Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) is the most common gastrointestinal disorder, but it is not actually a disease. It is instead a collection of symptoms that seem to have no clearly defined cause. In fact, people with IBS appear to have completely normal digestive systems. It is estimated that between 10 and 20 percent of Americans suffer from IBS at some point in their life. Woman, tend to be affected twice as often as men. For years doctors believed that it was all in your head. While there are still unanswered questions, new research points to problems with increased perception of pain in the gut and a problem with the neurotransmitter serotonin. While stress does not cause the problem it certainly can aggravate the situation. It also appears that certain foods cause problems for some people. Some foods that have been implicated are fatty foods, dairy products, chocolate, alcohol and caffeine. A study from the University of Iowa Medical Center that suggests fructose may cause some cases of IBS. So how do you know if you have IBS?

There are certainly other easier questions to answer than this one. Since IBS seems to mimic symptoms of many other diseases, it’s “usually a diagnosis of exclusion”. Which means that you may go through a battery of test before you get your diagnosis. Typical symptoms are pain that occurs anywhere in the stomach, back, lower ribs, rectum or esophagus, a change in your bowel habits (constipation or diarrhea, or alternating boats of both) and bloating tends to be common. Be careful, often people have had their symptoms for so long they think they are normal. Weight loss, fever, rectal bleeding and anemia are not associated with IBS and you should tell your physician if you experience any of these symptoms. Not to worry though, a good doctor can diagnose IBS by a review of your symptoms, a physical exam and the tests that are necessary. Then you can work with your doctor for the best management of this disorder. To learn about typical symptoms and diagnostic testing, read Current Approach to Diagnosis of Irritable Bowel Syndrome by George F. Longstreth, M.D., Chief of Gastroenterology, Kaiser Permanente Medical Care Plan, San Diego, CA.

Treating IBS can be as elusive as diagnosing IBS. However, with a good diet, stress reduction and the right medication IBS can be treated. For many people improving their diet helps, however it is a good idea to keep a food journal to find out what bothers you. Adding dietary fiber and avoiding large meals has been helpful for many. Meals high in carbohydrates (whole grain breads, rice, cereals, fruits and vegetables) and low in fat help some. Others have found eliminating dairy products (lactose intolerant people) reduces symptoms. Be careful to supplement calcium if you limit your dairy. Many different medications have given relief, discuss the possibilities with your doctor and pharmacist. Many of these medications are over the counter but don’t be tempted to treat yourself. First, go to your doctor and get diagnosed and work together for treatment. Dr. Anthony Lembo and Laura Zurawski answer some Frequently Asked Questions about IBS.