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IRRITABLE
BOWELL SYNDROME WHAT
IS IRRITABLE BOWEL SYNDROME?
Irritable bowel syndrome (IBS) is a common
disorder that may affect up to 30 percent of all Americans at some time during
their lives. The disorder has many names, including nervous colon, spastic colon,
spastic bowel, mucous colitis and spastic colitis. However, it should not be confused
with diseases like ulcerative or Crohn's colitis.
IBS is a syndrome, a pattern
of symptoms such as pain and bloating that tend to occur together. It is not a
"disease" in the normal sense of the word (i.e., it cannot be caught
or transmitted from person to person as a cold can nor can it be cured by an operation
or medication). It is not life-threatening.
WHAT ARE THE SYMPTOMS OF IBS?
People with IBS may experience constipation,
diarrhea, or a combination - constipation at some times and diarrhea at other
times. In addition, IBS may produce cramps, urgency, or a gassy, bloated feeling
in the abdomen. Mucus, sometimes seen in bowel movements, is also a symptom of
IBS. Rectal bleeding is never caused by IBS, and any rectal bleeding must be properly
and thoroughly evaluated.
WHAT
CAUSES IBS?
The underlying cause of this disorder is an abnormality in
the way the intestinal muscles contract. These muscles, which form the outer layer
of the intestine, work automatically to move food products along the intestine
to the rectum and out the anus. IBS is a disorder of the function of the intestinal
muscles. Even when the muscles appear normal under a microscope, they may not
function normally, contracting too forcefully or weakly, too slowly or rapidly,
at certain times. 
Although there is no
physical obstruction, a patient may perceive cramps or functional blockage. WHAT
ROLE DOES STRESS PLAY IN IBS?
Emotional stress may contribute to IBS.
The brain and the intestine are closely connected by nerve fibers that control
the automatic functioning of the intestinal muscles, and many people may experience
nausea or diarrhea when nervous or anxious. While we may not be able to control
the effect stress has on our intestines, reducing the sources of stress in our
lives - high pressure jobs, family tensions, etc. - may alleviate the symptoms
of IBS. HOW
CAN I TELL IF THE PROBLEM IS IBS OR SOMETHING ELSE?
A careful medical
history and physical examination by a colon and rectal surgeon or other physician
are essential to proper diagnosis. Tests performed to ensure that your symptoms
are not caused by other problems may include a flexible sigmoidoscopic examination,
colonoscopy, a hemmocult test to detect hidden blood in the stool, an x-ray examination
of the lower intestines and psychological evaluation. These tests may rule out
other diseases or conditions - cancer, diverticulitis, inflammation of the intestines
or depression, for example. HOW
IS IBS TREATED?
Simply understanding that IBS is not a serious or life-threatening
condition may relieve anxiety and stress, which often contribute to the problem.
Mental health counseling and stress reduction (relaxation training) can help relieve
the symptoms of IBS in some individuals.
In others, increasing the amount
of non-digestible, bulk-forming foods ("roughage") in the diet may be
all that is needed to relieve symptoms. Adding roughage, such as psyllium seed,
to your diet may eliminate or lessen the severity of cramps, result in softer
stools that pass along the intestine more easily, and absorb excess water in the
intestine to prevent diarrhea. When the major complaint is constipation, additional
water should be provided in the diet along with bulk agents to soften the stool.
In some cases,
dietary roughage alone may not provide adequate relief from cramping and bloating.
Your physician may prescribe medications that act directly on the intestinal muscles
to help the contractions return to normal. Some people obtain greater relief from
one medication than another. Therefore, your physician may recommend changing
medications to improve symptomatic relief.
ARE THERE ANY FOODS TO BE AVOIDED?
Sometimes, caffeine, milk products
or alcohol can make symptoms of IBS worse. Your physician may recommend avoiding
foods that contain significant amounts of caffeine - coffee, tea, chocolate and
cola drinks, for example - and alcoholic beverages, including beer, wine and "mixed"
drinks.
Your physician may also recommend that you avoid dairy products,
such as cheese and milk, which may cause diarrhea in some people and constipation
in others. Because dairy products are an important source of calcium and other
nutrients that your body needs, be sure to get adequate nutrients in the foods
that you substitute.
| In
addition, smokers should beware: IBS symptoms may be aggravated by nicotine. |  |
HOW
LONG DOES THE TREATMENT TAKE TO RELIEVE SYMPTOMS?
Relief of IBS Symptoms
is often a slow process. It may take six months or more for definite improvement
to be appreciated. Patience is extremely important in dealing with this problem.
The tendency for the intestine to respond to stress will always be present.
With attention to proper diet, an increase in dietary roughage, and in some cases,
use of appropriate medications, the symptoms of IBS can be greatly improved or
eliminated. Mild symptoms may recur from time to time, but rarely will become
more than a minor nuisance. CAN
IBS LEAD TO MORE SERIOUS PROBLEMS?
IBS does not cause cancer, bleeding
or inflammatory bowel diseases, such as ulcerative colitis. Over the long term,
IBS can be associated with but does not cause diverticulosis, "pockets"
in the intestinal wall, which is a benign condition. This can occasionally result
in diverticulitis, an inflammatory condition of one or more of the diverticula
or "pockets" in the intestine that sometimes requires surgery. Treatment
of IBS with bulk agents helps to prevent diverticulosis and other colon problems.
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The
executive office of the 1,800-member American Society of Colon and Rectal Surgeons
is located in the Chicago suburb of Arlington Heights. Board-certified colon and
rectal surgeons complete a residency in general surgery, plus an additional year
in colon and rectal surgery. They also pass an intensive examination conducted
by the American Board of Colon and Rectal Surgery administered after successful
completion of written and oral examinations conducted by the American Board of
Surgery.
For
additional information or a list of colorectal surgeons in your area, contact:
American Society
of Colon and Rectal Surgeons
85 W. Algonquin Rd., Suite 550
Arlington
Heights, IL 60005
(847)290-9184 or (800)791-0001
Email: ascrs@fascrs.org
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