Irritable bowel syndrome is characterized by symptoms of abdominal discomfort or pain, usually in the lower abdomen (although the location and intensity are variable, even at different times within the same person), and altered bowel habit (change in frequency or consistency) – chronic or recurrent diarrhea, constipation, or both in alternation.
Abdominal pain has been reported as primarily crampy or a generalized ache with superimposed periods of abdominal cramps, although sharp, dull, gas-like, or nondescript pains are also common. The abdominal discomfort or pain is usually relieved with a bowel movement.
Irritable Bowel refers to a disturbance in the regulation of bowel function that results in unusual sensitivity and muscle activity.
Syndrome refers to a number of symptoms and not one symptom exclusively.
Everyone suffers from an occasional bowel disturbance. However, for those with IBS the symptoms are more severe, or occur more often – either continuously or off and on. IBS affects men and women of all ages.
Some or all of IBS symptoms can occur at the same time – some symptoms may be more pronounced than others.
IBS is not caused by stress. It is not a psychological or psychiatric disorder. It is not “All in the mind.” Because of the connection between the brain and the gut, symptoms in some individuals can be exacerbated or triggered by stress. Dietary and hormonal factors can affect symptoms of IBS.
IBS is not an indication of another more serious disease, like cancer. Irritable bowel syndrome can, however, seriously compromise a person’s quality of life. Chronic and recurrent symptoms can disrupt personal or professional activities, upset emotional well being, and limit individual potential.
Anemia, bleeding, unexplained weight loss, or fevers are not characteristic of IBS. You should alert your physician immediately if you are experiencing these symptoms. Other factors that may suggest the presence of an organic disease include awakening from sleep at night, family history of colon cancer or inflammatory bowel disease, and onset of symptoms (or change in symptoms) over the age of 50.
Treatment Strategies for IBS
An occasional bout with abdominal pain and diarrhea or constipation is an experience nearly everyone has in common. People may view these symptoms as normal, even when they frequently occur. However, chronic and recurring symptoms are not normal. They may signal IBS – and are often treatable.
The diagnosis of IBS currently is based on a pattern of symptoms that fit established criteria, in conjunction with a detailed history, a physical examination, and tests that rule out other identifiable causes.
Patients with mild IBS symptoms comprise the most prevalent group, and are usually treated by primary care practitioners, rather than specialists. They do not see a clinician very often, and usually maintain normal daily activities. Treatment is directed toward education, reassurance, achievement of a healthier lifestyle, and occasional medication. Dietary advice may include avoiding offending foods that can trigger symptoms. Fiber supplementation has been shown to be effective for symptoms of constipation.
Pharmacologic therapy is best used in IBS patients with moderate to severe symptoms refractory (which do not respond) to physician counseling and dietary manipulations. First line treatment has traditionally been aimed at treating the most bothersome symptom because of the lack of effective treatment for the overall improvement of multiple symptoms in IBS patients. However, new therapies for IBS have been recently introduced and have been shown to effectively treat multiple symptoms of IBS.
For individuals with IBS, effective diagnosis and treatment starts with the recognition of the validity of symptom complaints. Working in partnership with a physician or care-provider can help achieve the best possible results. Once a diagnosis is made it is helpful to develop a treatment plan and an outcome goal in an effort to control symptoms. Each individual’s symptoms may vary and respond differently to treatment.
The precise cause of IBS is not fully understood and, as yet, there is no cure. Treatments are aimed at alleviating symptoms. Most individuals with IBS have relatively mild symptoms that can be sufficiently treated with dietary or lifestyle modifications and without the use of medication. The use of medications can be effective for some, but not all, people with IBS.
Medications are meant to be used in addition to other treatment approaches, not in place of them. An integrative approach that combines different treatment methods, selected according to individual circumstances and with a physician as a partner, is generally most effective for persons with IBS.
Changes in medical concepts and advances in investigative techniques have contributed, over the past decade, to better understanding of the underlying mechanisms of irritable bowel syndrome. As understanding increases, therapeutic approaches to the disorder change. Promising new treatments for IBS are on the horizon.