Irritable bowel syndrome, or IBS, is a gastrointestinal syndrome frequently characterized by abdominal pain and often accompanied by a change in bowel pattern. Because the cause is unknown there is no cure. The treatment has largely been aimed at managing the symptoms. Recurrent abdominal pain that improves with having a bowel movement coupled with a change in the frequency or form of the stool are typical features of the disorder. Irritable bowel syndrome may cause either diarrhea or constipation.
While IBS is not a dangerous problem, it can be painful, cause anxiety and be disruptive to a patient's life. IBS is diagnosed when physicians are able to eliminate other structural or metabolic conditions and diseases such as celiac disease, Crohn's disease or ulcerative colitis that may explain the symptoms.
While anyone can have IBS, it is more common in women. Women are twice as likely to have IBS. IBS also decreases in prevalence with age. Overall, it is fairly prevalent with as many as 10-15 percent of the population suffering from the disorder. About one-third of people with IBS report that the symptoms resolve over time.
Only about 15 percent of people with IBS will seek medical attention. Many people with symptoms of IBS often mistake them for a sensitive gastrointestinal tract. However, there are some symptoms that you shouldn't ignore such as weight loss, bleeding, anemia or pain and diarrhea that awakens you at night. These signs or symptoms could be a warning of something more serious.
If symptoms are mild and no warning signs are present, dietary changes may be the best place to start treatment. For example, if bloating and diarrhea are an issue, a change in diet may be all that is needed to help with the symptoms. A FODMAP diet is one that is low in fermentable sugars that tend to be poorly absorbed. Poorly absorbed sugars can cause diarrhea and bloating in some patients. If this diet is ineffective, gluten-free or lactose free diets are sometimes recommended.
Treatment for IBS will also vary based on the symptoms present. There are a number of medications used to treat IBS. Most of these are selected to manage specific symptoms. For those with IBS that present with symptoms of constipation, laxatives and a high fiber diet are often recommended initially. For those where pain is the main feature, antispasmodic agents are often used. Those with predominantly diarrhea can be treated with a variety of agents directed at eliminating or minimizing the diarrhea.
In most instances, your family care practitioner can treat mild to moderate IBS. Young patients with classic symptoms of IBS do not necessarily need extensive testing. However, if symptoms are atypical or warning signs are present, a visit to a gastrointestinal specialist may be in order.
Your gastrointestinal doctor may need to conduct other tests to eliminate more serious issues. Studies such as colonoscopy, x-rays, blood work, and cultures looking for infection may be needed to determine if a more serious health concern exists.
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Dr. James Pezzi is a physician with KentuckyOne Health Gastroenterology Associates.