Irritable Bowel Syndrome, or IBS, is one of the most common disorders of the bowel. It affects 15% of people in the United States, and is seen more often in women than in men.

IBS is a problem that occurs in the large intestine when food travels too quickly through the intestines, leading to pain and discomfort. It is a chronic, or ongoing, condition.

Symptoms of IBS include:

  • Constipation or diarrhea
  • Urge to have a bowel movement even when the colon is empty
  • Abdominal cramping and pain
  • Bloating and gas
  • Mucus in the stool

Symptoms increase with:

  • Stress
  • Fatty, processed or fried foods
  • Menstruation
  • Eating certain trigger foods (dairy, chocolate, wheat)
  • Alcoholic beverages
  • Caffeinated beverages
  • General practitioner: The first line of defense in IBS. These doctors deal with prevention, discovery and treatment of illnesses in all age categories.
  • Internist: Focuses on diagnosis, treatment and prevention of adult illness.
  • Gastroenterologist: Doctor who specializes in the diagnosis and treatment of digestive system diseases.
  • Psychologist: Specializes in mood and emotional disorders. This therapist offers counseling and alternative therapy like hypnosis and biofeedback to lower stress and lessen the frequency of IBS attacks.
  • Nutritionist/dietician: Creates meal plans to help lessen IBS attacks, which may include removing any foods that the patient may have sensitivity to.

Before Your Visit

After you make an appointment for IBS diagnosis and treatment, there are some steps you can take to make your visit a smooth one.

  • Keep a diary of frequency and severity of bowel symptoms as well as anything that seems to trigger them.
  • Make a list of all medications you’re taking, including vitamins and herbs.
  • Compile your complete medical history, including any allergies you have and your family history.

It’s also a good idea to bring a list of any questions you may have to your first appointment to discuss them with your doctor. Review this list of common concerns before your visit, or print it out to bring with you.

Question About My Diagnosis

  • Does IBS lead to colon cancer?
  • Is IBS associated with other medical conditions?
  • Are there triggers that cause IBS flare-ups?
  • How do I determine the triggers?
  • Is Irritable Bowel Syndrome curable?

Questions About My Treatment

  • Will I need surgery eventually?
  • Are there medications that prevent a flare-up?
  • Will I need to take medication forever?
  • What are the side effects of the treatment?
  • Are there nonprescription or herbal treatments for IBS?
  • Should I take or avoid laxatives?

Questions About My Lifestyle and Family

  • Is IBS genetic?
  • What diet and exercise do you advise? Are there foods I should avoid?
  • Does stress cause IBS? Smoking? Do alcoholic beverages cause IBS flare-ups?
  • Are there complementary therapies available for IBS?

Tests and Diagnosis

There are no definitive tests for Irritable Bowel Syndrome (IBS). Diagnosis is usually done based on the frequency or severity of a patient’s symptoms.

Tests may be run to rule out conditions that can cause symptoms similar to IBS. This is especially important in patients over 50 who are experiencing IBS-like symptoms for the first time. These tests may include:

  • Complete blood count (CBC): A blood test to check for inflammation and blood loss
  • Stool analysis: Stool is examined for the presence of blood, parasites, bacteria, fungus and viral infections
  • Colonoscopy: Looks for growths, tumors, ulcer or narrowing in the large intestine. After you are sedated, the doctor inserts a long, flexible device with a light attached to a video monitor into your rectum to view the entire large intestine.
  • Thyroid function tests: Done to test the thyroid; may be a blood test, x-ray or ultrasound depending on whether the doctor wants to check levels or examine the gland itself
  • Blood tests for celiac disease: Looks for three specific antibodies that are markers for celiac disease: anti-gliadin, anti-tissue transglutaminase, and endomysial
  • Small intestinal biopsy: Looks for loss of villi and increased white blood cells which are characteristic of celiac disease. The doctor inserts a long, flexible device through the mouth and into the duodenum. A long biopsy tool is passed through a channel in the endoscope to take snips of the duodenal lining.

Medications and Treatment

For some people, making simple lifestyle changes can help them to effectively manage Irritable Bowel Syndrome (IBS). These steps may include:

  • Avoiding food that trigger IBS attacks
  • Exercising regularly
  • Avoiding alcohol and caffeine
  • Adding fiber to your diet
  • Eating on a regular schedule
  • Reducing stress

If lifestyle changes don’t provide relief from IBS, there are medications that can help you manage the condition. While there is no one “magic pill” to relieve IBS permanently, these drugs can help to control the symptoms that interfere with everyday life like diarrhea, constipation and pain:

  • Antidiarrheals (Immodium): Slows down intestinal movement
  • Bile acid binders (Prevalite, Colestid): Prevents bile acids from stimulating the colon; slows stool passage and decreases diarrhea
  • Stool softeners: Encourages water absorption by stool for easier passage
  • Laxatives: Promotes bowel movements; lessens constipation
  • Antispasmodics (Levsin, Bentyl): Relieves cramps and intestinal spasms
  • Antidepressants: Decreases depression; lessens IBS pain
  • Anti-anxiety medications: Lessens anxiety to decrease IBS symptoms