meaning
Irritable bowel syndrome (IBS) is a disease that causes abdominal pain and changes in the intestines.
IBS is different from inflammatory bowel disease (IBD).
alias
IBS; irritable bowel; spasmodic colon. Irritable colon. Mucinous colitis; spastic colitis. Abdominal pain – IBS; Diarrhea – IBS; Constipation – IBS; IBS-C; IBS-D
cause
It is not clear why IBS develops. It may occur after a bacterial or parasitic infection of the intestines (giardiasis). This is called post-infectious IBS. It may also be caused by other factors, such as stress.
The gut is connected to the brain using hormones and nerve signals that travel between the gut and the brain. These signals influence intestinal function and symptoms. Nerves can become more active when you are stressed. This can make your intestines more sensitive and contract more.
IBS can develop at any age. It often begins in the teen years or early adulthood. It is twice as common in women as in men.
People over the age of 50 are less likely to develop the disease.
Approximately 10% to 15% of people in the United States have symptoms of IBS. This is the most common intestinal problem that causes people to be referred to an intestinal specialist (gastroenterologist).
symptoms
IBS symptoms vary from person to person and can range from mild to severe. Most people have mild symptoms. A person is said to have irritable bowel syndrome when symptoms persist for at least three days a month for more than three months.
The main symptoms are:
- abdominal pain and cramps
- gas
- feeling of fullness
- bloating
- Changes in bowel habits. You can have either diarrhea (IBS-D) or constipation (IBS-C).
Pain and other symptoms often reduce or disappear after defecation. Symptoms may worsen if the frequency of bowel movements changes.
People with IBS may go back and forth between constipation and diarrhea, or they may have one or the other, or most people may have one or the other.
- Irritable bowel syndrome with diarrhea often causes loose, watery stools. You may have an urgent need to defecate and it may be difficult to control.
- Irritable bowel syndrome with constipation makes it difficult to defecate and reduces the frequency of bowel movements. You may have to strain to defecate and may experience cramps. Often only a small amount of stool is passed, or no stool is passed at all.
Symptoms may worsen for a few weeks or a month, then briefly subside. In other cases, symptoms are almost always present.
If you have IBS, you may also lose your appetite. However, bloody stools and unintentional weight loss are not part of his IBS.
exams and tests
There is no test to diagnose IBS. In most cases, your health care provider can diagnose her IBS based on your symptoms. Feeding her a lactose-free diet for two weeks may help a health care provider identify lactase deficiency (or lactose intolerance).
The following tests may be performed to rule out other issues:
- A blood test to check if you have celiac disease or a low blood cell count (anemia)
- Fecal occult blood test
- Stool culture to check for infection
- Microscopic examination of stool samples for parasites
- Stool testing for a substance called fecal calprotectin
Your health care provider may recommend a colonoscopy. This test involves inserting a flexible tube through the anus to examine the colon. This test may be required if:
- Symptoms appeared late in life (over age 50)
- Symptoms include weight loss and bloody stools
- Abnormal blood tests (low blood cell count, etc.)
Other diseases that can cause similar symptoms include:
process
The goal of treatment is to reduce symptoms.
In the case of IBS, lifestyle changes may be helpful. For example, regular exercise and improved sleep habits can help reduce anxiety and reduce intestinal symptoms.
Dietary changes may help. However, because IBS conditions vary from person to person, we cannot recommend a specific diet.
The following changes may be helpful:
- Avoid foods and drinks that irritate the intestines (caffeine, tea, cola, etc.)
- eat a small meal
- Increase fiber in your diet (this may improve constipation and diarrhea, but worsens bloating)
Consult your doctor before taking over-the-counter medications.
There is no medicine that works for everyone. Some of the things your provider may suggest include:
-
Anticholinergic drugs (dicyclomine, propantheline, belladonna, hyoscyamine) are taken about 30 minutes before meals to control spasms in the intestinal muscles.
- Loperamide to treat IBS-D
- Alosetron (Lotronex) for IBS-D
- Eluxadrine (Viberzi) for IBS-D
- probiotics
- Low-dose tricyclic antidepressants to reduce intestinal pain
- Lubiprostone (Amitiza) for IBS-C
- Bisacodyl to treat IBS-C
- rifaximin, antibiotic
- Linaclotide (Linzess) for IBS-C
Psychotherapy and medications for anxiety and depression may help resolve the problem.
Outlook (prognosis)
IBS can be a lifelong condition. For some people, symptoms can be disabling and interfere with work, travel, and social activities.
Symptoms often improve with treatment.
IBS does not cause any permanent harm to your intestines. It also does not cause serious diseases such as cancer.
When to contact a medical professional
If you have symptoms of IBS or notice changes in your bowel habits that don’t go away, contact your health care provider.
References
Aronson JK. laxative.Source: Edited by Aronson JK Mailer’s drug side effects. 16th edition Philadelphia, PA: Elsevier. 2016:488-494.
Canavan C, West J, Card T. Epidemiology of irritable bowel syndrome. Clinepidemiol. 2014;6:71-80. PMID: 24523597 pubmed.ncbi.nlm.nih.gov/24523597/.
Charles MB. Common clinical symptoms of gastrointestinal disease: abdominal pain. Source: Wing EJ, Shiffman FJ, eds. cecil medical essentials. 10th edition Philadelphia, PA: Elsevier. 2022: Chapter 31.
Feli FF. Irritable bowel syndrome.Published in: Feli FF edition Ferri Clinical Advisor 2022. Philadelphia, PA: Elsevier. 2022:893-895.
Ford AC, Tully, NJ. Irritable bowel syndrome. Author: Feldman M, Friedman LS, Brandt LJ, eds. Slizenger and Fordtran gastrointestinal and liver diseases: pathophysiology/diagnosis/management. 11th edition Philadelphia, PA: Elsevier. 2021:Chapter 122.
Mayer EA. Functional gastrointestinal disorders: irritable bowel syndrome, indigestion, chest pain and heartburn presumed to originate from the esophagus. Source: Goldman L, Schafer AI, eds. goldman cecil medicine. 26th edition Philadelphia, PA: Elsevier. 2020: Chapter 128.