Irritable Bowel Syndrome

Fact: IBS affects about twice as many women as men.

What is IBS?
IBS is also known as spastic colon, irritable colon, mucous colitis, and spastic colitis. It is a separate condition from inflammatory bowel disease and isn’t related to other bowel conditions. IBS is a group of intestinal symptoms that typically occur together. The symptoms vary in severity and duration from person to person. However, they last at least three months for at least three days per month. 
IBS can cause intestinal damage in some cases. However, that is not common. 
IBS doesn’t increase your risk of gastrointestinal cancers, but it can still have a significant effect on your life.

What Are the Symptoms of IBS?
People with IBS have symptoms that can include:

  • Diarrhea (often described as violent episodes of diarrhea)
  • Constipation
  • Constipation alternating with diarrhea
  • Belly pains or cramps, usually in the lower half of the belly, that get worse after meals and feel better after a bowel movement
  • A lot of gas or bloating
  • Harder or looser stools than normal (pellets or flat ribbon stools)
  • A belly that sticks out

Stress can make symptoms worse. Some people also have urinary symptoms or sexual problems.

There are four types of the condition. There is IBS with constipation (IBS-C) and IBS with diarrhea (IBS-D). Some people have an alternating pattern of constipation and diarrhea. This is called mixed IBS (IBS-M).  Other people don’t fit into these categories easily, called unsubtyped IBS, or IBS-U.

What Are the Causes?
While there are several things known to trigger IBS symptoms, experts don't know what causes the condition.

Studies suggest that the colon gets hypersensitive, overreacting to mild stimulation. Instead of slow, rhythmic muscle movements, the bowel muscles spasm. That can cause diarrhea or constipation.
Some think that IBS happens when the muscles in the bowels don't squeeze normally, which affects the movement of stool. But studies don’t seem to back this up.

Another theory suggests it may involve chemicals made by the body, such as serotonin and gastrin, that control nerve signals between the brain and digestive tract.

Other researchers are studying to see if certain bacteria in the bowels can lead to the condition
Because IBS happens in women much more often than in men, some believe hormones may play a role. So far, studies haven’t borne this out.

Who Is at Risk for Irritable Bowel Syndrome (IBS)?
Doctors don’t know for sure what causes irritable bowel syndrome, but some things seem to make people more likely to have it than others. These risk factors for IBS include:

Being a woman. About twice as many women as men have the condition. It’s not clear why, but some researchers think the changing hormones in the menstrual cycle may have something to do with it.

Age. IBS can affect people of all ages, but it's more likely for people in their teens through their 40s.

Family history. The condition seems to run in families. Some studies have shown that your genes may play a role.

Emotional trouble. Some people with IBS seem to have trouble with stress, have a mental disorder, or have been through a traumatic event in their lives, such as sexual abuse or domestic violence. 

It's not clear what comes first -- the stress or the IBS. But there's evidence that stress management and behavioral therapy can help relieve symptoms in some people with the condition.

Food sensitivities. Some people may have digestive systems that rumble angrily when they eat dairy, wheat, a sugar in fruits called fructose, or the sugar substitute sorbitol. Fatty foods, carbonated drinks, and alcohol can also upset digestion. 
There's no proof any of these foods cause IBS, but they may trigger symptoms.

Large meals, or eating while you do something stressful, like driving or working. Again, these activities don’t cause irritable bowel syndrome, but for those with a very sensitive colon, they can spell trouble.

Medications. Studies have shown a link between IBS symptoms and antibiotics, antidepressants, and drugs made with sorbitol.

Other digestive problems, like traveler's diarrhea or food poisoning. Some scientists think these illnesses may trigger a person’s first IBS symptoms.
Talk to your doctor if you think you might have irritable bowel syndrome. She can discuss your symptoms with you and do some tests to find out what’s going on.

Treating IBS
There is no cure for IBS. Treatment is aimed at symptom relief. Initially, your doctor may have you make certain lifestyle changes. These “home remedies” are typically suggested before the use of medication.

Home remedies for IBS
Certain home remedies or lifestyle changes may help to relieve your IBS symptoms without the use of medication. Examples of these lifestyle changes include:

  • participating in regular physical exercise
  • cutting back on caffeinated beverages that stimulate the intestines
  • eating smaller meals
  • minimizing stress (talk therapy may help)
  • taking probiotics (“good” bacteria normally found in the intestines) to help relieve gas and bloating
  • avoiding deep-fried or spicy foods

Foods to avoid with IBS
Managing your diet when you have IBS may take a little extra time but is often worth the effort.

Modifying amounts or eliminating certain foods such as dairy, fried foods, indigestible sugars, and beans may help to reduce different symptoms. For some people, adding spices and herbs such as ginger, peppermint, and chamomile has helped to reduce some IBS symptoms.

IBS medication
If your symptoms do not improve through home remedies, such as lifestyle or dietary changes, your doctor may suggest the use of medications. Different people can respond differently to the same medication, so you may need to work with your doctor to find the right medication for you. 

As with all medication, when considering new medication, it’s important to tell your doctor what you are already taking, including herbal remedies and over-the-counter medications. This will help your doctor avoid any medication that could interact with what you are already taking. 

Some drugs are used to treat all symptoms of IBS, while other drugs are focused on specific symptoms. Drugs that are used include medications to control muscle spasms, anticonstipation drugs, tricyclic antidepressants to ease pain, and antibiotics. If your main IBS symptom is constipation, linaclotide and lubiprostone are two drugs that are recommended by the American College of Gastroenterology (ACG).

Want to learn more?
The following organizations and/or websites offer additional information and education about 
Irritable Bowel Syndrome (IBS). They are listed in alphabetical order without any preference or prejudice.  Listing these organizations is not a recommendation or referral in any regard for seeking treatment or consultation or support for treatment.   

Information on this page taken from: