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Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder of unknown cause. Common symptoms include abdominal cramping or pain, bloating and gassiness, and altered bowel habits. Irritable bowel syndrome has also been called spastic colon, functional bowel disease, and mucous colitis. However, IBS is not a true "colitis." The term colitis refers to a separate group of conditions known as inflammatory bowel disease (IBD). Irritable bowel syndrome is not contagious, inherited, or cancerous. It is estimated that 20% of adults in the U.S. have symptoms of IBS. It occurs more often in women than in men, and the onset occurs before the age of 35 in about half of the cases.
Abdominal cramping and pain that are relieved with bowel movements Alternating periods of diarrhea and constipation Change in the stool frequency or consistency Gassiness (flatulence) Passing mucus from the rectum Bloating
Abdominal distension
The following are NOT symptoms or characteristics of IBS (but should still be brought to the attention of a physician since they may be signs and symptoms of other conditions):
Blood in stools or urine Black or tarry stools Vomiting (rare, though may occasionally accompany nausea) Pain or diarrhea that interrupts sleep Fever Weight loss
A combination of history, physical examination, and selected tests are used to help diagnose irritable bowel syndrome. No single blood test or x-ray study confirms a diagnosis of IBS.
Certain foods, such as cruciferous vegetables (cauliflower, broccoli, cabbage, brussels sprouts) and legumes (beans) may worsen bloating and gassiness. Dietary fiber may lessen symptoms. Individuals with IBS should drink plenty of water, and avoid soda, which may cause gas and abdominal discomfort. Eating smaller meals may lessen the incidence of cramping and diarrhea. Low fat and high carbohydrate meals such as pasta, rice, and whole grain breads may help IBS symptoms (unless the affected individual has celiac disease).
Medical Treatment
Most people with irritable bowel syndrome have problems only occasionally. A few may experience long-lasting problems and require prescription medications.
A common treatment for IBS is the addition of fiber to the diet. This theoretically expands the inside of the digestive tract, reducing the chance it will spasm as it transmits and digests food. Fiber also promotes regular bowel movements, which helps reduce constipation. Fiber should be added gradually, because it may initially worsen bloating and gassiness. Stress may cause IBS "flares." Doctors may offer specific advice on reducing stress. Regularly eating balanced meals and exercising may help reduce stress and problems associated with irritable bowel syndrome. Smoking may worsen symptoms of IBS, which gives smokers another good reason to quit. Since many patients with irritable bowel syndrome report food intolerances, a food diary may help identify foods that seem to make IBS worse.
Medications
Antispasmodic medicines, such as dicyclomine (Bemote, Bentyl, Di-Spaz) and hyoscyamine (Levsin, Levbid, NuLev), are sometimes used to treat symptoms of irritable bowel syndrome. Antispasmodic medicines help slow the action of the digestive tract and reduce the chance of spasms. They may have side effects and are not for everyone. Other treatment plans are available, depending on symptoms and condition. Antidiarrheal medicines, such as loperamide (Imodium), a kaolin/pectin preparation (Kaopectate), and diphenoxylate/atropine (Lomotil), are sometimes used when diarrhea is a major feature of IBS. Do not take these on a long-term basis without first consulting a doctor.
Antidepressants may be very effective in smaller doses than those typically used to treat depression. Imipramine (Tofranil), amitriptyline (Elavil), nortriptyline (Pamelor), and desipramine (Norpramin) are some commonly used medicines that may alleviate irritable bowel syndrome symptoms. Some other antidepressants are more commonly prescribed when depression and IBS coexist. The following medications are typically reserved for patients with symptoms that do not improve with the above treatments: o Lubiprostone (Amitiza) is a type of laxative used to treat irritable bowel syndrome with constipation in women who are at least 18 years of age. It is a capsule taken orally, twice a day with food. It is used to relieve stomach pain, bloating, and straining; and produce softer and more frequent bowel movements in people who have chronic idiopathic constipation.
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Alosetron (Lotronex) is a restricted drug approved only for short-term treatment of women with severe, chronic, diarrhea-predominant IBS who have failed to respond to conventional IBS therapy. Fewer than 5% of people with irritable bowel syndrome have the severe form, and only a fraction of people with severe IBS have the diarrhea-predominant type. Alosetron was removed from the United States market but was reintroduced with new restrictions approved by the FDA in 2002. Physicians must be registered with the pharmaceutical manufacturer in order to prescribe the medication. Serious and unpredictable gastrointestinal side effects (including some that resulted in death) were reported in association with its use following its original approval. The safety and efficacy of alosetron has not been sufficiently studied in men; therefore, the FDA has not approved the drug for treatment of IBS in men. Tegaserod (Zelnorm) was a medication used to treat IBS but was removed from the market in 2008 due to increased risk of heart attack, stroke, and ischemic colitis.
Limit foods that contain ingredients that can stimulate the intestines and cause diarrhea, such as:
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Fatty foods Foods high in sugar Artificial sweeteners (sorbitol and xylitol)
Some vegetables (cauliflower, broccoli, cabbage, brussels sprouts) and legumes (beans) may worsen bloating and gassiness and should be avoided. Dietary fiber may lessen symptoms of constipation. Drink plenty of water, and avoid carbonated drinks such as soda, which may cause gas and discomfort. Eat smaller meals and eat slowly to help reduce cramping and diarrhea. Low fat, high carbohydrate meals such as pasta, rice, and whole-grain breads may help (unless you have celiac disease).
In addition to dietary changes, there are some healthy habits that may also help reduce IBS symptoms.
Maintain good physical fitness to improve bowel function and help reduce stress. Stop smoking for overall good health. Avoid coffee and chewing gum. Reducing or eliminating alcohol consumption may help. Stress management can help prevent or ease IBS symptoms.
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Use relaxation techniques: deep breathing, visualization, yoga Do things you find enjoyable: talk to friends, read, listen to music
good relationship with a doctor may help alleviate concerns over symptoms and allow rapid recognition of changing or worsening symptoms.