What is irritable bowel syndrome?
Irritable bowel syndrome (IBS) is a highly prevalent intestinal disorder that can cause abdominal pain, abnormal and erratic bowel movements, and other symptoms. Although IBS symptoms may not be constant, they are persistent and require long-term management. IBS is not life-threatening, and in many patients, IBS is a minor annoyance, but in others, it significantly reduces the quality of life.
Two out of every three IBS patients are female. Although IBS can strike at any age, it is most common before age 50, and often develops in the second and third decade of life.
What are the symptoms of IBS?
The most obvious symptom of IBS is usually abdominal pain. Other common symptoms can include:
- Change in your bowel habits
- Persistent constipation
- Persistent diarrhea
- Passing a lot of gas
- Depression or other mood changes
Irritable Bowel Syndrome: Seeking the cause
The specific cause of IBS can be difficult to pinpoint. The syndrome sometimes develops after a severe bout of diarrhea, if the diarrhea attack is caused by bacteria or a virus. In other people, IBS has been associated with a surplus of certain types of bacteria in the intestines, a condition called small intestine bacterial overgrowth (SIBO).
Stress, particularly major early life stress, also seems to be a factor. In fact, people who are exposed to stressful events, especially in childhood, tend to have a greater incidence and more symptoms of IBS.
How does the gastroenterologist diagnose IBS?
There is no specific test for IBS. Rather, we establish the diagnosis based on your clinical history and physical exam, and by excluding disorders that may mimic IBS, such as intestinal infection, celiac disease, or lactose intolerance. Typically, we also will do blood and stool tests and may request imaging studies (e.g. CT or MRI) and endoscopic studies (e.g. colonoscopy or esophagogastroduodenoscopy).
How is IBS treated?
Although IBS cannot be “cured,” in most cases we can significantly lighten your symptoms. Successful treatment may require diligent detective work, careful observation of symptoms patterns, and trial and error.
Often, we will work in partnership with an allied health professional, such as a dietician, psychologist, or physical therapist. Typically, the most effective approach is multi-pronged — involving diet, lifestyle, and medication treatment.
We individualize IBS treatment based on your symptoms, lifestyle, and needs. Your doctor may start by recommending lifestyle changes such as eating a healthier diet, or giving up cigarettes.
We often utilize a combination of over-the-counter and prescription agents, as well as medical foods that have proven benefit in certain types of IBS. We use drugs in IBS in order to lessen diarrhea or constipation, decrease painful contractions (spasms), and interrupt aberrant nervous signaling between the gut and the brain.