What is irritable bowel syndrome?

Irritable bowel syndrome (IBS) is a chronic (ongoing) problem with the large intestine. IBS is not a disease. It is a term used to describe a group of symptoms that typically happen together.  Common IBS symptoms include abdominal pain, bloating, and diarrhea or constipation, or a combination of both diarrhea and constipation. IBS may cause physical discomfort and emotional distress, but it does not cause damage to the large intestine. It's not the same as inflammatory bowel diseases like ulcerative colitis, which do damage the intestine.

IBS is very common and occurs more often in women. IBS also has been called functional bowel syndrome, irritable colon, spastic bowel, and spastic colon.

What causes IBS?

Doctors describe IBS as a “functional gastrointestinal disorder.” This means that it is caused by changes in how the gastrointestinal (digestive) system works, but no one knows exactly what causes these changes to occur. Most doctors and researchers believe that IBS is caused by a combination of health problems. Possible health problems that may cause or worsen IBS include:

• Problems with the nerve signals from your brain to your intestine
• Problems with how your intestines push food through your system
• Mental health problems, such as depression, anxiety, and panic disorders
• An infection in your stomach or intestines
• An overgrowth of bacteria in the intestines
• Changes in hormone levels or other body chemicals
• Undiagnosed food sensitivities or allergies

How is IBS diagnosed?

Your doctor probably will do a physical exam and ask you about your medical history. Before your appointment, keep a record of your symptoms and when they occur. Share this record with your doctor at your appointment. Depending on your symptoms, your doctor may also need to do some tests, such as a blood test, stool test, X-ray, or colonoscopy, just to make sure that your symptoms aren't caused by something else.

What changes can I make at home to help control my symptoms?

There is no cure for IBS. The best way to help control your symptoms is to:

• Lead a healthy lifestyle: Eat a varied, healthy diet, and drink plenty of water. Try to eat 5 or 6 smaller meals each day, instead of 3 big meals. Exercise regularly and make sure you’re getting enough sleep.
• Avoid foods that make your symptoms worse: You may notice that your symptoms get worse when you eat certain foods. Foods that may make IBS symptoms worse include caffeinated beverages (coffee, tea), carbonated beverages, milk products, alcohol, chocolate, certain fruits, and beans or cabbage (which can cause gas). To help you figure out if a certain food bothers you, keep a food journal. Record what you eat and whether you have any IBS symptoms. If you find a pattern, talk to your doctor about whether you should remove that food from your diet and how to find healthy substitutes.
• Find ways to handle stress: Your symptoms may get worse when you're under stress, such as when you travel, attend social events, or change your daily routine, Talk to your family doctor about ways to deal with stress, such as exercise, relaxation training, or meditation. He or she may have some suggestions or may refer you to someone who can give you some ideas. Your doctor may also suggest that you talk to a counselor about things that are bothering you.

Why may fiber be helpful?

Fiber can be helpful because it helps improve how the intestines work. There are 2 types of fiber:

• Soluble fiber helps both diarrhea and constipation. It dissolves in water and forms a gel-like material. Many foods, such as oat bran, apples, beans, and citrus fruits, contain soluble fiber. Psyllium, a natural vegetable fiber, also is a soluble fiber. You can buy psyllium supplements (some brand names: Fiberall, Metamucil, Perdiem) to drink, and you can add it to other foods.
• Insoluble fiber helps constipation by moving material more quickly through your digestive system and adding bulk to your stool. Insoluble fiber is in whole grain breads, nuts, seeds, wheat bran, and many vegetables and fruits.

Increase the fiber in your diet slowly. Some people feel bloated and have gas if they increase their fiber intake too quickly. Gas and bloating usually improve as you get used to eating more fiber. The best way to increase your fiber intake is eat a wide variety of high-fiber foods. For more information, read the handout, "Fiber: How to Increase the Amount in Your Diet."

Can my doctor prescribe medicine for IBS?

If your symptoms are severe, your doctor may prescribe medicine to help you manage or lessen your symptoms. For example, if your main symptom is pain, your doctor may prescribe antispasmodic medicines such as hyoscyamine or dicyclomine to reduce cramping. Heating pads and hot baths can also be comforting.

If diarrhea is a frequent problem, medicine such as loperamide (brand name: Imodium) may help. If constipation is a problem, your doctor may prescribe a laxative or a medicine called lubiprostone.

Depending on your symptoms, your doctor may prescribe a tranquilizer or sedative, an antidepressant, or an antibiotic. Your doctor may also recommend a probiotic or fiber supplement.

Will IBS get worse over time?

No. While IBS will probably recur throughout your life, it won't get worse. It doesn't cause cancer or require surgery, and it won't shorten your life.

What if IBS interferes with my daily activities?

IBS may have caused you to avoid doing certain things, like going out or going to work or school. While it may take some time for your efforts to pay off, you may find new freedom by following a plan that includes a healthy diet, learning new ways to deal with your stress, and avoiding foods that may make your symptoms worse.

• What is a food diary and how will it help you diagnose irritable bowel syndrome.
• Is IBS a sign of another health conditions?
• Are there lifestyle changes I could make that will help IBS?
• What medicines are available to treat IBS? Are there side effects?
• What can I do to ease and cope with stress?
• What are the possible causes of my IBS?