Irritable Bowel Syndrome: The Facts
One of the most common digestive conditions treated in a primary care office is irritable bowel syndrome (IBS). Worldwide, about 11% of people suffer from IBS, with it being more common in females compared to males.
Some common symptoms of IBS include:
- Abdominal pain
- Cramping
- Bloating
- Gas
- Change in bowel habits - diarrhea and/or constipation
While these symptoms can occur occasionally in anyone, one of the hallmarks of irritable bowel syndrome (IBS) is that these symptoms become chronic and recurrent. Symptoms generally present themselves in early adulthood, although symptoms can develop in adolescence as well. Despite how common this condition is, only a small portion of patients seek medical care for their symptoms. IBS is often classified as either diarrhea-predominant or constipation-predominant or combined type.
Causes
An established cause has not been identified, though there are several theories. The leading theory is that patients with IBS have increased sensitivity in the intestines to otherwise normal sensations due to overactive nerves in the intestines. This overactive behavior can lead to bowel spasms that result in pain with movement of fluids and gas through the intestines. Other theories include food intolerance/allergies, stress/anxiety, and sequelae from some gastrointestinal infections from viruses or bacteria such as Salmonella or Campylobacter.
Diagnosis
Making the diagnosis can be challenging. Your doctor may order blood tests and stool tests to rule out other conditions like infections, Celiac disease, or inflammatory bowel disease (Crohn’s disease or Ulcerative Colitis). If you are older in age, a colonoscopy may be recommended as well to evaluate for conditions like colitis and colon cancer. If all of these tests are negative, the diagnosis can be made relatively easily.
Treatment
IBS can be challenging to manage, but several treatments are available. Symptoms diaries can be helpful. This is when a patient records all of their meals and subsequent symptoms and looks for correlations. Many patients report certain foods or food groups exacerbate their symptoms. The FODMAP food list is a list of foods that commonly worsen symptoms of IBS. Eliminating some or all of the foods on this list can help patients reduce their symptoms. Addition of fiber and/or over-the-counter constipation or anti-diarrheal medications is often helpful for symptoms as well and are probably the most commonly used treatments.
When the above treatments are not successful, prescription medications can be helpful for symptom relief. Medications directed at either slowing down or speeding up the intestines are how these medications can help relieve symptoms.
The good news is that nearly all patients with irritable bowel syndrome will find ways to manage their symptoms - either by themselves or with the assistance of their medical provider. If you are suffering from symptoms like persisting abdominal pain/cramping, bloating, diarrhea, or constipation, make an appointment with your medical provider to discuss this further.