Irritable bowel syndrome (IBS) is a common gastrointestinal syndrome that is characterized by abdominal pain and altered bowel habits in the absence of any underlying organic cause.  Other associated symptoms can include cramping, bloating, gas, diarrhea and/or constipation. IBS tends to be a chronic condition that requires long term management, although there will likely be times when the signs and symptoms are worse and times when they improve or even disappear completely. The effects of IBS may cause one to feel as if they are not able to live life to the fullest, leading to discouragement, depression, or sometimes a feeling of not wanting to leave the house or be social for fear of having an attack of symptoms.

As many as 1 in 5 American adults has signs and symptoms of irritable bowel syndrome, but fewer than 20% of those with symptoms seek medical help.  Despite the low percentage that seek help, the number of patients that do account for 25 to 50 percent of all referrals to gastroenterologists. IBS also accounts for a significant number of visits to primary care physicians, and is reported to be the second highest cause of absence from work after the common cold.

IBS can affect both men and women of any age.  However, it is most commonly seen, at least initially, in patients under 45, and women present with symptoms about twice as frequently as do men.  People with a family member with IBS may have an increased likelihood of developing symptoms, as may people with other conditions such as anxiety, depression, or a history of sexual or domestic abuse.

The precise cause of irritable bowel syndrome is not known.  It is felt that there are likely a variety of possibilities.  Changes in the way the muscles lining the gastrointestinal tract contract and relax may result in altered bowel habits as well as increased gas or bloating.  The communication between the gastrointestinal tract and the brain may play a role as well, causing the body to overreact to normal gastrointestinal function.

Triggers of IBS can be variable as well.  What affects one person may not trigger symptoms in another.  Commonly reported triggers include stress, hormonal changes such as around a woman’s menstrual period, illnesses, and various foods. Many foods have been implicated and not all affect everyone in the same way.  Examples include fresh fruits and vegetables, certain spices, MSG, milk, chocolate, and alcohol.

Since many conditions can present with symptoms similar to irritable bowel syndrome, it is important to exclude other causes. Signs and symptoms not typically associated with IBS that may indicate a more serious condition include rectal bleeding, abdominal pain that gets progressively worse or occurs during the night, anemia, or unintentional weight loss.  These should be evaluated right away.

It is important to talk with your doctor about any gastrointestinal symptoms.  He or she can determine whether or not a referral to a gastroenterologist is indicated.  There are many different treatment options for IBS.  Just as the symptoms are different from one person to another, the response to a particular therapy may vary as well.  A gastroenterologist can help work through some of those options to most effectively relieve symptoms and minimize the impact of irritable bowel syndrome.

Dr. Geoffrey Raymer is a gastroenterologist for Southeastern Indiana Gastroenterology and serves as the medical director for the Endoscopy Center at Columbus Regional Hospital.

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