Irritable bowel syndrome --
chronic disease that affects one in five Americans
By: Victoria Heren, M.D.
Just about everyone is familiar with the feeling of a stomachache. Discomfort can come in the form of cramps, bloating, gas, abdominal pain, diarrhea and constipation. For as many as one in five Americans who have irritable bowel syndrome, these symptoms can become chronic, occurring on and off for years.
Irritable bowel syndrome, or IBS, is one of the most commonly diagnosed disorders in the U.S. The disease is twice as common in women as men, and usually develops when a person is a young adult – from ages 20 to 40.
While IBS is a chronic disease, the disorder itself does not usually become worse over time. It does not lead to more serious diseases such as inflammatory bowel disease or cancer, but people with IBS can also have one of these more serious illnesses. Also, it's important to note that the symptoms associated with IBS can be caused by other more serious problems. So it's necessary to rule out other illnesses before a diagnosis of IBS is made.
A person is thought to have IBS if other conditions are ruled out and his or her abdominal pain is continuous or comes and goes for at least 12 weeks during the span of one year and the person experiences two of the following three symptoms: pain is relieved by having a bowel movement, there are changes in frequency of bowel movements and appearance or form of stools.
In addition to changes in bowel movements, people may experience lower abdominal pain with constipation and/or diarrhea. Other symptoms include intestinal gas and mucus in stools.
The exact causes of IBS are not completely understood. In IBS, the movement of the digestive tract is impaired, but no change in physical structure – such as inflammation or tumors – is evident. The symptoms of IBS are most likely related to faulty communication between the brain and the intestinal tract. This causes abnormal muscle contractions in the intestines, creating the pain, bloating and other symptoms associated with the disease.
People with IBS may also have extra sensitive intestines. That is, their intestines are more likely to react to certain foods, stress, certain medications and hormonal changes in the body. Finally, IBS tends to run in families, so there is likely a genetic component to the disease.
Most people with IBS experience mild symptoms that don't disrupt their lives. They usually don't need to see a health professional other than to rule out other more serious intestinal problems. About 25 percent of people with IBS experience moderate symptoms that occasionally disrupt daily activities. A small number – about 5 percent – of IBS sufferers have severe symptoms that are often accompanied by extreme anxiety or stress.
IBS treatment varies based on each individual patient. However, some common factors run through most treatment plans. Avoiding caffeine, foods high in fat, quitting smoking, drinking plenty of water, eating smaller portions and a regular exercise routine all help to decrease IBS symptoms. People with constipation often benefit from adding fiber to their diet.
Treatment plans often include medication to relieve symptoms. Your health care professional will make medication recommendations based on your unique situation. It is important to follow all medication recommendations carefully and consistently.
Patients are often advised to keep a journal of symptoms. This helps to identify triggers for their illness, and can help patients and their doctors better understand the disease. Triggers are often related to certain foods or stressful events. Avoiding food triggers is pretty straightforward and can help to reduce symptoms.
Unfortunately, stress can't always be avoided. And, there seems to be a definite link between stress and IBS. Learning stress management techniques can help a person deal more positively with stress and help prevent or reduce stress-related IBS episodes. Stress management options include relaxation therapy, biofeedback, hypnosis, cognitive behavioral therapy, self-help groups and traditional psychotherapy. Sometimes the simple act of doing something enjoyable – taking a walk with a friend or listening to music – can serve as a stress-reliever.
Keeping careful track of symptoms can help make patients aware of significant changes in their illness. It is important to communicate with your doctor about any symptomatic changes because they may indicate a need for additional tests to determine whether another disease is causing the symptoms.
IBS is a chronic condition, but the good news is that two-thirds of patients show a decrease in symptoms after making changes in diet and medication. It is important that you work closely with your doctor to develop a treatment plan that is right for you. By taking steps to prevent the symptoms of IBS, people can effectively manage their illness, leaving them free lead productive, healthy lives.
Dr. Heren is a board certified family practice physician at Raiter Clinic.