Irritable bowel syndrome (IBS) is a common condition that affects up to one in seven Americans and accounts for nearly 50 percent of office visits to gastroenterologists.
IBS occurs in people of all ages, typically presenting in young age – usually below age 40 – and often in the teens.
Irritable bowel syndrome is easier to understand if you visualize the intestines as one long tube of muscle. This tube – the digestive system – is separated by a series of sphincters (bands of muscle) that divide the digestive system into different compartments, each having a different function.
The function of the large intestine, or colon, is to absorb fluid and allow passage of solid waste. IBS, also referred to as spastic colon or spastic colitis, is caused by disordered muscle contractions in the colon, which lead to a disturbance in bowel function. This disorder usually results in abdominal pain and poor regulation of bowel function.
Classic symptoms of IBS include:
- lower abdominal pain often associated with or relieved by a bowel movement
- alternating diarrhea and constipation
- mucous in the stools
- abdominal bloating, swelling and gaseousness (symptoms of upper intestinal malfunctioning)
Because IBS represents a disorder of muscle contraction and not a disease condition, its diagnosis, in addition to a review of medical history, is one of exclusion—other conditions of the bowel need to be ruled out before a diagnosis of IBS can be made.
“Some people with IBS symptoms may need a full diagnostic work-up to rule out potentially serious gastrointestinal disease, such as colitis (inflammation of the bowel) and cancer, whose symptoms can be identical to those of IBS,” said Steven R. Peikin, M.D., head of the Division of Gastroenterology at Cooper’s Digestive Health Institute.
“Although in many cases the diagnosis of IBS can be made by history and physical exam alone, the diagnosis of IBS in some patients depends on having normal results from diagnostic testing, including such exams as a barium enema, colonoscopy, upper GI series and stool culture,” Dr. Peikin said.
In the case of IBS, such examinations would reveal a perfectly normal-appearing bowel.
While the exact cause of IBS remains unclear, certain foods and stressful situations are known to bring on or worsen symptoms. (See related article “How to Reduce IBS Symptoms”)
As painful and distressing as IBS symptoms can be, the disorder itself is not a serious one. It is not life-threatening and does not lead to cancer.
Prolonged, untreated contractions of the colon, however, can lead to diverticulosis, a disorder in which balloon-like pockets called diverticuli to push out from the bowel wall. Bacteria can seep through the thinner wall of diverticuli and cause diverticulitis, an infection that requires antibiotics, food avoidance and, in severe cases, hospitalization.
Treatment of IBS is entirely based on controlling symptoms. Successful treatment starts with an accurate diagnosis and, most importantly, a good doctor-patient relationship. Treatment usually involves a regimen of stress reduction, physical exercise, fiber supplementation, diet alterations and antispasmodic medications.
“Remember, there’s no cure for the many nasty symptoms of IBS, but they can be controlled through diet and lifestyle changes, as well as with prescription medications for IBS pain,” Dr. Peikin said.
If you suspect you might be suffering from IBS, see your gastroenterologist for an evaluation. Once diagnosed, IBS symptoms can be successfully treated and controlled.
Steven R. Peikin, M.D., who heads the Division of Gastroenterology at Cooper Digestive Health Institute, is the author of Gastrointestinal Health, a self-help book offering a nutritional program for the management of common gastrointestinal disorders. Based on the latest research and Dr. Peikin’s own clinical experience, Gastrointestinal Health is in its third edition and available in bookstores.