What are the symptoms of IBS?
The symptoms of IBS Most people's symptoms are so mild that they don't bother to see a doctor about them. However, some people can have symptoms that are more troublesome, especially abdominal cramps, bloating and diarrhoea. People with more severe IBS are usually affected by one symptom more than the others - either pain, constipation or chronic diarrhoea. The most common symptom is abdominal pain, which some people describe as aching or colicky. The pain may be mild or severe, and may be made either better or worse by opening the bowels, passing wind or eating. Pain may recur at a particular time of day, often in the evening. Women may find the fluctuation of pain relates to their menstrual cycle. People with IBS often feel an urgent need to open their bowels, especially after breakfast. The stools may vary in consistency from hard and pellet-like to loose and watery, or just small amounts of mucus. Afterwards, there may be a sense that the bowels have not been completely emptied. Women are more likely to suffer from constipation than diarrhoea. Other symptoms include a bloated abdomen, excess wind, nausea, vomiting and indigestion. Some people also experience a sense of fullness. If the main symptom is diarrhoea, food passes through the digestive system faster than usual. There may also be associated problems, such as back and groin pain, lethargy, depression, disturbed sleep and a tendency to urinate more frequently. The need to pass water is sometimes very urgent, and doing so can be painful (these symptoms are more common for women). Women may also experience painful periods and pain during sexual intercourse. Causes The exact cause of IBS is not known. It is termed a functional disorder, which means that the way the bowel works is affected, but medical tests find no physical abnormalities that might explain the symptoms. Symptoms are thought to be caused by muscle contractions in the bowel wall. These are generally more frequent and stronger in people with IBS. The contractions may be most troublesome after food and in stressful situations. Intolerance of specific foods (such as tea, coffee and dairy products) may trigger the symptoms. IBS sometimes develops after a bout of gastroenteritis, an inflammation of the stomach and bowel linings which causes sickness and diarrhoea. Gastroenteritis may be caused by food poisoning, or by infection with a bacteria or virus. Diagnosing IBS Doctors generally diagnose IBS after hearing someone describe their symptoms and examining them. The doctor may recommend further tests. One possible test is a sigmoidoscopy. This is an examination of the lower part of the colon ("sigmoid" is another name for the descending colon, please see diagram) using a flexible telescope called a sigmoidoscope, inserted through the anus into the rectum. This is not usually painful procedure, although it can be uncomfortable. Sometimes a biopsy is done. This involves removing a small piece of tissue from the bowel lining for examination in a laboratory. This test helps to exclude a different condition called inflammatory bowel disease. Certain symptoms mean that more tests are needed to rule out other conditions. These symptoms include weight loss, regularly passing blood and mucus with the stools, general ill health or greasy, offensive-smelling stools that are difficult to flush away. Another test that may be recommended is a colonoscopy, where a flexible tube is passed through the rectum into the colon. This allows the doctor to see the lining of the large bowel directly. A biopsy may be taken. Other tests include stool testing and X-rays of the bowel, taken after a barium enema (when the colon is filled with a liquid that shows up on X-rays). Treatment Although there is no cure for IBS, there are treatments that can help reduce the symptoms. Self-help For most people with IBS, self-help is the best way to improve symptoms. People whose main symptom is diarrhoea should avoid potential irritants such as tea, coffee, alcohol, spicy food and the artificial sweetener sorbitol, often found in sugar-free gum. For people with constipation, it is important to eat plenty of fibre, such as fruit and vegetables. If bloating or wind is a problem, cutting out gas-producing foods such as beans can help. To find out if any foods are triggers for IBS, it may help to cut out certain foods to see if symptoms improve, then reintroduce them one at a time, to see if symptoms return. It's important to drink sufficient fluids, (around six to eight glasses of water a day or so that your urine is no darker than straw coloured). For people with constipation this helps the fibre to work; for people with diarrhoea it replaces lost fluids. Taking regular, moderate exercise helps maintain bowel habit. Some people find complementary treatments such as acupuncture help, although there is little scientific proof of their effectiveness. If stress triggers IBS, psychological treatment or learning stress management techniques may be beneficial. It may help to keep a diary comparing symptoms with life events. If certain events are identified as triggers, it may be easier to deal with the stress of them. Regular exercise may also help reduce stress. Over-the-counter treatments There is no one medicine that improves IBS in the long term, but treatments available over the counter from chemists may relieve some symptoms. For people with diarrhoea, using anti-diarrhoea medicines such as loperamide (eg Imodium) may help in the short term. They should be taken as needed, not on a regular basis. For constipation, a bulk-forming laxative, such as bran or ispaghula husk (eg Fybogel), can be helpful if it is hard to get enough fibre. Lactulose is an alternative to bulk-forming agents. It increases the amount of water absorbed in the large bowel. Laxatives that stimulate the bowels (eg senna) should not be used for more than a week at a time, because they can cause constipation in the long term. Antispasmodic medicines, such as mebeverine hydrochloride (eg Colofac) and peppermint oil capsules, may help with pain and wind. Visiting a GP If self-help treatments do not control the symptoms, it may help to seek advice from a GP. He or she may prescribe other medicines or make a referral to a dietician when this is appropriate. For symptoms associated with anxiety or depression, a GP may make a referral to a specialist, for psychological therapy or stress management. Antidepressants or medicines which are used to reduce anxiety may also be recommend.
IBS has to do with irregular muscle contractions, and it is not true that it's not a real condition.
It also is not a psychiatric condition.
For people with IBS who mostly have diarrhea, Librax or
Lotronex are effective.
For those IBS is mostly constipation, Zelnorm is recommended.
Another thing: many people have lactose intolerance but don't know it. Taking Lactaid tablets (available at any grocery or drug store) with dairy foods will help that.
More serious are things like ciliac disease, ulcerative colitis, and Crohn's disease. CHECK WITH YOUR GASTROENTEROLOGIST!
Everyone should have a colonoscopy to rule out cancer of the colon, too.