IBS: The Syndrome Affecting An Estimated 40 Million Americans

By Dr. Tim Moser, Denver House Calls in Denver
Posted

Colleen was going to the bathroom - again. It was the third time this morning she had felt the urge to have a bowel movement, only to have a small amount of loose stool with mucous present. Her abdominal bloating had been distracting her for days now. Last week it was constipation, this week she was experiencing frequent stools that were loose. Her symptoms seemed to be worse after eating, especially if it were a large meal. At times, her symptoms kept her awake at night.

The stress Colleen was feeling from her job had been nearly unbearable for the past several months. Reflecting back on her symptoms, the changes she was experiencing seemed to coincide with the higher stress. The regular exercise routine she had previously enjoyed was now long gone in favor of working many nights and weekends. Her diet had also deteriorated, from frequent smaller meals that centered on whole grains and fruits, to junk food scavenged from the vending machine down the hall from her office.

Finally, Colleen had had enough. She made an appointment with her doctor, who made sure there were no warning signs such as unexplained weight loss, fever, or rectal bleeding. The doctor seemed reassured based on the answers she obtained from Colleen, and ordered some lab tests to check for gluten sensitivity, lactose intolerance, and anemia.

Irritable Bowel Syndrome (commonly abbreviated IBS), is a very common condition that affects more women than men. Symptoms may include abdominal pain, bloating, excess gas production, and changes in bowel movements.

Why dost thou bowel hurt?

Irritable Bowel Syndrome is not a disease. Those that suffer from the symptoms of IBS are not at an increased risk for cancer or other serious problems involving the colon. That is the good news.

The bad news is that IBS can last for years, and cause a great deal suffering for those afflicted. Since it is a syndrome, a diagnostic test is not available to prove that IBS is present, although tests are often performed to check for other conditions that may be more serious. Often the diagnosis of IBS is one of exclusion, meaning tests for other conditions are normal.

Pain is often a common complaint seen in patients with IBS. It appears that those suffering from IBS have large intestines that respond differently to pain than those that are not afflicted with the condition. Instead of pain medication, drugs that help stop colon spasms may be effective.

Many patients find their symptoms are worse during times of increased stress. Often, ‘trigger foods’ in the diet can also make things worse.

Symptoms of the Syndrome

Although there is no diagnostic test that can prove IBS is present, most specialists agree that certain symptoms must be present to make the diagnosis.

These symptoms include abdominal pain lasting at least 12 weeks, mucous in the stool, bloating, and a sensation of incomplete voiding following a bowel movement.

Symptoms not consistent with IBS  include weight loss, fever, blood in the stool, persistent vomiting, or abdominal pain that is constant. If worrisome signs or symptoms are detected, then further testing may be needed.

Depending on the patient’s age, a colonoscopy screening may be performed to examine the inside of the colon. Very small samples may be taken of the colon wall (known as biopsies) during the procedure to check for disease. If the only condition causing the symptoms is IBS, the biopsies will be normal.

The Search for Relief

Since millions of Americans experience the symptoms of IBS, it would make sense there would be a medication that would make most of the victims of this condition feel better. 

Although there are a plethora of prescription medications used to treat IBS, there isn't one particular medicine that helps most people with the syndrome. Some typical examples are drugs that help prevent colon spasms (Bentyl, otherwise known as Dicyclomine); drugs that help with diarrhea (Lomotil); and anti-depressant medications that can help reduce the colon’s sensitivity to pain (Fluoxetine, or Prozac).

The best way to treat IBS, howeevr, is to take the natural route as much as possible. Taking a probiotic has been shown in clinical trials to reduce the severity of IBS symptoms, while increasing fiber can help with both diarrhea and constipation. Regular exercise is a cornerstone of prevention and treatment as well, since it helps lower anxiety, promotes normal bowel function, and tends to reduce pain.

Want more information about IBS?

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001292/

http://www.mayoclinic.com/health/irritable-bowel-syndrome/DS00106

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