McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
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What is irritable bowel syndrome?

Irritable bowel syndrome (IBS) is a chronic (long-lasting) disorder of the large intestine (colon). It is the most common gastrointestinal disorder. It affects twice as many women as men and usually begins in early adult life. Although IBS can cause much distress, it does not lead to life-threatening disease.

Another term for IBS is spastic colon.

How does it occur?

The cause of IBS is not fully understood. Most symptoms of IBS probably result from abnormal muscle movement or spasm of the lower part of the colon. Sometimes the spasm delays bowel movements. At other times it may lead to more rapid passage of bowel movements, resulting in diarrhea. In either case the spasm usually causes abdominal cramps.

A specific food may trigger attacks. Spasms may also be triggered by stress or depression because muscle movement in the colon is controlled by the nervous system.

What are the symptoms?

The most common symptoms include:

• cramping and pain in the abdomen, which may be severe
• constipation or diarrhea
• a lot of gas.

Other symptoms include:

• bloating
• a feeling of fullness in the rectum.

Symptoms often occur after you've eaten a big meal or when you are under stress. Your symptoms may be temporarily relieved by having a bowel movement.

How is it diagnosed?

After taking your medical history, your health care provider will examine your abdomen and may do a rectal exam.

There is no specific test for IBS. Depending on your history and exam, your provider may do the following tests to look for other possible causes of your symptoms:

• tests of bowel movement samples to check for blood and infection
• x-rays
• colonoscopy or sigmoidoscopy (procedures that allow your provider to see the inside of your colon with a thin, flexible tube and tiny camera)
• barium enema (a procedure in which a special liquid is passed into the colon through the rectum before x-rays are taken) to check the colon lining
• blood tests.

Your health care provider may ask you to try a milk-free diet to see if lactose intolerance (trouble digesting milk) may be causing your symptoms.

How is it treated?

Doctors have not yet found a cure for IBS. However, controlling the diet and emotional stress usually relieves the symptoms. Some medicines may also help.

• Diet

  Increasing the fiber in your diet often helps, although sometimes a decrease in fiber is needed. Try eating smaller meals more often. Avoid gas-producing foods such as cabbage.

• Food diary

  Your health care provider may ask you to keep a food diary to see if eating a particular food, for example, milk or sausage, worsens your symptoms.

• Stress

  Your provider will help you identify things that cause stress in your life and will suggest ways to help you control them. Relaxation or biofeedback techniques may help you manage stress.

• Medicines

  Your provider may prescribe a combination of bulk-forming agents (such as bran or methylcellulose), antispasmodic drugs, and tranquilizers or antidepressants.

How long will the effects last?

Because IBS is a chronic disorder, you may have flare-ups of symptoms throughout your life. Although a cure hasn't been found yet, the disorder can usually be controlled. IBS will not progress to something worse.

How can I take care of myself?

Follow these guidelines to relieve the symptoms of IBS:

• Learn stress-management techniques to reduce stress and anxiety in your life. Professional counseling may be helpful.
• Drink six to eight 8-ounce glasses of water a day.
• Do not drink alcohol, which can make symptoms of IBS worse.
• Select your foods carefully. If a food appears to bring on your symptoms, avoid it. However, don't eliminate a food just because it appears to cause symptoms one time. Be sure that a food produces symptoms several times before you give it up. You should try to keep many different foods in your diet because a varied diet provides better nutrition.
• Ask your health care provider if you should have a high-fiber diet, especially if you tend to be constipated. High-fiber foods may cause gas and bloating, but usually these symptoms lessen as the digestive tract gets used to the increased fiber. Some high-fiber foods include:
  • whole-grain breads and cereals
  • fruits, especially apricots, blackberries, coconut, dates, figs, kiwi, peaches, pears, pineapple, prunes, raspberries, and strawberries
  • nuts, especially almonds, pistachios, and walnuts
  • vegetables, particularly Brussels sprouts, corn and popcorn, broccoli, and parsley
  • beans and lentils.
• Ask your health care provider about using a nonprescription fiber supplement.
• Eat smaller meals more frequently. Eat smaller portions of foods at a meal.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.