Irritable Bowel Syndrome

July 23rd, 2013 by Eduardo Krajewski, MD, FACS, FASCRS

Irritable bowel syndrome (IBS) is a chronic disorder of the large intestine. IBS is believed to affect up to 15% of the US population, and nobody is quite sure what causes the disorder. However, there are many different treatment options.

What are the Symptoms of Irritable Bowel Syndrome?

IBS symptoms can vary widely in quality and severity from person to person. Also, your symptoms can change in regards to time, diet and levels of stress.  Some of the more common symptoms of IBS are:

  • Abdominal cramps and pain
  • Abdominal bloating
  • Increased flatulence
  • Diarrhea and/or constipation (Classically, alternating episodes of constipation and diarrhea are seen in IBS.)
  • Mucus in stool

It is important to rule out other diseases when evaluating IBS symptoms. For example, your doctor will want to make sure you don’t have inflammatory bowel disease or colon cancer. We will learn more about this later.

What Causes Irritable Bowel Syndrome?

The exact cause of IBS is not clear, and there are many theories. Some believe that it has something to do with abnormal intestinal contractions or stool transit times. Others claim that it is a nervous system problem. Also, there is some evidence to suggest that IBS is related to abnormal levels of serotonin which is a chemical that works in brain and bowel function.

Now while the exact cause is not known, there are certain triggers that can lead to IBS symptoms. For example, some foods like milk, chocolate, fruits, vegetables or alcohol might cause symptoms in some people with IBS. Some people also have discomfort after drinking carbonated beverages.

Stress is commonly linked with increased IBS symptoms as well. This factor helps to understand treatment plans. In women, hormonal changes can influence bowel symptoms especially around menstrual periods.

Are There any Tests for Irritable Bowel Syndrome?

There is no one specific test that confirms the diagnosis of IBS. The reason for this is because all blood tests and imaging studies are usually normal when you have IBS and no other disease. So instead, your doctor goes by a set of criteria to establish the diagnosis. These are known as the Rome criteria.

To meet the diagnosis for IBS you must have abdominal pain or discomfort for at least 12 weeks. However, this doesn’t necessarily mean pain every day for 12 weeks. Then you must have at least two of the following symptoms:

  • A change in the consistency and/or frequency of your stool
  • Excessive straining, urgency or a feeling that you haven’t emptied your bowels completely
  • Mucus in the stool
  • Abdominal distention (swelling) or bloating

Now if you have other symptoms, it might be a sign that another, perhaps more serious, disorder is causing your problems. Signs to watch out for are age over 50, weight loss, blood in the stool, fever, nausea, vomiting, severe pain and diarrhea that awakens you from sleep. If these symptoms are present, then special tests, like a colonoscopy, should be ordered. This helps your doctor rule out other diseases like colon cancer or inflammatory bowel disease.

How is Irritable Bowel Disease Treated?

Stress reduction helps as well as avoiding food triggers. Getting adequate rest and exercise are also helpful. Good doctor and patient communication goes a long way in treating IBS. Other treatments your doctor might recommend are:

  • Increased fiber in the diet or fiber supplements
  • Anti-diarrhea medication like Imodium (loperamide)
  • Avoiding “gassy” foods like raw fruits and vegetables and carbonated drinks
  • Anticholinergic medications: These are used to treat bowel spasms
  • Antidepressants: This is related to the stress component of IBS. Some medications used to treat IBS are imipramine, amitriptyline, fluoxetine or paroxetine.
  • Lotrenox: This is a medicine that is used only in severe cases of IBS where diarrhea is prominent. Lotrenox carries the risk of serious side effects.
  • Lubiprostone: Increases fluids to the intestines and helps with constipation. For severe cases of IBS only.
  • Probiotics: Evidence shows that some bacteria, given in food or supplement form, may help reduce IBS symptoms.


Irritable bowel syndrome is very common, but the cause has yet to be discovered. Stress plays an important role in the disorder. Presently, there is no cure for IBS, but there are many effective treatment options.

Explore The H Doctor website. You will find many more articles and videos that give the best information available about hemorrhoid treatment and other important digestive health topics.

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