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Irritable bowel syndrome (IBS) occurs when muscles in your large intestine contract faster or slower than normal. This causes pain, cramping, gassiness, sudden bouts of diarrhea, and constipation.
People may have alternating bouts of constipation and diarrhea, or diarrhea-predominant IBS, or constipation-predominant IBS. Although the symptoms can be hard to live with, IBS doesn't cause permanent damage to your intestine.
Between 5 to 10% of the population has IBS. IBS peaks between the ages of 20 to 39. But it can occur at any age and is often associated with stress. It affects up to twice as many women as men.
Signs and Symptoms
Symptoms of IBS may include:
Criteria for an IBS diagnosis include abdominal pain or discomfort for at least 3 days per month for 3 months. Up to 50% of people with IBS have psychological symptoms, such as anxiety and depression. Some people with IBS have low levels of the brain chemical serotonin.
IBS may affect how the body is able to absorb nutrients, so that some people may not be getting all of the nutrients they need.
What Causes It?
Researchers don’t know what causes IBS, and the intestines of people with IBS appear normal when examined. It may be caused by a disturbance in the muscle movement of the intestine, or a lower tolerance for stretching and movement of the intestine.
Risk factors may include a history of physical or sexual abuse, low-fiber diet, emotional stress, use of laxatives, a bout of infectious diarrhea, or other temporary bowel inflammation.
Diet is also plays a major role in IBS. Some doctors believe that food allergies cause some cases of IBS, although studies have been mixed. Fatty foods, artificial sweeteners (sucralose or Splenda and saccharine or Sweet'N Low), chemical additives (dyes and preservatives), red meat, dairy products (such as milk, cheese, and sour cream), chocolate, alcohol, and carbonated beverages (sodas) may trigger or aggravate episodes in some people. Gluten contained in wheat and barley can also be a problem for some people with IBS.
What to Expect at Your Doctor's Office
Your doctor will feel your abdomen to check for signs of pain. Other tests may include a rectal exam, pelvic exam (for women), sigmoidoscopy, stool sample testing, blood and urine tests, ultrasound, and x-rays to rule out other conditions.
Doctors may also check to see if you are lactose intolerant. Lactase is an enzyme the body needs to digest sugars found in dairy products. If a person lacks this enzyme, they may have problems digesting dairy products, causing symptoms similar to IBS. Removing milk and dairy products from the diet for several weeks may help determine if the person is lactose intolerant.
The goal of treatment is to relieve symptoms. For some people, changing their diet may reduce symptoms. Adding more fiber and avoiding stimulants, such as caffeine, may help. Reducing anxiety by getting regular exercise and seeking counseling may also be helpful. Alternative and complementary therapies -- including herbs, supplements, and lifestyle changes -- may help relieve symptoms as well.
Two drugs are approved specifically to treat IBS. They are used cautiously and only when other treatments have failed.
Complementary and Alternative Therapies
IBS is often treated with alternative therapies. Stress reduction techniques, such as biofeedback, hypnosis, dietary changes, or counseling may help.
Nutrition and Supplements
Some doctors believe food allergies trigger IBS, at least for some people. The most common food allergens are dairy products, wheat, corn, peanuts, citrus, soy, eggs, fish, and tomatoes. Your health care provider may recommend an elimination diet, where foods that are suspected of causing an allergic reaction are eliminated from your diet, then gradually added back to see which foods trigger symptoms.
Eating a healthy diet that includes mainly fruits, vegetables, and whole grains may help. If gas is a problem, you may want to avoid beans, cabbage, broccoli, cauliflower, apple juice, grape juice, bananas, nuts, and raisins. These tips may also help:
These supplements may also help relieve IBS symptoms:
You can use herbs in the form of dried extracts (such as capsules, powders, and teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Herbs have active ingredients that can interact with other herbs, supplements, or medications. Speak to your doctor if you are taking any medications, or if you have underlying medical conditions. Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day.
Few studies have examined the effectiveness of specific homeopathic remedies. Professional homeopaths, however, may recommend treatments for IBS based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and intellectual makeup.
Several small studies suggest that acupuncture may help people who have IBS by improving general well being and reducing bloating. More research is needed.
Acupuncturists treat people with IBS based on an individualized assessment of the excesses and deficiencies of qi located in various meridians. In the case of IBS, an acupuncturist usually detects a qi deficiency in the spleen and lung meridians. Acupuncturists frequently use moxibustion (a technique in which the herb mugwort is burned over specific acupuncture points) for treatment of IBS because they believe its effects reach deeper into the body. Because acupuncture is considered safe, and IBS is not easily treated by available conventional methods, people with IBS may wish to try acupuncture therapy to improve symptoms.
There have been no well-designed studies of chiropractic for IBS. However, chiropractors report that spinal manipulation may improve symptoms of IBS in some people. In these cases, spinal manipulation may have a balancing effect on the nerves that supply impulses to the intestinal tract.
IBS may cause stress. Following a diet recommended by your doctor is very important.
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Review Date: 1/11/2014
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network. Also reviewed by the A.D.A.M. Editorial team.
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