Understanding Irritable Bowel Syndrome
November 29, 2023
Irritable bowel syndrome, commonly called IBS, is a chronic condition that can cause a number of reoccurring gastrointestinal symptoms – from abdominal pain and cramping to changes in consistency or frequency of bowel movements.
“Irritable bowel syndrome is a non-life-threatening illness, but it has a significant impact on patients’ lives and can cause significant distress,” said Ahmed Akhter, MD, a Franciscan Health gastroenterologist based in Crown Point, Indiana.
Because patients with IBS often experience challenges with bowel movements – including constipation, diarrhea or both – their condition can interfere with their usual routines at work or school.
Unlike Inflammatory Bowel Disease, or IBD – which is caused by inflammation or ulcers in the intestinal tract – irritable bowel syndrome happens in those who have no diagnosable structural damage in their intestines.
IBS is “a functional problem with the intestine and how it senses or perceives certain stimulants – rather than there being a problem with the structure of the intestine itself,” Dr. Akhter said.
Symptoms of Irritable Bowel Syndrome
Patients with irritable bowel syndrome report a range of symptoms, including:
- Abdominal pain or cramping
- Constipation, diarrhea, or a mix of both
- Changes in frequency of bowel movements
- Excessive gas or bloating
Plan to seek medical attention promptly if you experience frequent abdominal cramping, constipation or diarrhea, if you have a family history of IBS or colon cancer, or if you are having the following symptoms:
- Rectal bleeding
- Unexplained weight loss
- Recurrent nighttime bowel movements
- Difficulty swallowing
- Vomiting
These symptoms are not commonly associated with IBS and could be a sign of a more serious gastrointestinal condition.
Diagnosing Irritable Bowel Syndrome
Doctors can usually diagnose irritable bowel syndrome just by taking inventory of a patient's symptoms. Typically, patients must experience symptoms at least once per week for at least three months in order to be diagnosed with IBS. Most IBS patients are diagnosed with the condition in their teens through their early 20s or 30s. IBS is rarely diagnosed in patients over the age of 50.
A range of tests – including CT scans, endoscopy and blood tests – can help physicians rule out other, more critical conditions, such as IBD, celiac disease or colorectal cancer, on the path toward an IBS diagnosis. He or she may begin by testing your stool for occult, or hidden, blood. (Colon cancer -- but not IBS -- can cause internal bleeding, which in turn can lead to blood in the stool.) Some patients may also need to have their colons examined with the aid of a barium enema X-ray, colon scan, or endoscope to rule out colon cancer and other diseases.
“If all tests are normal, then the diagnosis of irritable bowel syndrome becomes higher on the differential diagnosis,” Dr. Akhter said.
Self-Care For Irritable Bowel Syndrome
Patients with irritable bowel syndrome often experience symptom flareups when they feel especially stressed, depressed or anxious. Setting aside personal time each day for self-care is an important step in managing IBS symptoms.
If your day is shaped by stress, you may want to learn a relaxation technique to calm your nerves, whether it's some form of meditation, a breathing exercise or just listening to music. If you make exercise, relaxation, and dietary changes a part of your routine, you'll probably find that the stomach troubles that were once part of your daily life are fading into the past.
“Behavioral interventions are very effective in a lot of patients with IBS,” said Dr. Akhter. “That can range from simple relaxation techniques, such as deep breathing and yoga or meditation, to meeting with a therapist to discuss some of their anxiety, worries or depression triggers.”
Treating Irritable Bowel Syndrome
There's no single treatment for coping with irritable bowel syndrome. You'll need to work with your doctor to find an individual approach that works best for your symptoms. Some patients also find keeping a food diary of potential dietary triggers – including dairy, gluten or high-fiber foods – can help them identify and avoid foods that tend to cause or worsen their IBS ymptoms. Following the Low-FODMAP Diet, a diet geared toward reducing intake of five types of dietary sugars, can also help reduce IBS symptoms.
Regular daily exercise is also helpful, particularly if you suffer from constipation.
In addition to these lifestyle interventions, there are a range of medications available to address IBS and IBS-related symptoms. Physicians typically advise patients to start with simple treatment options, including stool softeners or laxatives to relieve constipation or Imodium to treat diarrhea, before progressing to commonly prescribed IBS drugs such as Linzess or Zelnorm.
Even without taking IBS-specific medications, many patients report improvement in their IBS symptoms when they begin taking selective serotonin reuptake inhibitors – or SSRIs – to treat their depression or anxiety.
“A lot of times, we find those behavioral medicines are very helpful in reducing patients’ gastrointestinal symptoms – so much so that they don’t have to take any additional GI-focused prescriptions,” Dr. Akhter said.
Irritable bowel syndrome is one of the most commonly diagnosed gastrointestinal conditions. If you’re experiencing symptoms that could be IBS-related, don’t feel embarrassed. Talk to your doctor. Your physician can help determine if you have irritable bowel syndrome – and work to create a customized plan to help you address it.
