Irritable bowel syndrome (IBS) is a common disorder of the intestines affecting perhaps 20% of the adult population that leads to pain, gassiness, bloating, and changes in bowel habits. Symptoms include constipation, diarrhea, or a painful but unsuccessful urge to move the bowels.
Through the years, IBS
has been called by many names – colitis
, mucous colitis, spastic colon
, spastic bowel, and functional bowel disease. Most of these terms are inaccurate. Colitis, for instance, means inflammation
of the large intestine (colon). IBS, however, does not cause inflammation and should not be confused with another disorder, ulcerative colitis
Often IBS is just a mild annoyance, but for some people it can be disabling. They may be unable to go to social events, to go to work, or to travel even short distances.
The colon, which is about 6 feet long, connects the small intestine
with the rectum and anus. The major function of the colon is to absorb water and salts from digestive products that enter from the small intestine. Two quarts of liquid matter enter the colon from the small intestine each day. This material may remain there for several days until most of the fluid and salts are absorbed into the body. The stool then passes through the colon by a pattern of movements to the left side of the colon, where it is stored until a bowel movement occurs. Movements of the colon propel the contents slowly back and forth but mainly toward the rectum. A few times each day strong muscle contractions move down the colon pushing fecal material ahead of them. Some of these strong contractions result in a bowel movement.
Ordinary events such as eating and distention from gas or other material in the colon can cause the colon to overreact in a person with IBS
, or certain medicines and foods may trigger spasms
. Sometimes the spasm
delays the passage of stool, leading to constipation
. Chocolate, milk products and large amounts of alcohol are frequent offenders. Caffeine
causes loose stools in many people, but it is more likely to affect those with IBS. Researchers also have found that women with IBS may have more symptoms during their menstrual
periods, suggesting that reproductive hormones may exacerbate the problem. People with IBS sometimes pass mucus with their bowel movements.
Causes and Development
Researchers at Cedars-Sinai Medical Center in Los Angeles think they may have identified the cause of this mysterious and very common condition, and found an effective way to treat it. The Cedars-Sinai researchers found that 78% of the IBS
patients they tested had what they called small intestinal bacterial
overgrowth (SIBO), a condition in which excessive amounts of bacteria
are present in the small intestine
The researchers treated the patients who tested positive for SIBO with a 10-day course of antibiotics. Tests at the end of that time found that 25 of 47 patients had no bacterial overgrowth present, and that 12 of them had no IBS
symptoms, while the symptoms were "significantly reduced" in the other 13. The symptoms were also reduced in the patients in which some SIBO was still detected, suggesting that if treatment had been continued until it was completely eliminated, perhaps with an alternative antibiotic, better results would have been obtained.
Signs and Symptoms
Bleeding, fever, weight loss, and persistent severe pain are not
symptoms of IBS
but may indicate other problems.
Eating causes contractions of the colon
and normally this response may cause an urge to have a bowel movement within 30 to 60 minutes after a meal. In people with IBS, the urge may come sooner and be accompanied by cramps
. The strength of the response is often related to the number of calories consumed, particularly the amount of fat in a meal. Fat in any form (animal or vegetable) is a strong stimulus of colonic
Treatment and Prevention
Most people with IBS
, however, are able to control their symptoms through medications prescribed by their physicians, diet and stress management.
For many people, eating a proper diet lessens IBS symptoms. Before changing your diet, it is a good idea to keep a journal noting which foods seem to cause distress.
causes a great deal of discomfort and distress, but it does not cause permanent harm to the intestines and does not lead to intestinal bleeding of the bowel, serious organic diseases or to cancer. No link has been established between IBS and inflammatory
bowel diseases such as Crohn's disease
or ulcerative colitis