Irritable bowel syndrome (IBS) generally refers to recurrent diarrhea and/or constipation. IBS does not have one, distinct cause, and is a very common condition. Many patients complain of lifelong problems, while others note an onset in adulthood. Effects may follow a bad infection or heavy antibiotic use. Since symptoms vary, it’s likely that several factors play a role in the development of this condition.
What is IBS?
IBS is a disorder of the intestines. It causes belly pain, cramping or bloating, and diarrhea or constipation. Many people with IBS go back and forth between having constipation and having diarrhea. But for most people, one of these happens more often than the other.
Your symptoms may be worse or better from day to day, but your IBS will not get worse over time. [Source: http://www.webmd.com/ibs/guide/irritable-bowel-syndrome-overview-facts]
The primary symptoms of IBS are abdominal pain or discomfort in association with frequent diarrhea or constipation and a change in bowel habits. There may also be urgency for bowel movements, a feeling of “not getting it all out”, bloating, or abdominal distension. In some cases, the symptoms are relieved by bowel movements. People with IBS, more commonly than others, have acid reflux, and even suffering from chronic fatigue. Headaches and backaches are quite common. Recent studies indicate that depression and anxiety are occurring in up to 60% of persons with IBS.
It is not clear what causes irritable bowel syndrome, and the cause may be different for different people. Some ideas for what causes IBS include problems with the way signals are sent between the brain and the digestive tract, problems digesting certain foods, and stress or anxiety. The flora balance of the gut tends to be unbalanced in people suffering from IBS. It can also be attributed to having unusually sensitive intestines or problems with the way the muscles of the intestines move.
For some people with IBS, certain foods, hormonal changes, stress, and antibiotics may trigger pain and other symptoms.
What has many medical professionals stumped is the complexity of the combination of possible causes of IBS – including psychological stress, hormones, the immune system, and chemicals called neurotransmitters interfering with messages between the brain and the bowel. The miscommunication causes abnormal muscle contractions or spasms, which often cause a cramping pain. The spasms may either speed the passage of stool, causing diarrhea, or slow it down, causing constipation or bloating. Anyone suffering from IBS is continuously wondering which way the pendulum will swing.
There are a number of other biochemical factors that may play a role in IBS. For example, people with IBS may have abnormal serotonin levels. Serotonin is a chemical messenger that’s normally associated with brain function, but it also plays a role in normal digestive system function. It’s also possible that people with IBS don’t have the right balance of good bacteria in the intestine, making digestion and absorption of nutrients difficult.
Triggers affect some people, not others
For reasons that still aren’t clear, people with IBS react very strongly to certain triggers – the same triggers that cause no reaction whatsoever in people without IBS.
Many people have occasional signs and symptoms of irritable bowel syndrome, which can lead to over diagnosis of the condition. However, there are some people who are naturally more prone to IBS. They include people who:
- Are young. IBS symptoms first appear before the age of 35 for about half of those with the disorder.
- Are female. More women than men are diagnosed with this condition.
- Have a family history of IBS. Studies have shown that people who have a first-degree relative — such as a parent or sibling — with IBS are at increased risk of the condition. It’s not clear whether the influence of family history on IBS risk is related to genes, to shared factors in a family’s environment, or both.
A diagnosis of irritable bowel syndrome depends largely on a complete medical history and physical exam.
Criteria for making a diagnosis
Because the symptoms of IBS are so broad and can change drastically from one person to another, it can be difficult to diagnose. Doing so often involves a process of elimination. To help in this process, researchers have developed diagnostic criteria, known as Rome criteria, for IBS and other functional gastrointestinal disorders. These are conditions in which the bowel appears normal, but doesn’t function normally. Your doctor must identify several of these symptoms in order to diagnose someone owth Irritable Bowel Syndrome.
The most important symptom is:
- Abdominal pain and discomfort lasting at least 12 weeks, though the weeks don’t have to occur consecutively
You also must have at least two of the following:
- A change in the frequency or consistency of your stool — for example, you may change from having a normal, formed stool once a day to three or more loose stools daily, or you may have only one hard stool every few days
- Straining, urgency or a feeling that you can’t empty your bowels completely
- Mucus in your stool
- Bloating or abdominal distension (hardeness)
Your doctor will likely assess how you fit these criteria, as well as whether you have any other signs or symptoms that might suggest a more-serious condition. Some red flag symptoms that might prompt your doctor to do additional testing include:
- New onset after age 50
- Weight loss
- Rectal bleeding
- Nausea or recurrent vomiting
- Abdominal pain, especially if it’s not completely relieved by a bowel movement
- Diarrhea that is persistent or awakens you from sleep
If you have these red flag signs, you’ll need additional testing to further assess your condition.
If you fit the IBS criteria and don’t have any red flag signs or symptoms, your doctor may suggest a course of treatment without doing additional testing. After a sufficient time with the prescribed treatment and no change, additional tests would be required to find an underlying problem.
Anyone may experience digestive upset from worry or anxiety. But if you have irritable bowel syndrome, stress-related problems such as abdominal pain and diarrhea tend to occur with greater frequency and intensity. Finding ways to deal with stress may be helpful in preventing or alleviating symptoms going forward.
Regardless, a sudden change in bowel movements is a sign of something worth talking to your doctor about.
For more information about IBS and gastrointestinal issues, the International Foundation for Functional Gastrointestinal Disorders (IFFGD) offers a complete resource for trustworthy information, support, and assistance about Irritable Bowel Syndrome. http://www.aboutibs.org/
If you or someone you love suffers from IBS and is not responding to traditional treamtment, perhaos Our Approach can give relief from this condition.