Irritable bowel syndrome
What is it?
Irritable bowel syndrome (IBS) is also called spastic colon or mucous colitis. It is a common problem of the bowel (intestines). With IBS, food does not move through the bowel normally. The food may be pushed through the bowel too slowly or too quickly. The bowel is the long tube that connects the stomach with the anus. The anus is the opening where bowel movements (BM) pass from the body. With IBS, the normal contractions of the bowel are painful.
IBS is more common in people under 35 years. Women get IBS more than men. You may have it on and off during your lifetime but symptoms sometimes go away as you age. IBS cannot be cured but it can be controlled.
It is not known for sure what causes IBS. Following are possible causes of IBS:
- The bowel does not work correctly. The muscle contractions in the bowel may not be normal. A contraction is the gentle squeezing motion of the bowel to move food through the digestive system.
- Stress, anxiety, and depression may cause changes in how fast or slow the bowel moves.
- Eating certain foods may also change the speed at which your bowel moves food. Some foods may make your symptoms worse.
Signs and Symptoms:
The signs and symptoms of IBS may come and go any time. You may have one or more of the following signs and symptoms:
- Abdominal (belly) bloating and gas.
- Lower abdominal pain and cramps that may be worse after eating and better or gone after having a BM.
- Diarrhea (loose runny BMs) or constipation (hard formed BMs) or both. You may feel like you need to pass more BM even though you just finished having a BM.
Try to decrease the stress in your life as it can make your IBS symptoms worse. Aerobic exercise is a good way to reduce stress.
- Antispasmodic medicines can decrease cramps and spasms in the bowel. This medicine may cause dry mouth, sleepiness, or other side effects.
- Antianxiety medicines may be helpful to control anxiety or emotional stress. This medicine may also be habit forming.
- Other medicines may be used to decrease gas, diarrhea, or constipation.
- Eating high fiber foods may control your symptoms. Fiber tends to decrease constipation and diarrhea. Some patients complain that eating high fiber foods causes more bloating, cramping, and gas. This is more likely to be a problem if there are sudden changes in the diet. Due to the problems that may happen in IBS with high fiber diets, it is best to make these changes slowly.
- Do not eat foods that cause diarrhea, cramping, or make your BMs too hard or too runny. Keep a daily food diary. Slowly begin to remove one food at a time from your diet to learn if it is causing problems. You may do better eating some foods that are cooked rather than eating them raw. Some food may be tolerated alone but not when combined with other foods.
Herbs and Supplements:
Before taking any herbs or supplements, ask your caregiver if it is OK. Talk to your caregiver about how much you should take. If you are using this medicine without instructions from your caregiver, follow the directions on the medicine label. Do not take more medicine or take it more often than the directions tell you to. The herbs and supplements listed may or may not help treat your condition.
Research has shown that acupuncture, biofeedback, and hypnosis can decrease IBS symptoms.
Recommended Screening Tests/Exams:
Your BM may need to be tested for blood, abnormal bacteria, or parasites. You may also have blood tests and bowel x-rays.
Other ways of treating your symptoms : Other ways to treat your symptoms are available to you.
Talk to your caregiver if:
- You would like medicine to treat IBS.
- Your symptoms have not gone away or improved by these self-help measures.
- You have questions about what you have read in this document.
SEEK CARE IMMEDIATELY IF:
- You see bright red flecks in your BMs or your BMs are black.
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care will be used to treat you. You always have the right to refuse treatment.
1. Arfmann S, Andersen JR, Hegnhoj J et al. Irritable bowel syndrome treated with wheat bran-a controlled, double-blind trial. Scand J Gastroenterol 1983;18 (S86):3.
2. Bennett EJ, Tennant CC, Piesse C et al: Level of chronic life stress predicts clinical outcome in irritable bowel syndrome. Gut 1998; 43(2):256-261.
3. Blanchard EB, Schwarz SP, Suls JM et al: Two controlled evaluations of multicomponent psychological treatment of irritable bowel syndrome. Behav Res Ther 1992; 30(2):175-189.
4. Bohmer CJ & Tuynman HA: The clinical relevance of lactose malabsorption in irritable bowel syndrome. Eur J Gastroenterol Hepatol 1996; 8(10):1013-1016.
5. Cann PA, Read NW & Holdsworth CD. What is the benefit of coarse wheat bran in patients with irritable bowel syndrome? Gut 1984; 25:168-173.
6. Chan J, Carr I & Mayberry JF: The role of acupuncture in the treatment of irritable bowel syndrome: a pilot study. Hepatogastroenterology 1997; 44(17):1328-1330.
7. Collins MD & Gibson GR: Probiotics, prebiotics, and synbiotics: approaches for modulating the microbial ecology of the gut. Am J Clin Nutr 1999; 69(5):1052S-1057S.
8. Collins SM, Barbara G & Vallance B: Stress, inflammation and the irritable bowel syndrome. Can J Gastroenterol 1999; Suppl AO:47A-49A
9. Cotterell CJ, Lee AJ & Hunter JO: Double-blind cross-over trial of evening primrose oil in women with menstrually-related irritable bowel syndrome. In: Omega-6 Essential Fatty Acids: Pathophysiology and Roles in Clinical Medicine. Alan R Liss, New York, NY; 1990.
10. Dancey CP, Taghavi M & Fox RJ: The relationship between daily stress and symptoms of irritable bowel: a time-series approach. J Psychosom Res 1998; 44(5):537-545.
11. Friedman G: Diet and the irritable bowel syndrome. Gastroenterol Clin North Am 1991; 20(2):313-324.
12. Friedman G: Nutritional therapy of irritable bowel syndrome. Gastroenterol Clin North Am 1989; 18(3):513-524.
13. Friedman G: Treatment of the irritable bowel syndrome. Gastroenterol Clin North Am 1991; 20(2):325-333.
14. Goldberg J & Davidson P: A biopsychosocial understanding of the irritable bowel syndrome: a review. Can J Psychiatry 1997; 42(8):835-840.
15. Liu JH, Chen GH, Yeh HZ et al: Enteric-coated peppermint oil capsules in the treatment of irritable bowel syndrome: a prospective, randomized trial. J Gastroenterol 1997; 32(6):765-768.
16. McHardy G: Management of chronic constipation and "irritable bowel syndrome": a clinical test. J La State Med Soc 1971; 123(12):405-408.
17. Niedzielin K, Kordecki H & Birkenfeld B: A controlled, double-blind, randomized study on the efficacy of Lactobacillus plantarum 299V in patients with irritable bowel syndrome. Eur J Gastroenterol Hepatol 2001; 13(10):1143-1147.
18. Nobaek S, Johansson ML, Molin G et al: Alteration of intestinal microflora is associated with reduction in abdominal bloating and pain in patients with irritable bowel syndrome. Am J Gastroenterol 2000; 95(5):1231-1238.
19. Pittler MH & Ernst E: Peppermint oil for irritable bowel syndrome: a critical review and meta-analysis. Am J Gastroenterol 1998; 93(7):1131-1135.
20. Prior A & Whorwell PJ: Double-blind study of ispaghula in irritable bowel syndrome. Gut 1987; 28(11):1510-1513.
21. Roth DL & Holmes DS: Influence of aerobic exercise training and relaxation training on physical and psychologic health following stressful life events. Psychosom Med 1987; 49(4):355-365.
22. Volz HP & Kieser M: Kava-kava extract WS 1490 versus placebo in anxiety disorders-a randomized placebo-controlled 25-week outpatient trial. Pharmacopsychiatry 1997; 30(1):1-5.
Last Updated: 6/4/2018