Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome (IBS) is a digestion problem that causes episodes of belly pain, cramping or bloating, and diarrhea or constipation. Symptoms may be worse or better from day to day, but IBS won't get worse over time. It doesn't cause more serious diseases.

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What happens when you have irritable bowel syndrome (IBS)?

Symptoms of irritable bowel syndrome (IBS) may last for a long time. But IBS doesn't cause cancer or shorten your life.

The pattern of IBS varies from one person to the next and from one bout to the next. Some people have symptoms off and on for many years. You may go months or years without having any symptoms. But most people have symptoms that keep coming back. It is rare for a person to have symptoms constantly.

Between 7 and 10 out of 100 people in the world have irritable bowel syndrome. But most people with IBS don't see a doctor about their symptoms.

Definition

Irritable bowel syndrome (IBS)

Irritable bowel syndrome (IBS) is a digestion problem that causes episodes of belly pain, cramping or bloating, and diarrhea or constipation. Symptoms may be worse or better from day to day, but IBS won't get worse over time. It doesn't cause more serious diseases.

Irritable bowel syndrome is a long-term problem, but treatment can help you manage your symptoms.

Diagnostics

How is irritable bowel syndrome (IBS) diagnosed?

Most of the time, doctors can diagnose IBS from the symptoms. Your doctor will ask you about your symptoms and past health and will do a physical exam. In some cases, you may need other tests, such as stool analysis or blood tests to rule out other problems.

Diet

Changing your eating habits to manage symptoms of irritable bowel syndrome (IBS)

You can manage your IBS by limiting or not eating foods that may bring on symptoms, particularly diarrhea, constipation, gas, and bloating.

Here are some suggestions to get you started.

  • Eat slowly, and have meals in a quiet and relaxing environment.
  • Try to eat meals at about the same time each day.

    Don't skip meals or wait too long between meals.

  • Drink plenty of fluids.

    Be sure to drink water in addition to your other beverages. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.

  • Limit or avoid caffeine, such as from coffee and tea.
  • Avoid alcohol and fizzy (carbonated) drinks.
  • Avoid foods that may cause gas and bloating.

    Vegetables such as artichokes, asparagus, broccoli, brussels sprouts, cabbage, cauliflower, cucumbers, green peppers, onions, peas, radishes, and raw potatoes may not be digested well by your body and can cause gas and bloating.

  • Limit your intake of fresh fruit and fruit juice.

    These are high in fructose. People who have IBS may not be able to digest fructose well. This can cause diarrhea, gas, and bloating.

  • Limit the amount of lactose you get.

    Lactose is a sugar found in milk. People who have IBS may have worse symptoms when they eat or drink dairy.

  • Be careful eating some types of fiber.

    Fiber affects each person who has IBS in different ways.

    If you have diarrhea, try limiting the amount of high-fiber foods you eat. This includes vegetables, fruits, whole-grain breads and pasta, high-fiber cereal, and brown rice.

    To reduce constipation, add fiber such as fruits, vegetables, beans, and whole grains in your diet each day and drink plenty of water.

  • Try the low-FODMAP diet.

    FODMAPs are carbohydrates that are in many types of foods. It stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.

    If you have digestive problems, these can make your symptoms worse.

    A low-FODMAP diet is when you stop eating high-FODMAP foods for about two months. Then you slowly add them back in to your diet to see what foods cause digestion problems.

  • Keep a daily food diary.

    Track what you eat, your emotions, activities, and your symptoms after eating. If you notice patterns of symptoms after eating certain foods, you can try removing those foods from your diet.

Which foods might cause symptoms when you have irritable bowel syndrome (IBS)?

Many people find that their IBS symptoms get worse after they eat. Sometimes certain foods make symptoms worse.

Make sure that you don't stop eating completely from any one food group without talking with a dietitian. You need to make sure that you're still getting all the nutrients you need.

Foods most commonly listed as causing symptoms include:

  • Cabbage.
  • Onions.
  • Peas and beans.
  • Hot spices.
  • Deep-fried and fried foods.
  • Pizza.
  • Coffee.
  • Cream.
  • Smoked food.
  • Alcohol.
  • Carbonated (fizzy) drinks.

Other types of food that can make IBS symptoms worse include:

  • Lactose. This is a sugar found in milk. Some dairy products (like cheese and yogurt) have less lactose.
  • Fructose. This is a sugar found in vegetables and fruit.
  • Sorbitol and xylitol. These are artificial sweeteners found in sugar-free chewing gum, drinks, and other sugar-free sweets.
  • Caffeine.

Overview

Irritable bowel syndrome (IBS): Overview

Irritable bowel syndrome, or IBS, is a problem with the intestines that causes belly pain, bloating, gas, constipation, and diarrhea. The cause of IBS is not well known. IBS can last for many years, but it does not get worse over time or lead to serious disease.

Most people can control their symptoms by changing their diet and reducing stress.

Providers

Who can diagnose and treat irritable bowel syndrome (IBS)?

The following health professionals can diagnose and treat irritable bowel syndrome (IBS):

  • General practitioner
  • Family medicine physician
  • Internist

If more tests are needed or your symptoms don't respond to treatment, it may be helpful to see a doctor who specializes in treating digestive system problems (gastroenterologist). If stress may be playing a role in IBS, it may be helpful to see a psychiatrist or psychologist.

Self-care Treatment Options

How can you care for yourself when you have irritable bowel syndrome (IBS)?

  • To reduce diarrhea, limit or avoid:
    • Alcohol.
    • Caffeine, which is found in coffee, tea, colas, and chocolate.
    • Nicotine from smoking or chewing tobacco.
    • Gas-producing foods, such as beans, broccoli, cabbage, or apples.
    • Dairy products that contain lactose (milk sugar), such as ice cream or milk.
    • Foods and drinks high in sugar, especially fruit juice, soda, candy, and other packaged sweets (such as cookies).
    • Foods high in fat, including bacon, sausage, butter, oils, and anything deep-fried.
    • Sorbitol and xylitol. These are artificial sweeteners found in some sugarless candies and chewing gum.
  • To reduce constipation:
    • Slowly increase the amount of fiber you eat. For some people who have IBS, eating more fiber may make some symptoms worse, including bloating. Adding fiber slowly may help you avoid these problems.
    • Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber.
    • Drink plenty of fluids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
    • Get some exercise every day. Build up slowly to 30 to 60 minutes a day on 5 or more days of the week.
    • Take a fiber supplement, such as Citrucel or Metamucil, every day if needed. Read and follow all instructions on the label.
    • Schedule time each day for a bowel movement. Having a daily routine may help. Take your time and do not strain when having a bowel movement.
  • Keep a daily diary of what you eat and what symptoms you have. This may help find foods that cause you problems.
  • Eat slowly. Try to make mealtime relaxing.
  • Find ways to reduce stress.

Signs and Symptoms

What are the symptoms of irritable bowel syndrome (IBS)?

The main symptoms of IBS are belly pain with constipation or diarrhea. Other symptoms are bloating, mucus in the stools, and a feeling that the bowels haven't completely emptied. These symptoms are real and not imagined, even though there are no structural problems in the intestines of people with IBS.

Treatment

How is irritable bowel syndrome (IBS) treated?

For most people who have irritable bowel syndrome (IBS), home treatment may be the best way to manage the symptoms. It is also helpful to learn all you can about IBS so you can better share your concerns and questions with your doctor.

Careful attention to diet, exercise, and stress management should help keep your symptoms under control. They may even prevent your symptoms from coming back.

Diet

In many people who have IBS, eating may trigger symptoms. But for most people, there is not a certain type of food that triggers symptoms.

Increasing the amount of fiber in your diet can help control constipation. High-fiber foods include fresh fruits (raspberries, pears, apples), fresh vegetables (carrots, leafy greens), wheat bran, and whole-grain breads and cereals. Beans such as kidney, pinto, and garbanzo are also high-fiber foods. (So are vegetables such as peas, cabbage, and broccoli. But they should probably be avoided if gas is one of your symptoms.)

If you have trouble getting enough fiber in your diet, you can take a fiber supplement such as psyllium (for example, Metamucil) or wheat dextrin (for example, Benefiber). If you take a fiber supplement, read and follow all instructions on the label. Also, make sure to drink plenty of fluids.

You can take steps to make it less likely that certain foods will cause symptoms. For example, avoid or limit gas-producing foods (including beans and cabbage), sugarless chewing gum and candy, caffeine, and alcohol.

If you have diarrhea, try limiting the amount of high-fiber foods you eat. This includes vegetables, fruits, whole-grain breads and pasta, high-fiber cereal, and brown rice.

Exercise

Getting more exercise can make your symptoms less severe. Exercise also can improve your quality of life (especially how well you sleep, your energy level, and your emotional and social life).

Getting more exercise doesn't have to be hard. In one study, people with IBS increased their activity level by adding 20 to 60 minutes of moderate to vigorous physical activity, 3 to 5 days a week. They did activities such as swimming, jogging, cycling, and walking.

In the group that did not increase their activity level, more people had an increase in their IBS symptoms. These people weren't active, and their symptoms got worse.

Stress management

If stress seems to trigger your symptoms, these tips may help you better manage stress and avoid or ease some IBS episodes:

  • Keep a diary or journal of your symptoms as well as life events that occur with them. This often helps clarify the connection between symptoms and stressful occasions. After you have identified certain events or situations that bring on symptoms, you can find ways to deal with these situations.
  • Get regular, vigorous exercise (such as swimming, jogging, or brisk walking) to help reduce tension.
  • A hobby or an outside activity can provide a break from stressful situations.
  • Find a support group. In a support group, you can share with other people who have IBS.
  • Psychiatrists, psychologists, counselors, social workers, and biofeedbck specialists can provide methods for coping with stress.

Treatment Options

How is irritable bowel syndrome (IBS) treated?

Treatment for IBS depends on what symptoms you have, how severe they are, and how they affect your daily life. No single treatment works best for everyone.

Learn all you can about IBS so that you and your doctor can work together to find out what triggers your symptoms. You will need to adapt your lifestyle to best deal with your symptoms and still carry on with your daily activities. Let your doctor know if parts of your treatment aren't helping your symptoms.

Record your symptoms

The first step in treating IBS usually involves watching and recording your symptoms, your bowel habits, what you eat, and other daily activities (such as exercise) that affect your symptoms. Writing all this down in a notebook for a few weeks can help you and your doctor see patterns of symptoms in your daily life. You may be able to see what things make your symptoms worse (such as eating dairy products). Then you can start to avoid them.

Manage your symptoms

For some people who have IBS, certain foods may trigger symptoms. The following steps may help prevent or relieve some IBS symptoms:

  • Limit caffeine and alcohol.
  • Limit your intake of fatty foods.
  • If diarrhea is your main symptom, limit dairy products, fruit, and artificial sweeteners such as sorbitol and xylitol.
  • Increase fiber in your diet. It can help relieve constipation.
  • Avoid foods such as beans, cabbage, or uncooked cauliflower or broccoli. This can help relieve bloating or gas.

Here are some other steps you can take to help your symptoms:

  • Get some exercise, such as swimming, jogging, cycling, or walking. It can also improve your quality of life (especially how well you sleep, your energy level, and your emotional and social life).
  • Quit smoking, if you smoke.
  • Reduce stress, if stress seems to trigger symptoms.

Take medicines

If diet and lifestyle changes don't help enough on their own, your doctor may prescribe medicines. Medicines may help ease symptoms such as pain, diarrhea, constipation, cramping, depression, and anxiety. Your doctor may also want you to try different medicines, or different dosages of your medicines, if your symptoms aren't responding to treatment.

Watch for new symptoms

Because IBS is a long-term problem, it's important for you to be aware of big changes in symptoms. For example, watch for blood in your stools, increased pain, severe fever, or unexplained weight loss. If any of these occur, your doctor may want to do more tests to find out if there is another cause for your symptoms.

What Causes It

What causes irritable bowel syndrome (IBS)?

It isn't clear what causes IBS. The cause may be different for different people. IBS may be caused by problems with the way signals are sent between the brain and the digestive tract. In some people, this miscommunication causes abnormal muscle contractions or spasms, which often cause cramping pain. The spasms may speed the passage of stool, causing diarrhea. Or they may slow it down, causing constipation or bloating.

People with IBS may have unusually sensitive intestines or problems with the way the muscles of the intestines move. It isn't known why their intestines are more likely to react strongly to the things that contribute to IBS.

People who have IBS may start having symptoms because of one or more causes, such as:

  • Eating. (But no particular foods have been linked with IBS.)
  • Stress and psychological issues, such as anxiety and depression.
  • Hormonal changes, such as during the menstrual cycle.
  • Some medicines, such as antibiotics.
  • An infection in the digestive tract, such as salmonella.
  • Genetics. IBS may be more likely to occur in people who have a family history of it.

What It Is

What is irritable bowel syndrome (IBS)?

Irritable bowel syndrome (IBS) is a disorder of the intestines. It's a long-term problem that causes belly pain, cramping or bloating, and diarrhea or constipation. Symptoms may be worse or better from day to day, but IBS doesn't get worse over time or cause more serious diseases.

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