Irritable bowel syndrome (IBS) is one of the most common
disorders that doctors see. Yet it's also one that many people aren't
comfortable talking about because the signs and symptoms may be embarrassing.
Some signs and symptoms of irritable bowel syndrome are:
- Abdominal cramping
- Bloating and gas
- Diarrhea, constipation or both
As many as one in five American adults has irritable bowel syndrome. Most
people with IBS find signs and symptoms improve as they learn to control
the condition. Only a small percentage of people with irritable bowel
syndrome have severe 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 irritable bowel syndrome 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 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. Sometimes these problems can be disabling, however. 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 be present with other 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
No one knows exactly what causes irritable bowel syndrome. The walls of
the intestines are lined with layers of muscle that contract and relax
as they move food from your stomach through your intestinal tract to your
rectum. Normally, these muscles contract and relax in a coordinated rhythm.
But 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, however, the
opposite occurs. Food passage slows, and stools become hard and dry.
Some researchers believe IBS is caused by changes in the nerves that control
sensation or muscle contractions in the bowel. People with IBS may have
a heightened sensitivity to stretching of the bowel with gas leading to
pain or bloating. Others believe the central nervous system may affect
the colon. And because women are twice as likely to have IBS, researchers
believe that hormonal changes also play a role. Also, many women find
that signs and symptoms are worse during or around their menstrual periods.
Triggers bother some, not others
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 more bloating and discomfort in
some people with IBS. The role of food allergy or intolerance in irritable
bowel syndrome hasn't been well studied.
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 or family arguments.
But while stress may aggravate symptoms, it doesn't cause them.
- Other illnesses. Sometimes another illness, such as an acute episode
of infectious diarrhea (gastroenteritis), can trigger IBS.
Risk factors
Many people have occasional signs and symptoms of irritable bowel syndrome,
but you're more likely to have IBS if you're young and female. IBS begins
before the age of 35 for 50 percent of people. Overall, about twice as
many women have the condition. Genetics or heredity also may play a role.
When to seek medical advice
Although as many as one in five American adults has signs and symptoms
of irritable bowel syndrome, fewer than half seek medical help. Yet 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, because these
may be an indication of a more serious condition such as 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, and
colon cancer. He or she can also help you avoid possible complications
from problems such as chronic diarrhea.
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