
    • Chocolate
    • Alcohol
    • Caffeine (found in coffee, tea, and some sodas)
    • Carbonated drinks like soda
    • Sorbitol, a sweetener found in certain foods and in some chewing gums
    • Gas-producing foods such as beans and certain vegetables like broccoli or cabbage

    You may want to keep a journal tracking the foods that seem to cause trouble. You also may want to consult a registered dietitian, who can help you make changes in your diet.

  • What can I do to help my IBS besides avoiding problem foods and beverages?
  • Answer:

    Drinking lots of water and increasing your fiber intake may help, especially if constipation is a problem. Fiber is found in bran, bread, cereal, beans, fruits, and vegetables. It's a good idea to increase the fiber in your diet gradually to avoid causing gas and pain. Many people with IBS also use a fiber supplement to add soluble fiber, often from psyllium seeds, to the diet.

  • What drugs are used to treat IBS?
  • Answer:

    Drugs sometimes used for IBS symptoms include:

    • Fiber supplements and occasional use of laxatives (for constipation)
    • Antispasmodics -- drugs that control colon muscle spasms and help with diarrhea and pain
    • Tranquilizers and antidepressants to help with stress, anxiety, and depression
    • Alosetron (Lotronex) -- a drug called a nerve receptor antagonist, only for those with diarrhea-predominant IBS; this drug has severe potential side effects and was removed from the market for awhile. It is now prescribed only by gastroenterologists -- doctors who specialize in the gastrointestinal system -- who have expertise in its use.
    • Lubiprostone (Amitiza) -- a medicine for patients over age 18 who have severe constipation resistant to all other therapies; it increases fluid secretion in the small intestine to make stool passage easier. Side effects can include diarrhea, nausea, and abdominal pain.
    • Linaclotide (Linzess) -- a capsule taken once daily on an empty stomach, at least 30 minutes before the first meal of the day; Linzess helps relieve constipation by helping bowel movements occur more often. The drug should not be taken by those ages 17 and younger. The most common side effect is diarrhea.  

    Be sure to follow your doctor's instructions for use of all medicines. Some IBS drugs, including laxatives, can be habit-forming, and all drugs have side effects. Tell your doctor about any over-the-counter medications that you use. New drugs are being developed for IBS, so ask your doctor about new treatments.

WebMD Medical Reference

Reviewed by Michael Dansinger, MD on December 29, 2013

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