Do you have a question about irritable bowel syndrome (IBS)? Please send your question from our contact form. While we cannot provide specific advice, we will try to post questions and answers that apply generally to those with IBS.
What does “irritable” mean?
Irritable means that the nerve endings in the bowel wall, which control muscle function and affect sensation of the gut, are unusually sensitive.
This means that even normal conditions that can stimulate the bowel – eating a meal, having one’s menstrual period, feeling pressure at work – may lead to a greater response for persons with IBS when compared to others, and this can include a flare up of symptoms. This results in the nerves and muscles of the bowel becoming more active producing diarrhea, bloating, or pain and discomfort.
How common is IBS?
IBS is the most common functional gastrointestinal (GI) disorder. It affects males and females, adults and children.
Is IBS a “serious illness?”
The impact of IBS varies with each person. For some people, IBS causes symptoms that are manageable and/or mild and do not interfere with daily activities. For others, IBS may severely reduce their quality of life or be disabling.
IBS is a long-lasting, or chronic, condition. Symptom episodes are often unpredictable. For many, treatments are minimally effective.
Is IBS forever?
The prevalence of IBS (the proportion of people with IBS within a population at a point in time) remains fairly stable. Over time, some people with IBS will no longer have symptoms, while new people will develop IBS. It has been established that each year about 10% of IBS patients get better.
How do I know if I have IBS?
A knowledgeable physician can diagnose IBS by careful review of your symptoms, a physical examination, and selected diagnostic procedures that are often limited to a few basic tests.
I have been diagnosed with irritable bowel syndrome (IBS), but tests found nothing wrong. Do I need more tests?
In IBS, tests are expected to find nothing. In the absence of physical findings, the symptom-based Rome diagnostic criteria have been shown to be reliable. In addition, a physical exam and limited diagnostic tests help confirm this diagnosis with a high level of confidence. Extensive testing may be reserved for specific situations.
What is the Rome Criteria?
The Rome Criteria is a classification system that uses specific symptom patterns to identify functional GI disorders, such as IBS.
What is a “functional” bowel disorder?
A functional bowel disorder occurs when there is a problem with the way the bowels work, not their structure. The body’s normal activities are impaired.
Is IBS a risk factor for other serious diseases?
There are no long-term organic complications associated with IBS. Once an adequate evaluation is made to diagnose IBS, people with the disorder have no greater need of preventive checkups than other people.
Can the menstrual cycle affect IBS symptoms?
Bowel function appears to be influenced by changes in the level of female hormones. Symptoms can become worse at certain times of the cycle, particularly at the time of menstrual periods.
Women both with and without IBS report a higher prevalence of GI symptoms, such as pain and bloating, just prior and at the time of menstrual periods. These symptoms are reported as more intense in women with IBS.
This occurrence can sometimes make it difficult for the patient, as well as the physician, to determine whether she is having a gynecological problem (such as endometriosis or other pelvic pain condition) or a GI problem. It is important for the patient and the physician to realize that sometimes both possibilities must be explored.
What causes bloating and gas?
Bloating is a common symptom in IBS. It is usually described by people as a feeling of fullness or heaviness in the belly. It may be associated with visible abdominal distension in which the belly appears swollen.
Bloating may be due to any of several factors. This may be due to increased intake of gas-forming foods, slowed transit and evacuation of gas through the bowel, and increased sensitivity to food, gas, and other bowel contents.
Not everyone with IBS actually produces more gas than those who do not have IBS. People with IBS may also have an increased relaxation of the abdominal wall muscles even without an increase in intestinal gas. This is an unconscious muscle relaxation response in response to the pain of IBS.
However, people with IBS do appear to be more sensitive to the effects of normal amounts of gas. They also seem to have difficulties passing the gas that is present.
Do certain foods affect IBS symptoms?
This varies from person to person. Certain foods stimulate the GI tract in general, and in those with IBS eating too much of these might worsen symptoms. Your doctor or a registered dietitian can help you identify foods that are a problem for you.
Also, at times altered muscle and nerve function in IBS can cause the bowel to over-respond so that even the normal digestive process may bring on symptoms. Learn more about diet, eating, and IBS symptoms
Does lactose intolerance cause IBS?
Lactose (milk sugar) intolerance can cause similar symptoms to IBS. Lactose intolerance and IBS can occur at the same time in a person, but they are separate conditions which are treated differently.
Can bacteria affect IBS symptoms?
There are trillions of bacteria throughout the GI tract. Some help maintain normal functioning of the intestine. Others can cause infection or inflammation.
When the normal balance in the intestine between beneficial and harmful bacteria is changed, it may lead to changes in the function of the GI tract and chronic GI symptoms.
If my doctor prescribed an antidepressant to treat my IBS does that mean I have a psychological disorder?
Not necessarily. In IBS low-dose antidepressants are useful because this class of drugs can help to reduce pain and also overall symptoms. For these purposes, doses are much lower than what is used to treat depression. Learn more about the use of antidepressants for treatment of IBS
How do I find an appropriate health care provider?
In general, a good physician facilitates effective communication with the patient, which is the foundation for successful management of IBS.
However, not all physicians have an understanding of how to treat patients with IBS. If your physician is not meeting your needs, find one who can meet your needs. Get tips on finding a doctor
IBS is very common, and talking with your friends or coworkers may help you in finding a physician. Organizations such as IFFGD can also help you find an appropriate health care provider.
You should have a physician who takes an interest, listens to you, and has helped you to identify factors that seem to be contributing to your IBS symptoms.
If you are interested in being referred to another health care provider, such as a physician with expertise in IBS, a therapist for behavioral or psychological treatment, or an alternative medicine provider, you should explain this to your physician and an appropriate referral should be forthcoming.
How do I best work with my health care provider?
In general, a good relationship with your health care provider is important for successful management of IBS. This means your physician will:
- take into account your needs,
- help you to identify factors that seem to influence your IBS symptoms,
- and work with you to develop a long-term plan to manage your symptoms.
If you are interested in being referred to another health care provider, such as a physician with special expertise in IBS, a therapist for psychological treatment, or an alternative medicine provider, you should explain this to your physician and an appropriate referral should be made.
Is IBS a Disability?
Depending on the circumstances it is up to each employer, insurer, or governing authority to determine individual disability.
The U.S. Social Security Administration (SSA) defines disability as the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. (SSA Pub. No. 64-039, May 2002) However, the SSA does not recognize irritable bowel syndrome on its Listing of Impairments — Adults, Section 5, Digestive System.
On August 15, 2011, the Department of Veterans Affairs (VA) implemented a “presumptive service connection” when assessing disability benefits in soldiers affected by functional GI disorders (such as IBS) who served in Southwest Asia during the Persian Gulf War.
The Veterans Affairs Dept. first recognized IBS in the Veterans Education and Benefits Expansion Act of 2001, Public Law 107-103 signed by President Bush on December 27, 2001.Section 202 — Payment of Compensation for Persian Gulf War Veterans with Certain Chronic Disabilities — includes this provision: (2) For purposes of this subsection, the term “qualifying chronic disability” means a chronic disability resulting from any of the following (or any combination of any of the following): (B) A medically unexplained chronic multi-symptom illness (such as chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome) that is defined by a cluster of signs or symptoms. The law authorizes funding to expand and increase educational, housing, burial and disability benefits for chronic multi-symptom illnesses to the list of service-connected conditions for Gulf War veterans.
So overall, how do I deal with IBS?
Here are some guidelines to help find what works for you.
- Try to take an active role in your own health care. Obtain educational materials from your doctor and an organization such as IFFGD to learn more about IBS and how to best manage your symptoms.
- Try to identify factors that may make your symptoms worse. Keep a daily diary for at least a week or two. Talk to your doctor or other health care provider to help sort this out.
- Use medicines to relieve or avoid onset of symptoms. Talk to your doctor to discuss which medicine may be right for your symptoms and circumstances.
- Consider non-drug treatment options to help decrease symptoms. Look for and address any sources of stress in your life that may impact your symptoms.
- Work together with your health care provider to design and apply a plan to manage your particular symptoms and improve your quality of life.
Adapted primarily from IFFGD Publication #101 revised and updated by Douglas A. Drossman, MD, Drossman Gastroenterology PLLC, Chapel Hill, NC.