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What is IBS?

| April 1, 2016


Learn The Symptoms, Causes And Treatments

Irritable bowel syndrome (IBS) affects up to 10-15 percent of adults. It has a significant worldwide prevalence. Although IBS is not associated with an increased risk for life-threatening illness, it is associated with a significant health care and economic burden.

Studies have shown that IBS patients have an increased number of outpatient health care visits, diagnostic tests and surgeries. IBS can also severely compromise a person’s quality of life. IBS is second only to the common cold as a cause of absenteeism from work.


Understanding IBS

IBS is best understood as a long-term or recurrent disorder of gastrointestinal (GI) functioning. It usually involves the large intestine (colon) and small intestine with disturbances of intestinal/bowel (gut) motor function (motility) and sensation.

These gut related activities are regulated by the brain. This may also be impaired, which is why IBS is often called a brain-gut disorder.


Symptoms of IBS

Individuals with IBS may either have mostly diarrhea, mostly constipation, or both diarrhea and constipation (mixed pattern). The pain is often relieved by having a bowel movement and can at times be worsened after eating.

Symptoms can change over time. There can be periods when symptoms flare up as well as periods of remission when they diminish or disappear.

In addition, the main bowel habit can vary over time. For example, some people that suffer mainly from constipation (or diarrhea) may later experience a change to constipation alternating with diarrhea.

Other common symptoms of IBS include:

  • bloating (a sensation of fullness in the belly),
  • urgency (the need to use a restroom in a hurry),
  • mucus (white or yellow liquid) in the stool, and
  • the sensation of incompletely passing stools.

The typical features of IBS are generally recognizable by a physician. Usually the physician will examine the abdomen of a patient with IBS and it will be normal or have tenderness. A rectal examination is also done to evaluate the functioning of the rectal floor muscles, particularly if there is incontinence or severe constipation with straining.

The most important first step is to confidently recognize the diagnosis of IBS and remove the suspicion of other diseases.


Causes of IBS

The cause of irritable bowel syndrome is not completely understood. There are possible factors like genetics and prior adverse life experiences (e.g., infection, trauma) that can predispose someone to get IBS.

The symptoms appear to result from disturbances in colonic motility (muscle contractions) and increased sensitivity to food, gas, or stool in the bowel.

Finally, there is a tendency for the bowel to be overly reactive to various factors, which can amplify or bring about the symptoms. Examples include eating, stress, emotional arousal, GI infections, menstrual period or gaseous distension.

Brain-gut interactions: The altered patterns of colonic motility and sensation appear to be due to disruptions in the communication between the brain and gut. This interaction is known as the brain-gut axis. These interactions between the brain and gut are important in maintaining normal bowel function. They also respond to any potential disturbance or stressor.

In IBS, normal regulation of the brain-gut interactions become altered, which leads to changes in motility and sensation within the bowel. There are a number of factors that may play a role in the alteration in the brain-gut axis, including:

  • A genetic predisposition (e.g., family history) to developing IBS
  • An intestinal infection prior to symptom onset
  • Chronic stressful life events, or other psychosocial factors

Some of these factors may be more relevant in one individual with IBS, while other factors may be more important in another.


What are treatment options for IBS?

The key to achieving relief for IBS is to embrace the understanding that it is a complex motility (motor) and sensory disorder. It may have physical and stress-related dimensions.

A strong partnership between a knowledgeable patient and an empathetic, knowledgeable health care provider can produce significant improvement and control over symptoms for individuals with IBS.

The first line of treatment for IBS includes general measures such as:

  • establishing an effective patient-physician relationship,
  • obtaining education about IBS, and
  • implementing lifestyle changes, which may be associated with symptoms

Lifestyle changes: The term lifestyle refers to things in your life you have control over. For example, evaluate any dietary or stress-related factors that may be related to symptoms and discuss these with a health care provider. If certain foods set off or worsen symptoms, reduce or avoid them. If the abdominal discomfort or pain occurs after eating, it may be helpful to eat smaller and more frequent meals.

Increased stress may result in the onset or worsening of IBS symptoms and associated non-bowel symptoms such as fatigue or low energy. Proper rest and exercise can help reduce stress levels and positively influence IBS.

Remember that having IBS is also a stress and learning more about the disorder, communicating effectively with your health care provider, and taking more of a role in your self-care can reduce that stress.

Medicines: If lifestyle changes do not completely relieve IBS symptoms, a number of medications may be helpful, including. antispasmodics, anti-diarrheal agents, laxatives and anti-anxiety medications. A thorough evaluation by a physician is an important step toward selecting the treatment that is most appropriate for your individual circumstances. Regardless of the treatment therapy, always discuss it thoroughly with your doctor so you are familiar with the therapy or method, are aware of alternatives, understand the risks as well as benefits and know what to do if side effects occur or symptoms return.

Individuals who have not responded to lifestyle changes and careful use of medications should consider being evaluated by a physician who specializes in functional GI and motility or stress-related GI disorders. More complex medication regimens and specialized screening can reveal specific conditions which may respond to treatment.

Learn More

To learn much more about IBS, visit aboutibs.org.

Courtesy of the International Foundation for Functional Gastrointestinal Disorder

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