Diseases and Conditions » Irritable Bowel Syndrome

What is irritable bowel syndrome?

Irritable bowel syndrome (IBS) is a chronic (ongoing) problem with the large intestine. In people who have IBS, food moves too quickly or too slowly through the intestines. This can cause pain or discomfort (see symptoms below) and emotional distress, but it does not damage the large intestine. IBS is very common and occurs more often in women.

IBS is also called functional bowel syndrome, irritable colon, spastic bowel and spastic colon. It's not the same as inflammatory bowel diseases like ulcerative colitis.

What are the symptoms of IBS?

Common IBS symptoms

• Bloating and gas
• Mucus in the stool
• Constipation
• Diarrhea, especially after eating or first thing in the morning
• Alternating between constipation and diarrhea
• Feeling like you still need to have a bowel movement after you've already had one
• Feeling a strong urge to have a bowel movement
• Abdominal pain and cramping that may go away after having a bowel movement

The box to the right lists common symptoms of IBS. The symptoms may get worse when you're under stress, such as when you travel, attend social events or change your daily routine. Your symptoms may also get worse if you don't eat enough healthy foods or after you've eaten a big meal. Some people are bothered by certain foods. Women who have IBS may notice more frequent symptoms during their menstrual periods.

How is IBS diagnosed?

Your doctor may start by asking you questions about your symptoms. If your symptoms have had a pattern over time, the pattern may make it clear to your doctor that IBS is the cause.

If your symptoms have just started, something else may be the cause. Your doctor may need to do some tests, such as a blood test or colonoscopy, to make sure that your symptoms aren't caused by something else.

How is IBS treated?

There is no cure for IBS. The best way to handle your symptoms is to eat a healthy diet, avoid foods that seem to make you feel worse and find ways to handle your stress.

Why may fiber be helpful?

Fiber can be helpful because it improves how the intestines work. There are 2 types of fiber:

• Soluble fiber helps both diarrhea and constipation. It dissolves in water and forms a gel-like material. Many foods, such as apples, beans and citrus fruits, contain soluble fiber. Psyllium, a natural vegetable fiber, is a also a soluble fiber. You can buy psyllium supplements (some brand names: Fiberall, Metamucil, Perdiem) to drink and you can add it to other foods.
• Insoluble fiber helps constipation by moving material through your digestive system and adding bulk to your stool. Insoluble fiber is in whole grain breads, wheat bran and many vegetables.

Increase the fiber in your diet slowly. Some people feel bloated and have gas if they increase their fiber intake too quickly. Gas and bloating usually improve as you get used to eating more fiber. The best way to increase your fiber intake is eat a wide variety of high fiber foods. For more information, read the handout, "Fiber: How to Increase the Amount in Your Diet."

Do certain foods cause IBS?

No. Foods don't cause IBS. But some foods may make you feel worse. Foods that may make symptoms worse include the following:

• Drinks with caffeine, such as coffee, tea or soda
• Milk products
• Alcohol
• Chocolate
• Wheat, rye or barley

Keeping a diary for a few weeks may be a good way to find out if a food bothers you. Record what you eat and what your symptoms are. If you notice a pattern or think a food makes you feel worse, don't eat it. But don't cut out foods unless they have caused you problems more than once.

If gas is a problem for you, you might want to avoid foods that tend to make gas worse. These include beans, cabbage and some fruits.

If milk and other dairy products bother you, you may have lactose intolerance. Lactose intolerance means that your body can't digest lactose (the sugar in milk). If this seems to be the case, you may need to limit the amount of milk and milk products in your diet. Talk to your family doctor if you think you have trouble digesting dairy products.

How can stress affect IBS?

Stress may trigger symptoms in people who have IBS. Talk to your family doctor about ways to deal with stress, such as exercise, relaxation training or meditation. He or she may have some suggestions or may refer you to someone who can give you some ideas. Your doctor may also suggest that you talk to a counselor about things that are bothering you.

Can my doctor prescribe medicine for IBS?

If your symptoms are severe, your doctor may prescribe medicine to help you manage or lessen your symptoms. For example, if your main symptom is pain, your doctor may prescribe antispasmodic medicines such as hyoscyamine or dicyclomine to reduce cramping. Heating pads and hot baths can also be comforting.

If diarrhea is a frequent problem, medicine such as loperamide (brand name: Imodium) may help.

Your doctor may give you tranquilizers or sedatives for short periods to treat anxiety that may be making your symptoms worse. Your doctor may prescribe an antidepressant for you if your symptoms are severe and you are feeling depressed.

Will IBS get worse over time?

No. While IBS will probably recur throughout your life, it won't get worse. It doesn't cause cancer or require surgery, and it won't shorten your life.

What if IBS interferes with my daily activities?

IBS may have caused you to avoid doing certain things, like going out or going to work or school. While it may take some time for your efforts to pay off, you may find new freedom by following a plan that includes a healthy diet, learning new ways to deal with your stress and avoiding foods that may make your symptoms worse.

Tips on controlling IBS

• Eat a varied healthy diet and avoid foods high in fat.
• Drink plenty of water.
• Try eating 6 small meals a day rather than 3 larger ones.
• Learn new and better ways to deal with your stress.
• Avoid using laxatives. They may weaken your intestines and cause you to be dependent on them.