IRRITABLE BOWEL SYNDROME
What is Irritable Bowel Syndrome?
Irritable bowel syndrome (IBS) is a common disorder of the intestines that leads to crampy pain, gassiness, bloating, and changes in bowel habits. Some people with IBS have constipation (difficult or infrequent bowel movements); others have diarrhea (frequent loose stools, often with an urgent need to move the bowels); and some people experience both. Sometimes the person with IBS has a crampy urge to move the bowels but cannot do so.
What Causes IBS?
Because doctors have been unable to find an organic cause, IBS often has been thought to be caused by emotional conflict or stress. While stress may worsen IBS symptoms, research suggests that other factors also are important. Researchers have found that the colon muscle of a person with IBS begins to spasm after only mild stimulation. The person with IBS seems to have a colon that is more sensitive and reactive than usual, so it responds strongly to stimuli that would not bother most people.
What Are the Symptoms of IBS?
If you are concerned about IBS, it is important to realize that normal bowel function varies from person to person. Normal bowel movements range from as many as three stools a day to as few as three a week. A normal movement is one that is formed but not hard, contains no blood, and is passed without cramps or pain.
People with IBS, on the other hand, usually have crampy abdominal pain with painful constipation or diarrhea. In some people, constipation and diarrhea alternate. Sometimes people with IBS pass mucus with their bowel movements. Bleeding, fever, weight loss, and persistent severe pain are not symptoms of IBS but may indicate other problems.
How is IBS Diagnosed?
IBS usually is diagnosed after doctors exclude the presence of disease. To get to that point, the doctor will take a complete medical history that includes a careful description of symptoms. A physical examination and laboratory tests will be done. A stool sample will be tested for evidence of bleeding. The doctor also may do diagnostic procedures such as x-rays or endoscopy (viewing the colon through a flexible tube inserted through the anus) to find out if there is disease.
How Do Diet and Stress Affect IBS?
The potential for abnormal function of the colon is always
present in people with IBS, but a trigger also must be present
to cause symptoms. The most likely culprits seem to be diet
and emotional stress. Many people report that their symptoms
occur following a meal or when they are under stress. No one
is sure why this happens, but scientists have some clues.
Eating causes contractions of the colon. Normally, this response may cause an urge to have a bowel movement within 30 to 60 minutes after a meal. In people with IBS, the urge may come sooner with cramps and diarrhea.
How Does a Good Diet Help IBS?
For many people, eating a proper diet lessens IBS symptoms.
Before changing your diet, it is a good idea to keep a journal
noting which foods seem to cause distress. Discuss your findings
with your doctor. You also may want to consult a registered
dietitian, who can help you make changes in your diet. For instance,
if dairy products cause your symptoms to flare up, you can try
eating less of those foods. Yogurt might be tolerated better
because it contains organisms that supply lactase, the enzyme
needed to digest lactose, the sugar found in milk products.
Because dairy products are an important source of calcium and
other nutrients that your body needs, be sure to get adequate
nutrients in the foods that you substitute.
Dietary fiber may lessen IBS symptoms in many cases. Whole grain breads and cereals, beans, fruits, and vegetables are good sources of fiber. Consult your doctor before using an over-the-counter fiber supplement. High-fiber diets keep the colon mildly distended, which may help to prevent spasms from developing. Some forms of fiber also keep water in the stools, thereby preventing hard stools that are difficult to pass. Doctors usually recommend that you eat just enough fiber so that you have soft, easily passed, and painless bowel movements. High-fiber diets may cause gas and bloating, but within a few weeks, these symptoms often go away as your body adjusts to the diet.
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