Irritable bowel syndrome (IBS) is a gastrointestinal (GI) disorder characterized by a combination or all of the following symptoms: cramping, abdominal pain, bloating, constipation, and diarrhea.  Irritable bowel syndrome (IBS) can result in considerable discomfort and distress to those that are affected, but it does not tend to cause permanent harm to the gastrointestinal tract.

Irritable bowel syndrome (IBS) can range in severity from easily manageable to debilitating at times.  Most people with irritable bowel syndrome (IBS) can manage their symptoms with a combination of diet, stress management, and prescribed medications.  In severe cases irritable bowel syndrome (IBS) can affect work, ability to engage in activities, or ability to travel.  

Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) can cause cramping, abdominal pain, bloating, constipation and diarrhea.  Any given person afflicted with this condition can have a unique variation of these symptoms.  The constipation and diarrhea described by most people with irritable bowel syndrome is an alternating scenario of days of constipation followed by days of diarrhea.  However, this is not always the case.  Some people can experience one or the other and still some can have weeks of one followed by normal bowel movements.  Mucus is a common finding in the stools of those afflicted with irritable bowel syndrome.  Mucus is a fluid that helps to moisten and protect the gastrointestinal system.

There is no one specific cause of irritable bowel syndrome and thought to be variable between individuals.  The most common causes thought to contribute to irritable bowel symptoms involve sensitivity to specific foods, stress or emotional reactions, and an immune reaction.  
Some studies have shown that there may be a problem with the normal motility found in the intestines contributing to spasms leading to an increase or decrease in the movement of material through the gastrointestinal tract.  This may also lead to fluid absorption issues that can contribute to a more liquid stool versus a dry stool.  It is thought that these spasms may be a result of a food sensitivity or an emotional response to stress.  The most common food sensitivity related to irritable bowel syndrome is a reaction to gluten, which is a substance found in wheat, rye, and barley.  Dairy products, corn, and soy are the other most common food sensitivities that can cause problems.

Research has also linked several neurotransmitters such as serotonin and melatonin to normal gastrointestinal function.  Both of these neurotransmitters are found in high concentrations in the gastrointestinal system and in the brain.  Studies have shown that people with irritable bowel syndrome have low receptor activity that affects cellular transporters in the gastrointestinal epithelial cells.  This results in an abnormally low level of serotonin and melatonin in the gastrointestinal tract, which leads to abnormal bowel motility (movement), increased sensitivity to pain receptors, and inadequate cellular function.

There have also been some studies that have potentially linked irritable bowel syndrome to a post- bacterial infection.  Some patients that developed a gastroenteritis, a severe bacterial infection of the gastrointestinal tract, can develop irritable symptoms later on once the infection has been successfully treated.

Currently since there is no specific cause of irritable bowel syndrome, there is no specific test that can be done to determine if symptoms are a result of irritable bowel syndrome.  The diagnosis is made when everything else is ruled out as the cause and from the specific symptoms presented.  

Treatments Available

There is no cure for irritable bowel syndrome only management of symptoms.  Treatments can vary depending on symptoms and potential causes.  There are some medications and supplements that can help reduce symptoms along with dietary changes and stress management techniques that can be helpful.  In some cases physical manipulative therapies can also be helpful.

The medications available to treat irritable bowel syndrome range in effect from antispasmodics (help to relax muscles) and antidiarrheals (stop diarrhea) to antidepressants (to increase serotonin levels).  Since one medication is not right for everyone, some can worsen symptoms instead of making them better.  It is important to follow your doctor’s instructions on how to take and which medications or supplements would be appropriate to your specific condition.  For example, you would not want to take a fiber supplement if you are having mostly constipation or a laxative if you are having more diarrhea like symptoms.

There are several supplements that can be used to help treat irritable bowel syndrome.  Supplements that help irritable bowel syndrome range from probiotics (good bacteria that normally populate the intestines) to soothing herbs that help to calm the nervous system down and coat the gastrointestinal tract.  

Along with supplements there are a few manual therapies that can help irritable bowel syndrome.  Visceral manipulation is one therapy that can help reduce spasm and restore normal movement back into the intestines.  Hydrotherapy applications of hot and cold can also be helpful in gently stimulating the normal movement in the intestines.

Stress management is an important component of treatment for many suffering from irritable bowel syndrome.  Stress affects the body in many ways.  Some times we do not perceive how the body is reacting to the stress that it is under.  The gastrointestinal tract is one of the most highly innervated organ systems in the body, meaning that there are many nerve connections throughout its length.  These nerves help to control the normal peristaltic (wave-like) contractions of the intestines and can also produce the abdominal discomfort many feel when feeling anxious or ‘stressed out’.  The intestines can become overly responsive to the slightest perceived stressor making the mind more aware of the sensations that can arise in the intestines.

Dietary changes can help many patients even when the cause is not a specific food.  Sometimes food or overeating can just aggravate symptoms.  Some ways to determine if a food might be the culprit is to either keep a journal to see if a pattern arises or to do an allergy elimination diet.  The only way to truly tell if a food is causing a symptom is to eliminate it from the diet for several weeks.  Then add it back in to see if it will cause or aggravate current symptoms.  A journal may miss patterns and may not provide a good trial to determine, which foods may be the problem.

Soluble fibers can be more helpful especially in conditions involving constipation.  There are soluble and insoluble fibers.  Soluble fibers are found in fruits and vegetables.  These fibers are more helpful in bulking the stool and keeping water in the system to prevent hard compact stools and to help decrease spasm in the intestines.  Insoluble fibers are from things like grains and nuts.  In cases of spastic constipation this type of fiber will aggravate the pain that is felt and can sometimes cause more gas and bloating.

Staying well hydrated is very important in any condition, especially in irritable bowel syndrome that has diarrhea as a symptom.  Also eating smaller meals can help to decrease distention and decrease the potential of cramping.