Irritable bowel syndrome (IBS) is a chronic disorder of the large intestine (colon) that affects one in 10 people worldwide. With IBS, the muscles in the colon may:
- Contract strongly, resulting in bloating, gas or diarrhea
- Contract weakly, slowing the passage of food and resulting in hard stool
The causes of IBS are unknown, but there are certain stimuli that may trigger symptoms of IBS. Although triggers may vary from person to person, they include:
- Certain illnesses – On occasion, another acute illness such as gastroenteritis or an overgrowth of bacteria can trigger IBS.
- Foods – Many patients experience an increase in the severity of symptoms when certain foods are consumed, such as broccoli, milk or carbonated beverages.
- Hormones – Twice as many women as men have IBS and many of those women report severe symptoms around their menstrual cycles, hormones may play a role in the condition.
- Stress – Although it does not cause them, stress has been shown to aggravate symptoms of IBS. Physical or emotional stress increases catecholamine release, which are hormones produced by the adrenal glands that can increase motility. It can also exacerbate underlying processes that may be occurring, making intestinal spasms worse.
What Are the Risk Factors for IBS?
Risk factors for developing IBS include:
- A family history of IBS – Patients with a family member living with the condition have an increased risk of developing it.
- Age – IBS occurs more frequently in those under 45 years of age.
- Gender – Women are twice as likely as men to have IBS.
- Certain mental health conditions – Disorders such as anxiety, depression or a history of abuse may contribute to IBS.
What Are the Symptoms of IBS?
Just like triggers vary greatly from patient to patient, so do symptoms. Common IBS symptoms include
- Constipation (also known as IBS-C)
- Diarrhea (also known as IBS-D)
- Mucus in stool
- Pain or cramping in the abdomen
- Sleep issues not caused by other symptoms
- Unpleasant taste in the mouth
- Urinary problems
What Are the Treatments for IBS?
Since the cause of IBS in unknown, treatments focus more on relieving symptoms. In the majority of patients, mild symptoms can be fully managed with certain changes in diet and lifestyle. Dietary suggestions may include:
- Eliminating gassy foods, such as broccoli, cauliflower, cabbage and carbonated beverages
- Removing Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols (FODMAPs), such as fructose and lactose, since some patients may be sensitive to certain types of carbohydrates
As surgery is not performed for IBS, medication may be required for those with more severe symptoms. Medications may include:
- Anti-diarrhea medications, like Imodium®
- Antibiotics, in the event of infection or overgrowth of bacteria
- Fiber supplements, such as Metamucil® or Citrucel® combined with fluids to control constipation
- IBS-specific medication, such as Amitiza® to increase fluid in the small intestine and promote the passage of stool from IBS-C
- Laxatives should fiber supplements fail
- Linzess® to alleviate abdominal pain and accelerating bowel movements for patients with IBS-C
- Lotronex® to relax the colon and slow the movement of waste through the lower portion of bowel for patients with IBS-D
- Viberzi™ for reducing the occurrence of diarrhea and abdominal pain from IBS-D
- Xifaxin® to reduce or alter the bacteria in the digestive tract to relieve bloating and diarrhea