Irritable Bowel Syndrome (IBS)
What is IBS and its symptoms?
How is IBS treated?
IBS is a chronic condition of gastrointestinal “dys- IBS is not life threatening or associated with seri- function” affecting up to 20 % of the population, ous disease, but the symptoms for some may sig- characterized by symptoms of abdominal cramping/ nificantly affect quality of life. There is no one pill pain, bloating and/or an altered pattern of bowel that will cure IBS or eliminate symptoms, but your movements which can include diarrhea, constipa- provider will work with you to manage your symp- tion or both. The pattern of symptoms can vary toms. Communicate with your provider about what greatly from person to person, and from time to combination of treatments helps and what does not.
time. It can affect people of all ages, although its first presentation is more often in young adulthood. Dietary Changes
It is about twice as common in women and is • Your provider may ask you to monitor symp- sometimes associated with menses. Diarrhea can be toms for a given period of time and note wheth- accompanied by a sense of urgency to have a bowel er certain foods seem to TRIGGER increased movement(BM); mucus and gas can occur, as can a symptoms. Especially if gas is a predominant sense of incomplete “evacuation” after a BM. symptom, eliminating or limiting gas-producing foods may be suggested at least on a trial basis.
ALARM symptoms such as bloody stools, fever,
weight loss and nighttime symptoms, or recent • Examples of gas producing foods: legumes
onset after use of an antibiotic are NOT typical for
(beans/lentils) cruciferous veggies (broccoli, IBS, and require that you see a provider for further
cauliflower, cabbage, brussel sprouts), artificial sweeteners (such as sorbitol) contained in many products and drinks, carbonated beverages, What causes IBS?
sometimes celery, carrots, onions, raisins, ba- There are multiple theories but the exact cause is nanas, apricots, prunes. Gum chewing can also not known. One school of thought is that the bowel muscle is contracting abnormally, leading to cramps and irregular squeezing that leads to varying stool • Other food intolerances vary greatly among consistency and frequency. Another idea is that those with IBS but may include fatty foods, al- nerves in the bowel are hypersensitive, leading to cohol, chocolate, caffeine. If a certain food seems increased perception of pain from normal amounts to trigger symptoms, do a trial elimination for a of gas. There is some suggestion that stress worsens symptoms, but it is unlikely that this is the cause of IBS alone. Another area of study is whether food • Since intolerance of lactose, present in milk intolerances may be a contributing factor. Recent and ice cream, is a common problem which may studies have raised questions about bacteria in the cause symptoms similar to IBS, your provider may ask you to eliminate milk products for about 1-2 weeks to observe the effect on your How is IBS diagnosed?
There is no single test for IBS. Because other intes- tinal disorders can cause similar symptoms, your • Fiber: Some IBS sufferers with a constipation
provider will need to examine you and ask many dominant pattern of symptoms, and even those questions as part of a medical history to distinguish with more diarrhea-predominant symptoms, may IBS from other conditions. Your provider may also benefit from adding a soluble fiber supplement to order lab tests to look for other causes, for example, their diet, to ”even out” the consistency of stool. inflammatory bowel disease (Crohn’s, ulcerative Fiber supplements such as psyllium or methyl- colitis) or celiac disease (gluten intolerance). You cellulose should be started slowly and gradually may be asked to do some trial eliminations of foods increased to avoid creating more intestinal gas. It to rule out other causes of symptoms, such as stop- can take a few weeks to see if adding fiber has a ping stopping milk to assess lactose intolerance. positive effect on IBS, so be sure to give a trial of Sometimes a referral to a gastroenterologist may fiber enough time. Insoluble fibers such as wheat/ corn bran can aggravate symptoms for some. B R O W N U N I V E R S I T Y H E A L T H S E R V I C E S | www.brown.edu/health | 401.863-3953
• Foods that may be easier to digest in people • A few other medications are also prescribed in with IBS, some of which also contain soluble limited cases of IBS and usually by GI special- fiber include:Whole grain breads and cereals, ists, (eg Lubiprostone, Alosetron), because pasta and rice, as well as fruits, vegetables (not specific prescribing criteria must be met. These medicines are costly and their effectiveness is • Large meals seem to trigger IBS symptoms for some, so smaller meals and regular eating • Herbal treatments- use of “natural treatments” advertised for IBS especially on internet, such as peppermint oil,acidophilus, and chamomile • Drinking adequate fluids is also suggested 6-8 have not been shown to have proven benefit in clinical studies. Wormwood and comfrey can
be dangerous and should not be taken.
Stress and anxiety may worsen IBS symptoms in • Antibiotics- use of certain antibiotics which tar- some people, possibly by triggering spasm in in- get gas-producing bacteria are currently being testinal muscle. Talk to your provider about stress studied for treating IBS. While this is an emerg- management, and whether talking to a counselor ing area of investigation, effectiveness needs may be useful for you. Exercise may promote nor- further evaluation, and using antibiotics is not mal contractions in your intestine and also manage currently a standard practice in treating IBS.
• Probiotics-there is debate about whether pro- biotic supplements provide significant effect Medicines
in relieving IBS symptoms. Studies have not There is no drug that can cure IBS and studies are clearly made the case for using such products, inconsistent in proving that medicines available are but there is some evidence of modest effect from more effective than placebo (sugar pills). Sometimes a medication to control symptoms may be suggested by your provider, especially in people who do not seem to respond to non-medicinal treatments. Ask your provider about side effects which may occur for • Antispasmodics- sometimes used preventatively for irregular contractions of intestine to reduce cramps and urgent/frequent stools (eg Bentyl, • Antidepressants- low doses, especially those in the tricyclic family can have a pain-relieving effect in people with IBS; may take 3-4 weeks to see effect (eg Amitriptyline,imipramine). Other antidepressants in the SSRI family may also be helpful in some people with IBS; treating any underlying depression may also help IBS symptoms.
• Antidiarrheals- can slow stool moving through GI tract in diarrhea-predominant IBS; used on as-needed basis for reducing stool frequency, but have not been shown to have effect on pain B R O W N U N I V E R S I T Y H E A L T H S E R V I C E S | www.brown.edu/health | 401.863-3953

Source: http://x2fwww.pembrokecenter.org/Student_Services/Health_Services/library/documents/IBS11.pdf


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