We all have heard of or may even know someone who has Irritable Bowel Syndrome (IBS). What you may not know is what this really means. Irritable Bowel Syndrome is a condition that affects about 10-15% of the US population, and is characterized by abdominal pain and changes in bowel habits. Some patients get constipation, some get diarrhea, some have alternating periods of diarrhea and constipation and some have mostly pain. It affects both males and females although females are about twice as likely to have it then men and most people are diagnosed sometime between the ages of 20 to 50.
Symptoms can vary considerably. As stated previously the hallmark of the disease is abdominal pain and changes in bowel function. Usually the pain is improved with defecation. The diarrhea or constipation can range in severity from mild to severe and symptoms are often exacerbated by stress and possibly food indiscretions. People with IBS also usually have some component of gas and bloating.
Diagnosis can be difficult as there is no definitive test that indicates that a person has the disease. It is usually a diagnosis of exclusion and your physician needs to make sure that nothing more serious is causing your symptoms before they can tell you that you likely have IBS. This is especially true with people who are being diagnosed with IBS later in life. Patient’s often have other non-specific symptoms associated with irritable bowel including fatigue, fibromyalgia, headache, depression etc. It is unclear whether irritable bowel may lead to these problems or whether people with IBS are just more likely to also have these types of issues.
Treatment options are typically based on symptom control as there is no cure for IBS. With that being said, the 3 areas of treatment usually focus on stress management, dietary modification and symptom control. Trying to limit stress and establishing a good relationship with your doctor is very important. Often it can be difficult to determine what foods make symptoms worse but often lactose and gluten are foods that can cause problems. Recent research has linked a condition called small bowel bacterial overgrowth with IBS. It is a benign condition where the normal bacteria from your colon can move into the small intestine. These bacteria then start to break down the food that you eat causing gas production. This can lead to bloating, abdominal pain with diarrhea. Treatment with a short course of antibiotics can alleviate a lot of the symptoms. If you have this, frequently a low FODMAP diet can help with symptoms as well. There are prescription medications that can help with the diarrhea or constipation. These are often taken in conjunction with antispasmodic medication which helps with the pain by relaxing the smooth muscles that line the intestinal tract. Lastly some physicians will use low dose antidepressant to help with the discomfort associated with IBS. As this is a difficult disease to diagnose and treat, if you suspect that you may have IBS, you should speak with your physician.
Dr. Alan Gingold is a partner at Digestive Healthcare Center in Hillsborough, NJ. He also has offices in Somerville and Warren, NJ. If you would like to make an appointment you can call his office at (908) 218-9222 or you can visit the website www.DHCcenter.com