What is irritable bowel syndrome?

Irritable bowel syndrome (IBS) is a chronic (long-lasting) disorder of the large intestine (colon). It is the most common gastrointestinal disorder. It affects twice as many women as men and usually begins in early adult life. Although IBS can cause much distress, it is not serious and does not lead to serious disease.

Another term for IBS is spastic colon.

How does it occur?

The cause of IBS is not fully understood. Most symptoms of IBS are probably related to abnormal muscle movement or spasm of the lower part of the colon. Sometimes the spasm delays bowel movements. At other times it may lead to more rapid passage of bowel movements, resulting in diarrhea. In either case the spasm causes abdominal cramps.

A specific food may trigger attacks. Spasms may also be triggered by stress or depression because muscle movement in the colon is partly controlled by the nervous system.

What are the symptoms?

The most common symptoms include:

• Cramping and pain in the abdomen (may be severe)
• Constipation
• Diarrhea
• Constipation alternating with diarrhea
• A lot of gas.

Other symptoms include:

• Bloating
• A feeling of fullness in the rectum.

Symptoms often occur after you've eaten a big meal or when you are under stress. Your symptoms may be temporarily relieved by having a bowel movement.

How is it diagnosed?

After taking your medical history, your health care provider will examine your abdomen and may do a rectal exam.

There is no specific test for IBS. Depending on your history and exam, your provider may do the following tests to look for other possible causes of your symptoms:

• Tests of bowel movement samples to check for blood and infection
• X-rays
• Endoscopy or sigmoidoscopy
• Barium enema
• Blood tests.

Your health care provider may ask you to try a milk-free diet to see if an allergy to milk may be causing your symptoms.

How is it treated?

Doctors have not yet found a cure for IBS. However, controlling the diet and emotional stress usually relieves the symptoms. Some medicines may also help.

• Diet

Dietary changes are usually helpful. Increasing the fiber in your diet often helps, although sometimes a decrease in fiber is needed. Try eating smaller meals more frequently. Avoid high-fat foods or gas-producing foods such as cabbage.

• Food diary

Your health care provider may ask you to keep a food diary to see if eating a particular food, for example, milk or sausage, worsens your symptoms.

• Stress

Your health care provider will help you identify stress- producing factors in your life and suggest ways to help you control them. Relaxation or biofeedback techniques may help you manage stress. Counseling is sometimes helpful.

• Medicines

Your health care provider may prescribe a combination of bulk-forming agents (such as bran or methylcellulose), antispasmodic drugs, and tranquilizers or antidepressants.

How can I take care of myself?

Follow these guidelines to relieve the symptoms of IBS:

• Learn stress-management techniques to reduce stress and anxiety in your life. Seek professional counseling if necessary.
• Drink eight 8-ounce glasses of water a day.
• Do not drink alcohol, which can make symptoms of IBS worse.
• Select your foods carefully. If a food appears to bring on your symptoms, avoid it. However, don't eliminate a food just because it appears to cause symptoms one time. Be sure that a food produces symptoms several times before you give it up. You should try to keep many different foods in your diet because a varied diet provides better nutrition.
• Ask your health care provider if you should follow a high-fiber diet, especially if you tend to be constipated. High-fiber foods may cause gas and bloating, but usually these symptoms lessen as the digestive tract gets used to the increased fiber. High-fiber foods include:
• Whole-grain breads and cereals
• Fruits, especially Oranges, dates, pineapple. 
• Nuts, especially almonds, pistachios, and walnuts
• Vegetables, particularly Spinach, Cabbage and Drumstick
• Beans and lentils.
• Ask your health care provider about using a nonprescription fiber supplement.
• Eat less fat. Fat is found mainly in the following foods:
• Meat, especially bacon, sausage, hotdog, bologna
• Poultry skin
• Dairy products including whole milk, cream, cheddar cheese, butter, cream cheese
• Vegetable oil, margarine, and shortening
• Eat smaller meals more frequently. Eat smaller portions of foods at a meal.

Because IBS is a chronic disorder, you may have flare-ups of symptoms throughout your life. Although there is no known cure, the disorder can usually be controlled. IBS will not progress to something worse.