General Description

What is Irritable Bowel Syndrome?

Irritable Bowel Syndrome, known better simply as IBS, is an intestinal disorder characterized by a host of nebulous gastrointestinal symptoms. It is estimated that 1 in 5 Americans suffer from the condition.   

Unlike some other intestinal conditions, there is no evidence to suggest that IBS causes long term damage to the digestive system or that it pre-empts any more serious condition like cancer.  Most IBS patients find relief from the physical discomfort and emotional stress of the condition through a combination of treatments and lifestyle alterations.

• Nausea
• Heartburn
• Bad taste in mouth
• Abdominal cramping
• Premature fullness while eating
• Decreased appetite
• Frequent burping
• Audible sounds of digestion
• Compulsive urge to use the restroom
• Incomplete waste elimination
• Insomnia or disrupted sleep
• Headache
• Nutrient deficiencies
• Exhaustion
• Anxiety
• Depression
• Skin flush
• Frequent diarrhea lasting more than 2 days
• Constipation lasting more than 2 days
• Excessive mucus in stools
• Pain while passing stools
• Abdominal discomfort relieved by stool passage
• Increased flatulence
• Visible and uncomfortable abdominal bloating

The following list indicates symptoms that are never associated with IBS and may be indicative of a more serious condition. If you are exhibiting any of these symptoms, we at Health911 urge you to immediately seek medical attention to identify the cause of these potentially dangerous symptoms.

• Blood in stools or urine
• Persistent fever
• Unintended weight loss
• Pain that prevents restful sleep or awakens you at night
• Hardening of the abdominal cavity or stomach
• Diarrhea that wakes you up or interferes with sleep

One exact cause of IBS has yet to be pinpointed.  Instead, a range of potential causes have been identified by doctors, natural remedy specialists, and even patients themselves, speaking to the delicate nature of the human digestive tract.  Some potential causes include: 

• Stress – Rosemary Nicol, author of the 1995 book Irritable Bowel Syndrome: A Natural Approach, notes, “Most people can trace their Irritable Bowel Syndrome back to a stressful time such as divorce, threat of job layoff, unemployment, exams, and so on.”  Her assertion is shared by doctors and patients alike, who often notice an increase in the severity of their symptoms during times of moderate to high stress.  

• Infection and Antibiotics - There are many health providers who see the disruption of the natural gut flora as a cause of IBS.  Every human has colonies of “helpful” bacteria that live inside their intestinal tract and provide valuable assistance digesting food, maintaining pH levels, and trapping harmful agents. When these colonies become compromised or eliminated, it can cause a variety of health problems for the individual including IBS.  The two main events that can alter the levels of helpful bacteria in the intestines are infection (especially Candida, or yeast, infection) and antibiotic use.

• Laxative Use - Very rare laxative use, while not the best solution to constipation, will not cause long term damage of the intestines.  However, too frequent use or abuse can hurt the two essential elements that keep bowels functioning in a proper manner: gut flora and muscle contractions.  This has been identified as a potential cause of IBS.

• Dietary Causes - The Western diet is one of the most commonly suspected culprits for causing IBS.  Too many refined foods, fried foods, wheat and dairy, compounded with too little fiber and water can lead to a variety of gastrointestinal problems, not the least of which is IBS.  One study reported that wheat, corn, dairy, coffee, tea, and citrus fruits were among the most common types of food known to causes IBS.   

For more valuable information on the causes of IBS, check out our full length report!

How is IBS Diagnosed

Diagnosing IBS can best be described as process of elimination.  Since the classic symptoms of IBS are common to just about every gastrointestinal disorder, the most common approach to diagnosing it is to rule out any other condition that might be the cause. 

Expect your health care professional to perform a general physical examination and ask about any symptoms you’ve noticed along with changes in appetite, sleep habits, sexual function, and medications. To eliminate other gastrointestinal conditions, your health care provider may order blood tests to check for Celiac Disease or hypothyroidism or have x-rays of your abdomen taken. Additionally, they may want to perform a colonoscopy to check for bowel obstructions.

If your doctor suspects a food allergy is causing all or some of your symptoms, they will likely encourage diet trials to establish which food(s) may be affecting your system.  Often, they will start with lactose intolerance tests to check for any dairy allergies. 

After the various exams assessing your condition are complete and negative for more serious conditions, your health care professional may feel ready to give you a diagnosis of IBS.  At this time, they will make suggestions regarding your dietary habits and may recommend a course of prescription or alternative treatment to address your symptoms.

For more valuable information on how IBS is diagnosed, check out our full length report!

Traditional Treatments

Over the past fifteen years, a variety of prescription and over-the-counter medications have been utilized by health care professionals to alleviate the symptoms of IBS, including anti-diarrheals, antibiotics, anti-cholinergics, and anti-depressants. There is currently no IBS-specific medication approved by the FDA.

• Anti-Diarrheals - A common suggestion for patients who suffer from IBS characterized by diarrhea is the chemical loperamide.  Known best under the brand names Imodium and Lomotil, loperamide is an anti-diarrheal medication available over-the-counter that works by slowing digestive rhythm.  Common side effects of anti-diarrheals include constipation and physical dependence.  Most anti-diarrheal medications are available over-the-counter.

• Anti-Depressants - Anti-depressants are often prescribed to patients reporting symptoms of IBS to both stimulate serotonin production and also relieve emotional stress and anxiety which may be antagonizing symptoms.  There is some evidence that selective serotonin reuptake inhibitors (SSRIs) help reduce symptoms of IBS by blocking the activity of specific intestinal nerves.  Common brand name SSRIs prescribed to IBS patients includes Prozac and Paxil.  It should be noted that when anti-depressants are used for IBS they are prescribed at doses significantly lower than prescriptions used to treat depression.  Side effects of anti-depressants include hypomania, headaches, reduced libido, and weight gain.

• Anti-Cholingerics - A health care provider may prescribe an anti-cholingeric, also known as an anti-spasmodic, to ease bowel spasms. This type of medication inhibits acetylcholine, a neural transmitter that works in the nervous system by binding with nerve cells to relay messages of action, sensation, or pain. While they can be effective in treating diarrhea, anti-cholingerics can exacerbate constipation as well as disrupt coordination, cause double vision, and increase body temperature.  The most well known brand of anti-cholingerics is Spiriva.

• Narcotic Analgesics - In some instances, narcotic analgesics have been prescribed to treat the symptoms of IBS.  Narcotic analgesics, known best under the brand names Vicodin, Percocet, and Codeine, are opioid painkillers which are used in situations where an IBS patient’s stress levels cannot be effectively controlled through other means or where the bloating and cramping caused by the condition is unmanageably uncomfortable.  The prescription of narcotic analgesics is relatively rare due to the significant risk of addiction associated with them. Side effects include neural chemical dependence, drowsiness, and constipation.

• Antibiotics - If it is suspected that an individual’s IBS is caused by a bacterial imbalance in the intestines, a health care professional may prescribe a course of antibiotics to reduce colonies of unwanted flora.  However, as previously noted, there is a growing body of evidence to suggest that antibiotic use is one of the main causes of IBS, making this traditional treatment option slightly ironic.  The general side effect of antibiotics for IBS is diarrhea, however decreased absorption of other medications is also common. 

For more valuable information on the traditional treatments for IBS, check out our full length report!

Misdiagnosis of Symptoms

One of the most challenging elements of IBS is that its symptoms are broad and common among most gastrointestinal conditions, making it easy to misdiagnosis the symptoms of IBS. To help you understand your symptoms more, below is a list of the most common conditions IBS can be mistaken for (and vice versa) including what their symptoms are and how they can be distinguished from IBS.

• Food allergies - Food allergies are immune system reactions to chemical compounds found in certain types of food. The most common symptoms of a food allergy include hives, numbness in the mouth, abdominal pain, diarrhea, nausea, stomach cramping, vomiting, and dizziness.  Food allergies and IBS may be hard to differentiate between because just as an IBS episode can be “triggered’ by certain types of food, an individual with a food allergy will experience a reaction every time they eat a food they are allergic to.  If an individual is not experiencing other symptoms of allergy, such as hives, swollen tongue or lips, or anaphylactic shock, the best way to distinguished between a food allergy and IBS is through blood tests which can measure the amount of immune cells present in the blood before and after eating potentially allergic foods.   

• Food intolerances - Food intolerances are physical reactions to chemical compounds found in certain types of food.  Unlike a food allergy, food intolerances are not caused by immune system responses but instead by a variety of issues, ranging from the absence of necessary digestive enzymes to sensitivity to synthetic preservatives. Symptoms for food intolerances typically include abdominal bloating, cramping, diarrhea, excess gas, and constipation. While food intolerances may trigger bouts of IBS, they are not synonymous with the condition.  There are several tests that can be done to establish if the symptoms an individual experiences are caused by IBS or an intolerance, including a trial and error test and an enzyme test.  

• Celiac Disease - Celiac Disease is an autoimmune condition that occurs when the body’s immune system mistakenly attacks the lining of the colon. Celiac Disease can cause long term damage to the intestinal tract and increase the risk of developing cancer, specifically lymphoma, by up to 50% due to the inappropriate activation of the immune system.  Celiac Disease exhibits almost identical symptoms to IBS.  The most common way to tell them apart is through a blood test that measures the amount of immune cell antibodies in the blood stream. Celiac patients will have high levels of antibodies in their blood, while IBS patients will not.

•  Crohn’s Disease - Crohn’s Disease is a type of inflammatory bowel disease (IBD) that is characterized by an inflammation of intestines.  Unlike Ulcerative Colitis, which affects just the upper layer of the intestinal lining, Crohn’s Disease causes inflammation deep in the lining tissue, causing severe pain and other serious complications. Many of the symptoms of Crohn’s Disease are similar to IBS, and common symptoms include diarrhea, abdominal pain and cramping.  Other symptoms of Crohn’s Disease are bloody stools, undesired weight loss, and ulcers. There are a variety of tests which should be performed if you report these symptoms, including fecal analysis, blood tests, and small bowel imaging to check for ulcers and other perforations in the intestinal lining that can lead to other, potentially fatal conditions.

• Ulcerative Colitis - Ulcerative Colitis (UC) is a type of inflammatory bowel disease (IBD) which is characterized by continual inflammation of the lining of the large intestine and rectum. The basic symptoms of all UC types are abdominal pain and diarrhea.  While Ulcerative Colitis shares symptoms with Irritable Bowel Syndrome, it is easily distinguished from IBS through bloody stools and side-specific pain.  While mucus in stools is common with IBS, blood in stools is not a recognized symptom of the condition.  Similarly, IBS does not cause severe pain or pain that is specific to one side of the body or intestinal tract.  Also, serious weight loss is not a symptom of IBS..

For more valuable information on potential IBS misdiagnosis, check out our full length report!

Companion Conditions

Because of its crucial role in digestion and nutrient absorption, dysfunctions of the gastrointestinal system can affect other systems in the body, causing not only a host of side effects but also an increased risk for developing several other conditions.  There are a few common “companion conditions” that often develop in tandem with IBS as a result of the syndrome.

• Fibromyalgia - Fibromyalgia is a chronic condition. Its symptoms include muscle pain, fatigue, stiffness, poor sleep, and inexplicably sore points on the body. The Mayo Clinic reports that around 2% of the United States population suffers from fibromyalgia.  A study published in the 1991 edition of the British Journal of Rheumatology reported that “as many as 60% of IBS patients also suffer from fibromyalgia syndrome (FMS). Conversely, as many as 70% of FMS patients have reported experiencing symptoms of IBS.” 

• Leaky gut syndrome - “Leaky gut syndrome” is a phrase used most often by alternative health practitioners to describe the physical situation when the lining of the intestines becomes too permeable, allowing toxins, parasites, and other harmful elements to pass out of the digestive tract and directly into the blood stream.  As these elements “leak” into the rest of the body, the immune system is triggered to neutralize them, thereby causing a variety of gastrointestinal symptoms like bloating, gas, cramping, and food sensitivity. Dr. Andrew Weil notes that currently, Leaky gut syndrome is not recognized as an accepted medical condition in the mainstream medical community, however suggests that evidence to support its existence is growing. However, many medical professionals believe that what some call LGS is really an instance of Celiac Disease. 

• Other Conditions - There has been some speculation that a link exists between Irritable Bowel Syndrome and other conditions, such as liver enzyme imbalances and arthritis, however these claims have not been validated by any significant mainstream or alternative research.  Furthermore, while mild nutrient malabsorption is possible in patients with IBS, there is not enough evidence to indicate it ever occurs on a serious or notable level.  Individuals who are concerned about nutrient loss due to chronic diarrhea should be sure to take a daily multivitamin and eat nutrient rich foods to avoid any slight potential of malabsorption.  

For more valuable information on companion conditions for IBS, check out our full length report!

Changes to Make