Overview

Irritable Bowel Syndrome, or IBS for short, is a common condition in adults. It affects the large intestines. Individuals who suffer from IBS experience symptoms related to the digestive system.

It is also known as a gastrointestinal (GI) disorder. This disorder is often thought of as a gut-brain interaction issue in how the gut and brain send information to each other. It causes the digestive system to be sensitive and how the bowel muscles contract.

This can result in a lot of pain in the abdomen, cause diarrhea, and constipation.

IBS also has other names that a person might hear which include:

• Irritable Bowel
• Irritable Colon
• Spastic Colon
• Nervous Stomach

Types

IBS has five different types, and a patient’s diagnosis depends on their bowel movements. For example, a patient may have normal bowel movements one day, and abnormal ones the next.

The types of abnormal bowel movements define your IBS type.

• IBS with constipation (IBS-C) – is the most common with hard or lumpy stool.
• IBS with diarrhea (IBS-D) – the stool is often loose and watery.
• IBS with mixed bowel habits (IBS-M) – the stool is hard and lumpy and can be loose and watery on the same day.
• Post-infectious IBS – occurs after a GI infection and is usually diarrhea.
• Post-diverticulitis IBS – includes having continued abdominal pain and constipation after infection.

Causes

The cause of IBS is not known. An oversensitive colon or immune system may contribute to IBS. This condition can be very hard to prevent because it has so many causes.

Some of the factors that can contribute to the development of IBS include:

• How the muscle contracts in the intestines. The walls of the intestines have muscles layered throughout. They move and contract food through the intestines for digestion. If those movements are stronger and are longer this can cause gas, bloating, and diarrhea. If the muscle contractions are slow then this can cause the food to move slow and lead to hard stool.
• The nervous system plays a role in IBS. Abnormal nerves in the intestines can cause communication problems between the brain and gut. The stretching and gas can cause pain in the abdomen. If the brain and gut are not working together, then the signals can cause the body to overreact. This is a negative reaction that results in pain and stool abnormalities.
• Severe infection from having diarrhea long-term. There can be an increased amount of bacteria or viruses in the intestines. The increased bacteria or virus can cause IBS symptoms.
• Early life stress caused in childhood from stress can cause IBS symptoms in adults.
• Changes in gut microbes. Research has shown that people with IBS have a different microbe profile than those who do not.

Symptoms

The common symptom for IBS is pain in the abdomen which correlates to a bowel movement. There can be changes in the bowel movement including diarrhea, constipation, or both. It will depend upon the type of IBS.

Other symptoms include:

• Bloating
• Having the feeling that a bowel movement is not finished
• Having a white mucus in the stool
• Abdominal pain

It is important to pay attention to symptoms and how often they occur. When going to a medical professional they will want to know how often the symptoms occur. The information will provide better treatment and diagnosis.

Treatment

Unfortunately, no one treatment can cure IBS. But most people do find something that helps with their symptoms. Medical professionals may recommend a change in diet and lifestyle to improve symptoms.

Some recommended dietary changes may include:

• Add supplemental fiber to the diet.
• Drink about eight 8 ounce glasses of water a day. Water helps soften hard stools or replenish water lost to diarrhea.
• Avoid as much caffeine as possible.
• Limit the amount of milk and cheese.
• Avoid gluten.
• Try the FODMAP diet, which is an eating plan that helps symptoms.

Medical professionals will also recommend activity changes. These can include:

• Exercising regularly.
• Reducing stress.
• Getting ample amount of sleep.

Medication

Medications for IBS depend on the symptoms.

For IBS with diarrhea, the prescribed medications are:

• Loperamide
• Rifaximin (Xifaxan)
• Eluxadoline (Viberzi)
• Alosetron (Lotronex)

If a patient has IBS with constipation, the prescribed medications are:

• Fiber supplements if an increase in fiber in the diet does not work
• Over-the-counter (OTC) Laxatives
• Amitiza (Lubiprostone)
• Linzess (Linaclotide)
• Trulance (Plecanatide)

To treat abdominal pain, the following medications may be prescribed:

• Antispasmodics – help with stomach pain and spasms.
• Antidepressants – works with gut motility, reduce abdomen pain, and increase gut transit speed.
• Coated peppermint oil capsules to help with pain and bloating.

If medications do not work, there are other options. Some medical professionals might try mental health therapies for relief.

They can include:

• Cognitive-behavioral therapy – can help reduce IBS symptoms by teaching strategies to calm the body during unpleasant sensations.
• Hypnotherapy – helps manage IBS through hypnosis.
• Biofeedback – retrains the body to manage responses.