What is IBS and how do you treat it?

IBS is a common disorder that affects your large intestine.

IBS commonly causes cramping, abdominal pain, bloating gas, diarrhea and constipation. 

Most people with IBS find that symptoms improve as they learn to control their condition. Only a small number of people with irritable bowel syndrome have disabling signs and symptoms.

Fortunately, unlike more-serious intestinal diseases such as ulcerative colitis and Crohn's disease, irritable bowel syndrome doesn't cause inflammation or changes in bowel tissue or increase your risk of colorectal cancer. In many cases, you can control irritable bowel syndrome by managing your diet, lifestyle and stress.

Signs and Symptoms

The signs and symptoms of IBS can vary widely from person to person and often resemble those of other diseases. Among the most common are:

• Abdominal pain or cramping
• A bloated feeling
• Gas (flatulence)
• Diarrhea or constipation — sometimes even alternating bouts of constipation and diarrhea
• Mucus in the stool

Like many people, you may have only mild signs and symptoms of irritable bowel syndrome. However, sometimes these problems can be disabling. In some cases, you may have severe signs and symptoms that don't respond well to medical treatment. Because symptoms of irritable bowel syndrome can occur with other more serious diseases, it's best to discuss these symptoms with your doctor.

For most people, IBS is a chronic condition, although there will likely be times when the signs and symptoms are worse and times when they improve or even disappear completely.

Causes

It's not known exactly what causes irritable bowel syndrome. The walls of the intestines are lined with layers of muscle that contract and relax in a coordinated rhythm as they move food from your stomach through your intestinal tract to your rectum. If you have irritable bowel syndrome, the contractions may be stronger and last longer than normal. Food is forced through your intestines more quickly, causing gas, bloating and diarrhea.

In some cases, the opposite occurs. Food passage slows, and stools become hard and dry. Abnormalities in your nervous system or colon also may play a role, causing you to experience greater than normal discomfort when your intestinal wall stretches from gas.

There are a number of other factors that may play a role in IBS. For example, people with IBS may have abnormal serotonin levels. Serotonin is a chemical messenger that's normally associated with brain function, but it also plays a role in normal digestive system function. It's also possible that people with IBS don't have the right balance of good bacteria in the intestine. 

 Triggers

For reasons that still aren't clear, if you have IBS you probably react strongly to stimuli that don't bother other people. Triggers for IBS can range from gas or pressure on your intestines to certain foods, medications or emotions. For example:

• Foods. Many people find that their signs and symptoms worsen when they eat certain foods. For instance, chocolate, milk and alcohol might cause constipation or diarrhea. Carbonated beverages and some fruits and vegetables may lead to bloating and discomfort in some people with IBS. The role of food allergy or intolerance in irritable bowel syndrome has yet to be clearly understood.
  
  If you experience cramping and bloating mainly after eating dairy products, food with caffeine, or sugar-free gum or candies, the problem may not be irritable bowel syndrome. Instead, your body may not be able to tolerate the sugar (lactose) in dairy products, caffeine or the artificial sweetener sorbitol.
• Stress. If you're like most people with IBS, you probably find that your signs and symptoms are worse or more frequent during stressful events, such as a change in your daily routine. But while stress may aggravate symptoms, it doesn't cause them.
• Hormones. Because women are more likely to have IBS, researchers believe that hormonal changes play a role in this condition. Many women find that signs and symptoms are worse during or around their menstrual periods.

When to see your doctor

It's important to see your doctor if you have a persistent change in bowel habits or if you have any other signs or symptoms of IBS. These may indicate a more serious condition, such as an infection or colon cancer.

Your doctor may be able to help you find ways to relieve symptoms as well as rule out other more-serious colon conditions, such as ulcerative colitis and Crohn's disease, which are forms of inflammatory bowel disease.

Risk Factors

Many people have occasional signs and symptoms of irritable bowel syndrome. However, you're more likely to have IBS if you:

• Are young. IBS symptoms first appear before the age of 35 for about half of those with the disorder.
• Are female. More women than men are diagnosed with this condition.
• Have a family history of IBS. Studies have shown that people who have a first-degree relative — such as a parent or sibling — with IBS are at increased risk of the condition. It's not clear whether the influence of family history on IBS risk is related to genes, to shared factors in a family's environment, or both.

Lifestyle and home remedies

In many cases, simple changes in your diet and lifestyle can provide relief from irritable bowel syndrome. Although your body may not respond immediately to these changes, your goal is to find long-term, not temporary, solutions:

• Avoid problem foods. If certain foods make your signs and symptoms worse, don't eat them. Common culprits include alcohol, chocolate, caffeinated beverages such as coffee and sodas, medications that contain caffeine, dairy products, and sugar-free sweeteners such as sorbitol or mannitol. If gas is a problem for you, foods that might make symptoms worse include beans, cabbage, cauliflower and broccoli. Fatty foods may also be a problem for some people. Chewing gum or drinking through a straw can both lead to swallowing air, causing more gas.
• Eat smaller meals. If you have diarrhea, you may find that eating small, frequent meals makes you feel better.
• Take care with dairy products. If you're lactose intolerant, try substituting yogurt for milk. Or use an enzyme product to help break down lactose. Consuming small amounts of milk products or combining them with other foods also may help. In some cases, though, you may need to eliminate dairy foods completely. If so, be sure to get enough protein and calcium from other sources. A nutrionist can help you analyze what you're eating to make sure you're getting adequate nutrition.
• Drink plenty of liquids. Try to drink plenty of fluids every day. Water is best. Alcohol and beverages that contain caffeine stimulate your intestines and can make diarrhea worse, and carbonated drinks can produce gas.
• Exercise regularly. Exercise helps relieve depression and stress, stimulates normal contractions of your intestines and can help you feel better about yourself. If you've been inactive, start slowly and gradually increase the amount of time you exercise. If you have other medical problems, check with your doctor before starting an exercise program.

Alternative Medicine

The following non-traditional therapies may help relieve symptoms of irritable bowel syndrome:

• Acupuncture. Although study results on the effects of acupuncture on symptoms of irritable bowel syndrome have been mixed, some people use acupuncture to help relax muscle spasms and improve bowel function.
• Allergy Therapy (NAET) Based on acupuncture, this acupressure treatment has helped people with IBS who have both food allergies and emotional triggers.
• Chiropractic and Osteopathy IBS symptoms can be caused by misalignment of the spine which affects the nerve supply to the digestive organs that can effect digestive function.
• Hypnosis Hypnosis may reduce abdominal pain and bloating. A trained professional teaches you how to enter a relaxed state and then guides you in relaxing your abdominal muscles.
• Massage This can be an effective way to relieve stress.
• Nutritional Therapy Probiotics are "good" bacteria that normally live in your intestines and are found in certain foods, such as yogurt, and in dietary supplements. It's been suggested that people with irritable bowel syndrome may not have enough good bacteria, and that adding probiotics to the diet may help ease symptoms. Some studies have found that probiotics may relieve symptoms of IBS, such as abdominal pain and bloating, but more research is needed. It is best to consult a qualified Nutritional Therapist if you are considering taking supplements or changing your diet. They may also suggest you have a food allergy test to help identify problem foods.
• Reflexology This can be both help with stress and has been found to encourage self healing in the body.
• Regular exercise, yoga, or meditation. These can all be effective ways to relieve stress. You can take classes in yoga and meditation or practice at home using books or videos.