For me personally I found this to be a problem in my life when I took certain medications, and now that I am med free...I'm symptom free too. I even underwent a colonoscopy because of the issues I was having. I have made certain changes to my diet and that has helped as well...exercise is another change.
If you experience bouts of IBS...give thought to the following entry and what you can do for yourself to minimize the symptoms you experience. Now I'm not saying to stop taking your meds and please do not use this information to make any changes to your health care plan...but use it to open the lines of communication with your doctor and treatment team.
This information is shared for your personal use and entertainment only. Please do not self-diagnose using this information. If you have questions about what you read here please speak to a qualified medical professional.
Irritable Bowel Syndrome (IBS) Topic Overview
Irritable bowel syndrome (IBS) is a disorder of the intestines. It causes belly pain, cramping or bloating, and diarrhea or constipation. IBS is a long-term problem, but there are things you can do to reduce your symptoms.
Your symptoms may be worse or better from day to day, but your IBS will not get worse over time. IBS doesn't cause more serious diseases, such as inflammatory bowel disease or cancer.
For some people with IBS, certain foods, stress, hormonal changes, and some antibiotics may trigger pain and other symptoms.
The main symptoms of irritable bowel syndrome are belly pain with constipation or diarrhea. Other common symptoms are bloating, mucus in the stools, and a feeling that you have not completely emptied your bowels.
Many people with IBS go back and forth between having constipation and having diarrhea. For most people, one of these happens more often than the other.
IBS is quite common, but most people's symptoms are so mild that they never see a doctor for treatment. Some people may have troublesome symptoms, especially stomach cramps, bloating, and diarrhea.
Because there are no structural problems in the intestines of people who have IBS, some people may think this means that the symptoms "are all in their head." This isn't true. The pain, discomfort, and bloating are real.
Most of the time, doctors can diagnose irritable bowel syndrome from the symptoms. Your doctor will ask you about your symptoms and past health and will do a physical exam.
In some cases, you may need other tests, such as stool analysis or blood tests. These tests can help your doctor rule out other problems that might be causing your symptoms.
Treatment usually includes making changes in your diet and lifestyle, such as avoiding foods that trigger your symptoms, getting regular exercise, and managing your stress.
If diet and lifestyle changes don't help enough on their own, your doctor may prescribe medicines for symptoms such as pain, diarrhea, or constipation.
The exact cause of irritable bowel syndrome (IBS) isn't known. But health experts believe that faulty communication between the brain and the intestinal tract is one cause of symptoms. In some people, this miscommunication causes abnormal muscle contractions or spasms, which often cause cramping pain. The spasms may speed the passage of stool, causing diarrhea. Or they may slow it down, causing constipation or bloating.
Many people who have IBS seem to have unusually sensitive intestines. It isn't known why their intestines are more likely to react strongly to the elements that contribute to IBS. People who have IBS may start having symptoms because of one or more factors, including:
- Eating (though no particular foods have been linked with IBS).
- Stress and psychological issues, such as anxiety and depression.
- Hormonal changes, such as during the menstrual cycle.
- Some medicines, such as antibiotics.
- An infection in the digestive tract, such as salmonella.
- Genetics. IBS may be more likely to occur in people who have a family history of the disorder.
What Increases Your Risk IBS tends to be more common in:
- People in their late 20s.
- People who have panic disorder or other psychological conditions.
- People who have a family history of IBS.
- People who have a history of physical or sexual abuse or other psychological trauma. Several studies have found a link between a past history of abuse and gastrointestinal disorders.3
- People who have other conditions such as depression, migraine headaches, and fibromyalgia.
Symptoms Symptoms of irritable bowel syndrome include:
- Changes in bowel movement patterns.
- Bloating and excess gas.
- Pain the lower belly.
- Mucus in stools.
You are more likely to have IBS if you have these symptoms and they have lasted at least 6 months, you have had belly pain at least 3 days each month for at least 3 months, and at least two of the following are true:
- The pain is relieved by having a bowel movement.
- The pain is linked to a change in how often you have a bowel movement.
- The pain is linked to a change in the appearance or consistency of your stool.
Because there are no structural problems in the intestines of people who have IBS, some people may think this means that the symptoms "are all in their head." This isn't true. The pain, discomfort, and bloating are real. They have many different causes that can be addressed to help relieve symptoms.
Bowel movement patterns
When you have IBS, your pattern of bowel movements may be different over time. Two or more of the following may happen:
- Bowel movements may occur either more often (diarrhea) or less often (constipation) than usual. For example, you may have more than 3 bowel movements a day or less than 3 a week.
- Bowel movements may differ in size or consistency. They may be hard and small, pencil-thin, or loose and watery.
- The way stools pass changes. You may strain, feel an urgent need to have a bowel movement, or feel that you haven't completely passed a stool.
- You may have bloating or a feeling of gas in the intestines.
Other intestinal symptoms
Some people may have pain in the lower belly with constipation that is sometimes followed by diarrhea. Other people have pain and mild constipation but no diarrhea.
Some people have intestinal gas and passage of mucus in stools.
You may sometimes have other symptoms that don't affect the intestines, such as:
- Anxiety or depression.
- An unpleasant taste in the mouth.
- Sleep problems (insomnia) not caused by symptoms of IBS.
- Sexual problems, such as pain during sex or reduced sexual desire.
- Heart palpitations. (You may feel like your heart skips a beat or is fluttering.)
- Urinary symptoms. (You may have a frequent or urgent need to urinate, trouble starting the urine stream, or trouble emptying your bladder.)
Symptoms often occur after a meal, during stressful times, or during menstruation.
Types of Irritable Bowel Syndrome (IBS)
There are three types of irritable bowel syndrome, or IBS. They include:
- IBS with constipation. This comes with stomach pain and discomfort, bloating, abnormally delayed or infrequent bowel movement, or lumpy/hard stool.
- IBS with diarrhea. This comes with stomach pain and discomfort, an urgent need to move your bowels, abnormally frequent bowel movements, or loose/watery stool.
- IBS with alternating constipation and diarrhea.
There are about an equal number of people with IBS in each category. There is also evidence that most people with IBS will alternate between types over time.
This all makes it difficult for researchers to find a single drug treatment that will relieve all the symptoms of IBS. Different medications work for IBS with constipation and for IBS with diarrhea. Doctors will usually tailor an individual treatment regimen for people who have IBS with alternating symptoms.
People with alternating IBS symptoms should not try to treat themselves, says J. Patrick Waring, MD, a gastroenterologist at Digestive Health Care of Georgia.
"They should not take something for their constipation on their own, and then when they get diarrhea, take something for their diarrhea, and go back and forth," he says. "That can actually exacerbate the problem."
Exams and Tests
Irritable bowel syndrome (IBS) can be diagnosed based on symptoms. A doctor diagnoses IBS when a person has the typical symptoms of the disorder and, if needed, tests have ruled out other possible causes.
Most people won't need tests, but some people may because of their age and symptoms. The amount of testing you get depends on several things: your age, how your symptoms come on and how severe they are, and how you respond to your first treatment. For example, a 20-year-old might not need tests. But a 50-year-old with new symptoms might need tests because of the higher risk of colon cancer in people over 50.
Tests may include:
- Medical history and physical exam.
- A blood test for celiac disease.
- Complete blood count (CBC).
- Sedimentation rate, which checks for inflammation in the body.
- Stool analysis.
Thyroid function tests and other tests, such as colonoscopy, are sometimes done.
Treatment for irritable bowel syndrome (IBS) will depend on the types of symptoms you have, how severe they are, and how they affect your daily life. No single type of treatment works best for everyone.
Learn all you can about IBS so that you and your doctor can work together to find out what may be triggering your symptoms. You will need to adapt your lifestyle to best deal with your symptoms and still carry on with your daily activities. Let your doctor know if parts of your treatment aren't helping your symptoms.
Record your symptoms
The first step in treating IBS usually involves watching and recording your symptoms, your bowel habits, what you eat, and other daily activities (such as exercise) that affect your symptoms. Writing all this down in a notebook for a few weeks can help you and your doctor see patterns of symptoms in your daily life. You may be able to see what things make your symptoms worse (such as eating dairy products) and start to avoid them.
Manage your symptoms
For some people who have IBS, certain foods may trigger symptoms. These tips may help prevent or relieve some IBS symptoms:
- Limit caffeine and alcohol.
- Limit your intake of fatty foods.
- If diarrhea is your main symptom, limit dairy products, fruit, and artificial sweeteners such as sorbitol or xylitol.
- Increase fiber in your diet to help relieve constipation.
- Avoid foods such as beans, cabbage, or uncooked cauliflower or broccoli to help relieve bloating or gas.
Here are some other steps you can take to help your symptoms:
- Get some exercise, such as swimming, jogging, cycling, or walking. It can also improve your quality of life (especially how well you sleep, your energy level, and your emotional and social life).4
- Quit smoking, if you smoke.
- Take medicines. You may need medicine for cramping, diarrhea or constipation, depression, or anxiety.
- Reduce stress, if stress seems to trigger symptoms.
To learn more, see Home Treatment.
Watch for new symptoms
Because IBS is a long-term problem, it's important for you to be aware of big changes in symptoms. For example, watch for blood in your stools, increased pain, severe fever, or unexplained weight loss. If any of these occur, your doctor may want to do more tests to find out if there is another cause for your symptoms.
Your doctor may also want you to try different medicines, or different dosages of your current medicines, if your symptoms aren't responding to treatment.
For most people who have irritable bowel syndrome (IBS), home treatment may be the best way to manage the symptoms. It is also helpful to learn all you can about IBS so you can better share your concerns and questions with your doctor.
Careful attention to diet, exercise, and stress management should help keep your symptoms under control. They may even prevent your symptoms from coming back.
Diet In many people who have IBS, eating may trigger symptoms. But for most people, there is not a certain type of food that triggers symptoms.
Increasing the amount of fiber in your diet can help control constipation. High-fiber foods include fresh fruits (raspberries, pears, apples), fresh vegetables (carrots, leafy greens), wheat bran, and whole-grain breads and cereals. Beans such as kidney, pinto, and garbanzo are also high-fiber foods. (So are vegetables such as peas, cabbage, and broccoli.) But they should probably be avoided if gas is one of your symptoms.
If you have trouble getting enough fiber in your diet, you can take a fiber supplement such as psyllium (for example, Metamucil) or wheat dextrin (for example, Benefiber). If you take a fiber supplement, start with a small dose. Then very slowly increase the dose over a month or more. Also, make sure to drink plenty of fluids, enough so that your urine is light yellow or clear like water.
You can take steps to make it less likely that certain foods will cause symptoms. For example, avoid or limit gas-producing foods (including beans and cabbage), sugarless chewing gum and candy, caffeine, and alcohol.
Getting more exercise can make your symptoms less severe. Exercise also can improve your quality of life (especially how well you sleep, your energy level, and your emotional and social life).4
Getting more exercise doesn't have to be hard. In one study, people with IBS increased their activity level by adding 20 to 60 minutes of moderate to vigorous-intensity physical activity, 3 to 5 days a week. They did activities such as swimming, jogging, cycling, and walking.
In the group that did not increase their activity level, more people had an increase in their IBS symptoms. These people weren't active, and their symptoms got worse.
If stress seems to trigger your symptoms, these tips may help you better manage stress and avoid or ease some IBS episodes:
- Keep a diary or journal of your symptoms as well as life events that occur with them. This often helps clarify the connection between symptoms and stressful occasions. After you have identified certain events or situations that bring on symptoms, you can find ways to deal with these situations.
- Get regular, vigorous exercise (such as swimming, jogging, or brisk walking) to help reduce tension.
- A hobby or an outside activity can provide a break from stressful situations.
- Find a support group. In a support group, you can share with other people who have IBS.
- Psychiatrists, psychologists, hypnotists, counselors, social workers, and biofeedback specialists can provide methods for coping with stress.
Medicine may be used along with lifestyle changes to manage symptoms of irritable bowel syndrome (IBS). It may be prescribed to treat moderate to severe pain, diarrhea, or constipation that does not respond to home treatment.
Medicine can help relieve your symptoms enough to prevent them from interfering with your daily activities. It may not be possible to eliminate your symptoms.
In most cases, the choice of medicine is based on your most troublesome symptom. For example, if diarrhea is the most bothersome symptom, using antidiarrheals or anticholinergics may be helpful.
Few medicines have proved consistently helpful, and all medicines have side effects. So medicine should be used for specific symptoms that disrupt your normal daily activities.
If you also have another illness, such as depression, that triggers symptoms of irritable bowel syndrome, medicine for that illness may be needed.
Medicines that may be used to treat severe diarrhea that does not improve with home treatment include:
- Antidiarrheals, including atropine and diphenoxylate (such as Lomotil) and loperamide (such as Imodium).
- Bile acid binding agents, including cholestyramine (such as Prevalite).
- Rifaximin (Xifaxan), which has been shown to help people who have diarrhea and bloating as their worst symptoms. In one study, people who had fewer symptoms after 2 weeks of taking rifaximin continued to have fewer symptoms for 10 weeks after stopping the medicine. But rifaximin is very expensive, and more research needs to be done. There are still many questions about this treatment, including who will get the most benefit, how long the effect will last, and whether retreatment will work when symptoms come back.
- Alosetron (Lotronex), which is used for some women who have severe diarrhea. This medicine has been shown to contribute to ischemic bowel disease. Specific guidelines for the use of alosetron require doctors who prescribe it to sign a certificate and patients to sign a consent form.
There are many medicines for severe constipation that doesn't improve with home treatment. Most of these medicines are available without a prescription and are okay to take once in a while. Check with your doctor before you use any of these medicines every day for constipation. Medicines for constipation include:
- Osmotic laxatives (such as Milk of Magnesia and nonabsorbable sugars such as lactulose).
- Polyethylene glycol (such as MiraLax).
- Stimulant laxatives (such as Senokot).
- Linaclotide (Linzess).
- Lubiprostone (Amitiza).
Pain and cramping
The following medicines may be used for long-term pain and cramping:
- Anticholinergics (antispasmodics). These include dicyclomine(Bentyl).
- Antidepressants, including desipramine (such as Norpramin). In low doses, they can help with pain caused by IBS.
The following medicines may be used if your IBS causes you to have anxiety or depression:
- Antidepressants, including fluoxetine (such as Prozac). They are especially helpful if you have depression and IBS.
- Antianxiety agents, including diazepam (such as Valium). These can be used short-term to help with anxiety if it makes your IBS symptoms worse.
Surgery is not an option for IBS
WebMD Medical Reference from Healthwise
Last Updated: November 05, 2012
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