Symptoms And Treatment Of Irritable Bowel Syndrome (IBS)

Symptoms And Treatment Of Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome (IBS) is a common disorder of the
intestines that leads to crampy pain, gassiness, bloating, and changes
in bowel habits. IBS is a functional abnormality of the
gastrointestinal tract that is estimated to affect up to 15% of the US
population. Some people with IBS have constipation (difficult or
infrequent bowel movements); others have diarrhea (frequent loose
stools, often with an urgent need to move the bowels); and some people
experience both. Sometimes the person with IBS has a crampy urge to
move the bowels but cannot do so.

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.

The cause of IBS is not known, and as yet there is no cure. Doctors
call it a functional disorder because there is no sign of disease when
the colon is examined. IBS 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 or to a serious
disease such as cancer. 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 out to a job, or to travel even short distances. Most
people with IBS, however, are able to control their symptoms through
medications prescribed by their physicians, diet, and stress management.

Because doctors have been unable to find an organic cause, IBS often
has been thought to be caused by emotional conflict or stress. While
stress may worsen IBS symptoms, research suggests that other factors
also are important. Researchers have found that the colon muscle of a
person with IBS begins to spasm after only mild stimulation. The person
with IBS seems to have a colon that is more sensitive and reactive than
usual, so it responds strongly to stimuli that would not bother most
people.

Ordinary events such as eating and distention from gas or other
material in the colon can cause the colon to overreact in the person
with IBS. Certain medicines and foods may trigger spasms in some
people. Sometimes the spasm delays the passage of stool, leading to
constipation. Chocolate, milk products, or 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 can increase IBS
symptoms.

Eating causes contractions of the colon. 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 with cramps and
diarrhea.

The strength of the response is often related to the number of
calories in a meal and especially the amount of fat in a meal. Fat in
any form (animal or vegetable) is a strong stimulus of colonic
contractions after a meal. Many foods contain fat, especially meats of
all kinds, poultry skin, whole milk, cream, cheese, butter, vegetable
oil, margarine, shortening, avocados, and whipped toppings.

Dietary fiber may lessen IBS symptoms in many cases. Consult your
doctor before using an over-the-counter fiber supplement. High-fiber
diets keep the colon mildly distended, which may help to prevent spasms
from developing. Some forms of fiber also keep water in the stools,
thereby preventing hard stools that are difficult to pass. High-fiber
diets may cause gas and bloating, but within a few weeks, these
symptoms often go away as your body adjusts to the diet. Also check for
folic acid and B12 deficiency.

The FDA approved (February 9, 2000) alosetron hydrochloride, a new
medication to treat IBS in women whose predominant bowel symptom is
diarrhea. Alosetron has not been shown to be safe and effective in men,
and its use in men is not recommended.