Irritable Bowel Syndrome

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Irritable Bowel Syndrome
Date Last Updated: 12/13/06
HealthyWomen.org


Irritable bowel syndrome (IBS) is a common medical disorder that is characterized by chronic abdominal discomfort or pain, bloating and changes in bowel habits. The abdominal pain or cramping can be a dull ache but, for some women, it can be intolerable and without relief. It can also lead to a tired feeling and even mild depression.

Some people with IBS suffer from constipation, others from diarrhea and some experience bouts of both. Symptoms associated with IBS include bloating, passage of mucus or straining with bowel movements, a sense of incomplete evacuation after bowel movements, or a sense of urgency to move the bowels.

According to the International Foundation for Functional Gastrointestinal Disorders (IFFGD), as many as 20 percent of all US adults experience symptoms of IBS, which may involve an abnormality of the contractions of the colon, as well as an increased sensitivity of the nerves in the colon. The syndrome can affect men and women of all ages, but it most often strikes younger women. The condition generally appears first in people in their 20s to 40s, and women are roughly three times more likely than men to suffer from it. Women with IBS seem to have more symptoms during their menstrual periods, suggesting that reproductive hormones may play a role in this disorder.

IBS is a major women's health issue. Data reveal an increased risk of unnecessary surgery for extra-abdominal and abdominal surgery in IBS patients, according to the IFFGD. For example, hysterectomy or ovarian surgery has been reported in as many as 47 to 55 percent of female patients with IBS.

"Syndrome" refers to a collection of symptoms, not just one or two. IBS is considered a "functional disorder" because there is no sign of structural disease on standard medical tests. It can strike otherwise healthy people. The causes are not well understood but are likely multiple, including: biological, psychological and social factors.

Some IBS patients report that their symptoms appear to have originated shortly after a bacterial infection, such as severe gastroenteritis. Clinicians have recognized this "post-infective IBS" for many years and there is increasing evidence that, in at least a subset of patients, infection and inflammation may play key roles in symptoms. These symptoms can last for months to years after the infection and inflammation improve.

IBS is indeed irritable, often causing a great deal of discomfort and distress. But the good news is that the syndrome does not cause permanent harm to the intestines, doesn't lead to intestinal bleeding and doesn't cause cancer or inflammatory bowel diseases (such as Crohn's disease or ulcerative colitis). Moreover, if you have IBS, you may not suffer all the time: some people can go for weeks or months with no symptoms. Others may experience daily symptoms.

Depression and anxiety are frequently associated with IBS, and some research indicates that the syndrome may be more common among people who were abused as children. But psychological factors notwithstanding, the symptoms are real and have a physiological basis. While stress may aggravate IBS symptoms, other factors—particularly colon motility and sensitivity of the nerves in the colon—play an important role. (Colon motility—the contraction of intestinal muscles and movement of its contents—is controlled by nerves and hormones.)

While there is no cure for IBS, you often can control symptoms through diet, stress management and prescription drugs. IBS is rarely debilitating, but in some cases, it restricts your ability to attend school or social functions, go to work or even travel short distances.

There are many names for IBS, including colitis, mucous colitis, spastic colon, spastic bowel and functional bowel disease. However, IBS does not result in more serious medical problems such as colitis or cancer. If left untreated, however, the symptoms of IBS will often persist, leading to pain and discomfort.

How the Colon Works
The colon, or large intestine, is about five feet long. Its primary function is to absorb water and salts from digestive products that enter from the small intestine. About two quarts of liquid matter enter the colon from the small intestine each day; it can remain there for days until most of the fluid and salts are absorbed. The leftover matter—the stool—then passes through the colon with a pattern of movements to the left side of the colon, where it is stored until a bowel movement occurs.

Movements of the colon propel the contents slowly back and forth but mainly toward the rectum. A few times each day strong muscle contractions move down the colon pushing fecal material; some of these contractions result in a bowel movement.

Some IBS patients experience an abnormality in this muscular action. The person with IBS also seems to have a colon that is more sensitive and reactive than usual. Otherwise ordinary events (such as eating and distension from gas or other material in the colon) can cause the colon to overreact. Certain medicines and foods, such as chocolate, high-fat foods, milk products or large amounts of alcohol, may trigger attacks. Caffeine can cause loose stools even in some people without the condition, and it is particularly problematic for people with IBS.

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