Irritable Bowel Syndrome (IBS)

What is Irritable Bowel Syndrome?
It’s a common condition that affects your colon which causes cramping, abdominal pain, bloating, gas, diarrhea and constipation. IBS is a group of symptoms that occur together and it’s not considered a disease.  It’s diagnosed when a person has had abdominal pain or discomfort at least 3 times a month for the last 3 months without other disease or injury which could explain the pain.

What Causes IBS?
There are many different triggers that cause IBS and it usually varies from person to person. Not everyone who has IBS experiences the same triggers. Here some common triggers:

Food: It’s important to know the difference between a food intolerance and allergy.  Many people experience severe symptoms when eating certain foods. A wide range of foods have been implicated for individuals who suffer from IBS: chocolate, spices, fats, fruits, beans, cabbage, cauliflower, broccoli, milk, carbonated drinks, and alcohol to name a few.

Stress: Many people with IBS experience symptoms during stressful situations, like finals week for students or starting a new job. Even though stress may aggravate symptoms, it doesn’t cause them.

Hormones: Unfortunately, women are twice as likely to experience IBS due to hormonal changes that occur during their menstrual cycle.

Other Illness: Sometimes IBS can be triggered by numerous episodes of infectious diarrhea (gastroenteritis), or too many bacteria in the intestines.

Tests and Diagnosis
There are two sets of criteria for making a diagnosis, Rome criteria and Manning criteria.

Rome Criteria: Three months of continuous or reoccurring symptoms of abdominal pain or irritation that

• May be relieved with a bowel movement,
• May be coupled with a change in frequency, or
• May be related to a change in the consistency of stools.

Manning Criteria: Focuses on pain relieved by defecation, having incomplete bowel movements, mucus in the stool and changes in consistency. The more symptoms present, the greater likelihood of IBS.

Additional tests may include imaging such as:

• Flexible Sigmoidoscopy
• Colonoscopy
• X-ray
• CT scan
• Low GI series

Laboratory tests:

• Lactose intolerance tests
• Breath tests
• Blood tests
• Stool tests

Treatment and Drugs
Dietary changes, medication, and counseling are long-term management options for symptoms of IBS:

• Dietary Changes: Eliminating high-gas foods, eliminating gluten, eliminating FODMAPs.
• Medications:  Fiber supplements, anti-diarrheal medication, anticholinergic and antispasmodic medications, antidepressant medication, antibiotic, counseling.
• Medications Specifically for IBS: Alosetron (Lotronex), Lubiprostone (Amitiza)
• Prevention: Counseling, biofeedback, progressive relaxation exercises, deep breathing, mindfulness training are ways we can deal with stress and may help prevent or ease IBS symptoms.