Understanding Irritable Bowl Syndrome

"Irritable bowel syndrome (IBS) is a fairly common gastrointestinal disorder," says Dr. Paresh Patel, a gastroenterology specialist with Kansas City Gastroenterology and Hepatology Physicians. "We treat a number of patients for this condition. In fact, in any GI practice, approximately 40 percent of patients suffer from IBS."

IBS symptoms include pain, gas, bloating, diarrhea and constipation. This common gastrointestinal disorder does not have a cure but has many treatment options.

It is estimated that irritable bowel syndrome (IBS) affects 10% to 20% of the American population, with women 20 to 40 years old accounting for the majority of patients. It is one of the most common gastrointestinal disorders seen in doctors' offices. About 12% of all primary-care doctor visits are IBS related, making IBS one of the top ten reasons people go to the doctor. It is also one of the leading causes of missed workdays in the United States, second only to the common cold.

Irritable bowel syndrome typically begins in people when they are in their teens and 20s. Onset in late adult life can also occur. In about half of people who develop the digestive tract disorder, it begins by 35 years of age.

Irritable bowel syndrome is exactly what you'd think it would be: It's classified by a crampy pain that occurs at least once a week for two months combined with a bothersome and frequent stool pattern. Kids will often experience constipation, diarrhea, or the all-frustrating combo of both. If that's not enough to make one irritable, we're not sure what is.

Irritable bowel syndrome happens when the bowels are literally irritable, or trying to move things through faster than is comfortable. Actually, passing the stool makes some people feel better and can relieve the cramping. The downside is that stools in IBS come more often than usual and are usually harder or softer than normal. You should also note that irritable bowel syndrome is different from a class of diseases called inflammatory bowel disease, which is marked by -- you guessed it -- inflammation of the bowels. Crohn's disease and ulcerative colitis fall into this category.

What You Need to Know About IBS

Irritable bowel syndrome affects between 10 and 15 percent of adults in the United States, but what is it?

Not to be confused with inflammatory bowel disease, irritable bowel syndrome is a chronic condition that affects the large intestine. IBS is characterized by a group of symptoms that occur at the same time, such as abdominal pain and cramping, bloating and changes in bowel movements.

IBS can affect anyone, but the condition is twice as likely to occur in women as in men, and most often begins in people younger than 45 years old.

Types of IBS:

Irritable bowel syndrome can be classified, based on stool consistency, into one of four types. This classification helps health care providers accurately treat symptoms.

IBS-C: Irritable bowel syndrome with constipation is characterized by hard or lumpy stool at least 25% of the time and loose or watery stool less than 25% of the time.

IBS-D: Irritable bowel syndrome with diarrhea is characterized by loose or watery stool at least 25% of the time and hard or lumpy stool less than 25% of the time.

IBS-M: Mixed irritable bowel syndrome is characterized by hard or lumpy stool at least 25% of the time and loose or watery stool at least 25% of the time.

IBS-U: Unsubtyped irritable bowel syndrome is characterized by hard or lumpy stool less than 25% of the time and loose or watery stool less than 25% of the time. It’s also common for people to switch between types.

Causes of IBS

The causes of irritable bowel syndrome are unclear, and triggers vary between people. While there is no single cause of IBS, experts believe a combination of problems, such as stress, intestinal infections, bacterial overgrowth in the small intestine, sensitivity to pain, genetics and food sensitivities, may lead to the condition.

Symptoms of IBS

IBS doesn’t lead to other health problems or damage the GI tract, but it does have some uncomfortable symptoms. People with IBS often experience abdominal pain or discomfort, gas, bloating, constipation, diarrhea or both. Discomfort often starts shortly after eating and dissipates after making a bowel movement. Changes in frequency of movements are also common.

As with other chronic conditions, symptoms of irritable bowel syndrome persist for long periods of time—often years. If symptoms have occurred at least three times per month for the last three months, and symptoms began at least six month ago, you may have IBS.

Diagnosis of IBS

There is no single test for diagnosing IBS; your health care provider will likely assess your symptoms to diagnose the condition. Your provider will review your medical history and symptoms, and administer a physical exam.

Your provider may also order tests to rule out other conditions. A blood test may be performed to check for celiac disease; a stool culture test for infection; and a colonoscopy to check for cancer, especially if a patient is over age 50, experiences sudden and unexplained weight loss, bloody stool or has an abnormal blood test.

Treatments for IBS

The goal in treating IBS is eliminating the symptoms, but treatments aren’t one-size-fits-all, and individuals may need to manage symptoms with a combination of methods. Often, lifestyle changes to reduce stress, such as exercise and getting more sleep, can help manage symptoms. Dietary changes may also be helpful. Fiber-rich diets can help alleviate diarrhea and constipation, but may increase bloating. Your provider may also recommend avoiding foods that stimulate the intestines, like caffeine and alcohol, eating small meals and taking fiber supplements or laxatives.

If lifestyle changes don’t reduce symptoms, your health care provider may prescribe medications to manage symptoms.

"At KCGI, patients with IBS undergo a comprehensive evaluation of their condition and symptoms," says Dr. Patel. "And even though it's a challenging disorder, the good news is we can offer most patients relief from their symptoms."