Irritable Bowel Syndrome

Overview

Irritable bowel syndrome (IBS) is a chronic often debilitating gastrointestinal disease that causes abdominal pain constipation and diarrhea. It is generally classified as a "functional" disorder which refers to a disorder or disease where the primary abnormality is an altered physiological function (the way the body works) rather than an identifiable structural or biochemical cause. It affects up to 20 per cent of Canadians and is more common in women than in men. While there is no known cure treatment options are available to manage IBS·whether symptoms are mild moderate or severe.

Causes

The precise cause of IBS is unknown. What is known is that those who suffer from it have unusually sensitive and active nerve endings in the lining of the bowel that trigger inappropriate muscle activity resulting in episodes of diarrhea constipation or both in alternation. Because the contractions of the digestive tract are stronger and more frequent food and stool is rapidly pushed through the large intestine. This results in bloating abdominal pain and diarrhea and/or constipation. Researchers have identified certain triggers including:

  • Dietary issues such as food allergies and the amount of fibre consumed
  • Neurological hyper-sensitivity
  • Stress
  • Antibiotic use
  • Gastrointestinal infection
  • Bile acid malabsorption
  • The amount of physical exercise
  • Chronic alcohol abuse
  • Abnormalities in gastrointestinal secretions and/or peristalsis (the process of movement along the digestive tract).

IBS is not an indication of another more serious disease like cancer. Irritable bowel syndrome can however seriously compromise a person's quality of life.

Symptoms

IBS is characterized by symptoms of abdominal discomfort or pain usually in the lower abdomen (although the location and intensity are variable even at different times within the same person) and altered bowel habit (change in frequency or consistency) -- chronic or recurrent diarrhea constipation or both in alternation.

Abdominal pain has been reported as cramps or a generalized ache with superimposed periods of cramps although sharp dull gas-like or nondescript pains are also common. The abdominal discomfort or pain is usually relieved with a bowel movement.

People with IBS also commonly report upper gastrointestinal symptoms such as heartburn feeling full early in a meal nausea and bloating. Many also report intermittent upper abdominal discomfort or pain (dyspepsia). Digestive pain often occurs following a meal and can last for hours. Some also complain of urgently needing to go to the washroom and of feeling that they never quite empty their bowels. Other non-gastrointestinal symptoms can include:

  • Fatigue
  • Muscle pain
  • Sleep disturbances
  • Headache
  • Low back pain

These symptoms may be due another condition such as fibromyalgia or chronic fatigue syndrome that overlaps with IBS.

Symptoms themselves are not life threatening nor an indication of something more serious

Before making a diagnosis of irritable bowel syndrome your doctor will want to see the following continuous or recurrent symptoms for at least three months:

  1. Abdominal pain or discomfort relieved with defecation or associated with frequency or consistency of stool; and
  2. An irregular (varying) pattern of defecation at least 25% of the time with three or more of:
  • Altered stool frequency;
  • Altered stool form (hard or loose/watery stool);
  • Altered stool passage (staining or urgency feeling of incomplete evacuation);
  • Passage of mucus; and/or
  • Bloating or feeling of abdominal distension.

Treatment

An occasional bout with abdominal pain and diarrhea or constipation is an experience nearly everyone has in common. People may view these symptoms as normal even when they occur frequently. However chronic and recurring symptoms are not normal. They may signal IBS -- and are often treatable. However many people with IBS never see a doctor perhaps because the nature of the symptoms makes the topic somewhat difficult to talk about.

Most people with IBS have mild symptoms which can be treated by their family doctor. Treatment consists of re-training the bowel and it may take time before the bowel function returns to normal. Different therapies shown to reduce IBS symptoms include modifying diet and eating habits increasing physical activity and using prescribed medications.

While IBS is not a psychological disorder people who have the condition often experience anxiety depression loss of self-esteem and possibly shame fear self-blame guilt and anger. Cognitive therapy biofeedback training and even hypnosis have also proven helpful when combined with medical treatment.

Additional Resources

Canadian Society of Intestinal Research

The International Foundation for Functional Gastrointestinal Disorders