Irritable Bowel Syndrome
IBS is a group of symptoms: abdominal pain; constipation and/or diarrhea; bloating that doesn’t go away or goes away and comes back. Pain or discomfort in the belly that occurs several days or more each month and is related to changes in the way the bowel moves. The discomfort may be relieved by having a bowel movement or it may begin when the bowels change from diarrhea to constipation.
Other symptoms may include heartburn, bloating, gas or burping, nausea, loss of appetite, early feelings of fullness, urgency to go to the bathroom, mucous in the stool or feeling incomplete emptying of stool.
What it’s not:
- IBS is
- not caused by, but aggravated by stress
- not caused by your diet
- not a risk for cancer
- not a risk for colitis
- does not cause malnutrition
- does not get worse with age
- does not shorten lifespan
- IBS is
- a long term condition
- symptoms may come and go- getting better or worse over time
- symptoms may change over time
- symptoms can be managed so that you feel better
Diagnosing IBS:
Your healthcare provider will take your history and do a physical exam. Some tests may be ordered to make sure you don’t have any other type of bowel problem. There is no test to diagnose IBS.
It is a long term or recurrent disorder of gut function. It is not a structural disorder or disease, so there is no visible change in the intestine that could be seen on x-ray, by blood test or biopsied by endoscopy, unlike inflammatory bowel diseases that cause visible tissue damage or inflammation. It is a disorder of functioning, meaning that the intestine reacts differently to the brain and nervous system’s signals. Irritable is used to describe the IBS symptoms because the nerve endings in the walls of the intestine are overly sensitive (causing increased or decreased movement- diarrhea or constipation) or sensation (which causes abdominal pain). The gut becomes over-reactive to normal stimuli: food, drugs (caffeine, alcohol, tobacco); hormones and stress or tension.
What if it’s not IBS?
Anemia, blood in bowel movements, weight loss, a major change in your IBS symptoms; beginning symptoms of IBS over the age of 50, nighttime symptoms that wake you up or having family members with inflammatory bowel disease are good reasons to look for other causes of your abdominal symptoms. Infections with campylobacter, shigella or salmonella may increase your chance of having IBS. IBS does not cause any other diseases and there is no reason to have more frequent checkups if you have it.
The brain-gut connection: Communication between the brain & gut are altered in IBS which causes the over sensitivity and leads to symptoms from changes in normal bowel function. Everyone has serotonin receptors in their gut and may have a gut response to emotion or stress. In IBS, the symptoms may occur with eating or other normal stimulants and occur more frequently than in others. This is why relaxation, aerobic exercise, massage, counseling to help manage stress and adequate sleep is so important to treating your IBS symptoms. The symptoms of IBS are not life-threatening and are not imaginary. It is a disorder of the brain-gut interactions that is influenced by both physical and psycho-social components.
Diet and IBS
Meals may stimulate your symptoms. It may not be the type of food you are eating, but the act of eating that stimulates the gut. Try eating smaller, more frequent meals, eat slowly- relax a few seconds before eating. Avoid fatty fried or greasy foods and large meals.
Fiber: insoluble fiber (bran cereals and whole grains) can be hard to digest. It is important to get enough fiber, especially with IBS. Insoluble fiber like Metamucil or Citrucel can help. Start taking them at ¼ of the recommended dose and increase weekly. Drink 6-8 glasses of water daily. Avoid foods that cause a lot of gas and bloating.
Coffee, caffeine, carbonated beverages and alcohol all affect the gut and may worsen IBS symptoms. Fructose and sorbital (artificial sweeteners) can have a laxative effect.
Lactose: A few people are truly lactose intolerant. This may cause similar symptoms to IBS.
You may talk with a registered dietitian at the IU Health Center to help you eat a healthy diet. Call 812-855-7688 for your appointment
Other Treatments:
- Have a routine: regular meals, a set time to have a bowel movement, enough sleep.
- Pain: antispasmodics or peppermint oil can be helpful
- Constipation: psyllium fiber supplements or a laxative like Miralax
- Diarrhea: loperamide, fiber for prevention, careful diet
- Relaxation techniques: treat all symptoms, and even more treat your reaction to pain, etc to help you cope better.
- Antidepressants can also be used at low doses to help manage pain and minimize symptoms.
- Probiotics may be helpful, especially if IBS is triggered by a recent infection.
Other information:
- International Foundation for Functional GI Disorders: www.iamibs.org
- Health and Wellness Education Department of IU Health Center, 3rd floor; 812-855-7338
- Registered Dietitians, Massage Therapists and education in relaxation techniques
- Counseling and Psychological Services of IU Health Center, 4th floor 812-855-5711
- For counseling, group or individual therapy to manage stress, anxiety or develop coping skills
