Irritable bowel syndrome (IBS)

The main symptoms of IBS are belly pain with constipation or diarrhea. Other common symptoms are bloating, mucus in the stools, and a feeling that you haven't completely emptied your bowels.

Many people with IBS go back and forth between having constipation and having diarrhea. Most people have one of these more often than the other.

IBS is quite common, but most people's symptoms are so mild that they never see a doctor for treatment. Some people may have troublesome symptoms, especially stomach cramps, bloating, and diarrhea.

Because there are no structural problems in the intestines of people who have IBS, some people may think this means that the symptoms "are all in their head." This isn't true. The pain, discomfort, and bloating are real.

It isn't clear what causes IBS. The cause may be different for different people. It may be caused by problems with the way signals are sent between the brain and the digestive tract, problems digesting certain foods, or stress or anxiety. People with IBS may have unusually sensitive intestines. Or they may have problems with the way the muscles of the intestines move.

For some people with IBS, certain foods, stress, hormonal changes, and some antibiotics may trigger pain and other symptoms.

Most of the time, doctors can diagnose IBS from the symptoms. Your doctor will ask you about your symptoms and past health and will do a physical exam.

In some cases, you may need other tests, such as stool analysis or blood tests. These tests can help your doctor rule out other problems that might be causing your symptoms. Most people won't need tests. But some people may need them because of their age and symptoms. The amount of testing you get depends on several things: your age, how your symptoms come on and how severe they are, and how you respond to your first treatment.

Tests may include a blood test for celiac disease and a complete blood count. Other tests include sedimentation rate, which checks for inflammation in the body, and a stool analysis. A thyroid function test or a colonoscopy is sometimes done.

Treatment for IBS depends on what symptoms you have, how severe they are, and how they affect your daily life. No single treatment works best for everyone.

Learn all you can about IBS so that you and your doctor can work together to find out what triggers your symptoms. You will need to adapt your lifestyle to best deal with your symptoms and still carry on with your daily activities. Let your doctor know if parts of your treatment aren't helping your symptoms.

Record your symptoms

The first step in treating IBS usually involves watching and recording your symptoms, your bowel habits, what you eat, and other daily activities (such as exercise) that affect your symptoms. Writing all this down in a notebook for a few weeks can help you and your doctor see patterns of symptoms in your daily life. You may be able to see what things make your symptoms worse (such as eating dairy products). Then you can start to avoid them.

Manage your symptoms

For some people who have IBS, certain foods may trigger symptoms. The following steps may help prevent or relieve some IBS symptoms:

• Limit caffeine and alcohol.
• Limit your intake of fatty foods.
• If diarrhea is your main symptom, limit dairy products, fruit, and artificial sweeteners such as sorbitol and xylitol.
• Increase fiber in your diet. It can help relieve constipation.
• Avoid foods such as beans, cabbage, or uncooked cauliflower or broccoli. This can help relieve bloating or gas.

Here are some other steps you can take to help your symptoms:

• Get some exercise, such as swimming, jogging, cycling, or walking. It can also improve your quality of life (especially how well you sleep, your energy level, and your emotional and social life).
• Quit smoking, if you smoke.
• Reduce stress, if stress seems to trigger symptoms.

Take medicines

If diet and lifestyle changes don't help enough on their own, your doctor may prescribe medicines. Medicines may help ease symptoms such as pain, diarrhea, constipation, cramping, depression, and anxiety. Your doctor may also want you to try different medicines, or different dosages of your medicines, if your symptoms aren't responding to treatment.

Watch for new symptoms

Because IBS is a long-term problem, it's important for you to be aware of big changes in symptoms. For example, watch for blood in your stools, increased pain, severe fever, or unexplained weight loss. If any of these occur, your doctor may want to do more tests to find out if there is another cause for your symptoms.

Irritable bowel syndrome, or IBS, is a problem with the intestines. IBS can cause belly pain, bloating, gas, constipation, and diarrhea. Most people can control their symptoms by changing their diet and easing stress.

No specific foods cause everyone with IBS to have symptoms. Many people find that they feel better by limiting or eliminating foods that may bring on symptoms. Make sure you don't stop eating all foods from any one food group without talking with a dietitian. You need to make sure you are still getting all the nutrients you need.

• To reduce diarrhea, limit or avoid:
  • Alcohol.
  • Caffeine, which is found in coffee, tea, colas, and chocolate.
  • Nicotine from smoking or chewing tobacco.
  • Gas-producing foods, such as beans, broccoli, cabbage, or apples.
  • Dairy products that contain lactose (milk sugar), such as ice cream or milk.
  • Foods and drinks high in sugar, especially fruit juice, soda, candy, and other packaged sweets (such as cookies).
  • Foods high in fat, including bacon, sausage, butter, oils, and anything deep-fried.
  • Sorbitol and xylitol. These are artificial sweeteners found in some sugarless candies and chewing gum.
• To reduce constipation:
  • Slowly increase the amount of fiber you eat. For some people who have IBS, eating more fiber may make some symptoms worse, including bloating. Adding fiber slowly may help you avoid these problems.
  • Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber.
  • Drink plenty of fluids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • Get some exercise every day. Build up slowly to 30 to 60 minutes a day on 5 or more days of the week.
  • Take a fiber supplement, such as Citrucel or Metamucil, every day if needed. Read and follow all instructions on the label.
  • Schedule time each day for a bowel movement. Having a daily routine may help. Take your time and do not strain when having a bowel movement.
• Keep a daily diary of what you eat and what symptoms you have. This may help find foods that cause you problems.
• Eat slowly. Try to make mealtime relaxing.
• Find ways to reduce stress.