Irritable Bowel Syndrome (IBS) represents a group of symptoms that cause a significant number of people to seek medical attention every year. It is estimated that 10-15% of North Americans suffer from IBS, and it is by far the most commonly diagnosed gastrointestinal condition. Irritable Bowel Syndrome is the second most common medical reason to miss work, after the common cold.
The specific symptoms of IBS vary widely among those who suffer from the condition, but the hallmark is a pairing of chronic abdominal pain and altered bowel habits. The abdominal pain may range from mild to severe. It may be associated with factors such as stress and eating. The bowel changes may include diarrhea, constipation, or alternating back and forth between both. There is also a sub-type called post-infectious IBS that develops after a gastrointestinal infection. According to the most current literature, IBS is defined as recurrent abdominal pain at least one day per week in the last three months, on average, and associated with two or more of the following:
- • Improvement with bowel movements
- • Associated with a change in stool frequency
- • Associated with a change in stool form or appearance
The following symptoms are NOT consistent with IBS and are reasons to see a gastrointestinal specialist:
- • More than minimal bleeding
- • Weight loss
- • Iron deficiency anemia
- • Nocturnal symptoms
- • Family history of colorectal cancer, inflammatory bowel disease, or Celiac sprue
The initial treatment of Irritable Bowel Syndrome includes dietary modifications such avoiding foods that contain lactose and gluten, as well as gas-producing foods. A low FODMAP diet is also a consideration as initial therapy. Pharmacologic (drug) therapy for IBS depends upon the troublesome symptoms. IBS with constipation is treated with increased dietary fiber as well as psyllium and prescription laxatives. IBS with diarrhea can be treated with OTC anti-diarrheal medications such as Imodium. Other options include prescription medications such as bile acid sequestrants and serotonin receptor blockers. Gas and bloating can be treated with antispasmodic medications. or even GI-selective antibiotics.
Due to the many different symptoms of IBS, there is a wide range of treatment options including dietary, behavioral, and medical therapies. It is important to discuss your symptoms and family history with your medical provider so that appropriate evaluation may take place. Ultimately, IBS is a very common but treatable condition.