What Is Irritable Bowel Syndrome (IBS)?

Irritable bowel syndrome (IBS), also known as spastic colon, is a medical condition involving abdominal pain, bloating, cramping, and changes in defecation without apparent cause due to injury or disease. Its symptoms are variable. 

Irritable bowel syndrome is common; one estimate places the number of Americans suffering from IBS between 7 and 16 percent of the population. It affects both sexes and all ages but is more likely in women and persons younger than 45 years old. 

Symptoms

Because symptoms of irritable bowel syndrome can be variable, IBS is best recognized as a pattern of behavior:

• Feelings of abdominal discomfort, cramping, or pain that only subside with a bowel movement
• Repetition of this pain-and-relief process on a regular basis
• Changes in defecation from normal solid stools to the extremes of constipation, diarrhea, or both.

Symptoms of IBS in females may be more pronounced than in males. Changes in hormone levels related to the menstrual cycle can intensify common irritable bowel syndrome symptoms like feelings of pain and bloating in the lower GI.

Symptoms of IBS can change and are not constant. Due to the lack of consistency with symptoms, it can be difficult to identify the cause of irritable bowel syndrome.

Causes

The exact cause of IBS is unknown. However, IBS may be related to oversensitivity in the lower GI or the body’s immune system.

There are certain physical indicators as well, including:

• Colonic spasms
• Abnormal serotonin levels

While these are not irritable bowel syndrome causes, physical indicators of lower GI oversensitivity can help point health professionals in the right direction. Identifying what triggers your IBS symptoms can also be beneficial.

IBS Triggers

Researchers have documented several triggers for IBS attacks. The most prevalent are high levels of stress and certain types of food. The latter may include:

• Beans
• Chocolate
• High-fat items
• Dairy products
• Spicy dishes
• Alcohol
• Soft drinks
• Cruciferous vegetables (such as broccoli, cauliflower, and cabbages)

Health professionals recommend keeping a food diary to identify possible triggers for irritable-bowel episodes. 

It's important to note that the items above are simply triggers for IBS. These trigger the signs of IBS, but are not the root cause of IBS. Irritable bowel syndrome is not initially caused by common IBS triggers. The exact cause of IBS is unknown.

Risk Factors

Common IBS risk factors include:

• Gender: Females are more at risk for IBS than males.
• Age: While IBS can impact people of any age, those from teenagers to those in their 40s are more at risk than other age groups.
• Family medical history: There can be a genetic predisposition for IBS and other GI conditions.
• Mental health: Those with behavioral conditions such as anxiety and depression can be at a greater risk for developing IBS.

Prevention

Though IBS is not entirely preventable, certain lifestyle changes can help reduce the frequency and intensity of attacks. Chief among these are changes in diet. If you are an IBS sufferer, you should consider:

Eating More Fiber

A higher-fiber diet can offset IBS-induced constipation. Especially helpful are soluble fibers, like those found in beans, fruit, and oats. A word of caution, though: adding too much fiber too quickly to your diet can have the opposite effect of triggering an IBS episode, by causing abdominal gas and bloating.

Avoiding Gluten

Gluten is a plant protein found in cereals, grains, and their derivatives, such as pasta and other processed-food items. Some IBS patients have reported an increase in the severity of their symptoms after eating foods with gluten, so your physician may recommend that you avoid them too. 

Adopting a Carb-Smart Diet

Your body needs carbohydrates but good health, including good digestive health, requires the right kind of carbohydrates. IBS patients may want to adopt what’s known as a low FODMAP diet, which avoids foods with hard-to-digest carbohydrates (the FODMAPs). High FODMAP foods include many fruits and fruit juices, dairy products, wheat and rye products, certain vegetables, honey, and items with high-fructose corn syrup. Because of its restrictive nature, the low FODMAP diet is typically pursued on a temporary basis, with a gradual and selective reintroduction of certain FODMAP items, based on their other healthy qualities. 

Diagnosis

IBS diagnosis is a relatively simple, three-part process. Your physician will review your symptoms, ask about your family medical history, and perform a physical exam commonly known as an IBS test.

• Family medical history is important because it may indicate a genetic predisposition for certain diseases or conditions of the lower GI.
• The physical exam will likely involve inspection of your abdomen for evidence of tenderness or bloating. Your doctor may also use a stethoscope to listen for the sounds your body makes during the digestive process.

On occasion, your physician will also order tests, either to confirm an irritable bowel syndrome diagnosis or to eliminate other, more serious possible causes of your abdominal discomfort and pain. These might include:

• Blood tests
• Stool samples
• Hydrogen breath test
• Upper GI endoscopy with a biopsy
• Colonoscopy

Treatment

There are several options for IBS treatment. These include:

• Lifestyle changes: Changes in diet, increased physical activity, more sleep, and stress reduction can all have a positive impact on the frequency and severity of IBS episodes. 
• Medications: There are several types of medicines that can assist with the symptoms of IBS, including antidiuretics for diarrhea, laxatives for constipation, and antispasmodics for lower GI spasms.
• Probiotics: Probiotics help your body maintain the healthy bacteria and other microorganisms that normally inhabit your GI system, and which aid in proper digestion and waste removal. 
• Counseling and other mental-health therapies: In some instances, physicians may recommend a form of counseling for controlling IBS. Possibilities include relaxation training and gut-directed hypnotherapy, which utilizes hypnosis as a means of reducing physical stress in the lower GI.