Relief for irritable bowel syndrome

IBS more often affects women than men; treatments help manage the condition

Irritable bowel syndrome, or IBS, is a common disorder that affects the large intestine. It can have a profound impact on a person’s life, limit her work, social and family interactions, cause severe abdominal pain, and be a difficult topic to discuss during a medical appointment. IBS includes a group of symptoms including cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. These problems can cause a patient’s gastrointestinal tract to be more sensitive and produce colon muscle contractions (spasms) at any given time. 

IBS doesn’t cause changes in bowel tissue or increase the risk of colorectal cancer, but it is a chronic condition that patients need to manage long term. Some people can control their symptoms by managing diet, lifestyle, and stress. More-severe symptoms can be treated with medication and counseling. Most people with IBS experience times when the signs and symptoms are worse and times when they improve or even disappear completely.

There are three types of IBS based on different patterns of changes in bowel movements or abnormal bowel movements. Some medicines work only for some types of IBS or make other types worse. Your doctor might diagnose IBS even if your bowel movement pattern does not fit one particular type. Many people with IBS have normal bowel movements on some days and abnormal bowel movements on other days. The three types include: IBS with constipation, IBS with diarrhea, and IBS with mixed bowel habits where at least one abnormal bowel movement each day includes stools that are hard or lumpy and loose or watery.

Who is more likely to develop IBS?

Women are nearly twice as likely as men to develop IBS. People younger than age 50 are more likely to develop IBS than people older than age 50. The precise cause of IBS isn’t known. Several factors appear to play a role including:

• Having a family member with similar GI disorders.
• A history of stressful or difficult life events such as trauma or abuse.
• Gastrointestinal infection
• A condition called Small Intestinal Bacterial Overgrowth or SIBO, can cause IBS.  SIBO occurs when bacteria that normally grow in other parts of the colon start growing in the small intestine. That causes pain and diarrhea and can also lead to malnutrition. Some studies claim women are most likely, to suffer from SIBO than men, however this is controversial. 
• Women nearing their menstrual cycles.

What are the symptoms of IBS?

The signs and symptoms of IBS vary. The most common include:

• Abdominal pain, cramping or bloating that is relieved or partially relieved by passing a bowel movement.
• Excess gas.
• Diarrhea or constipation — sometimes alternating bouts of diarrhea and constipation.
• Mucus in the stool.
• Urgency of defecation.

What other health problems occur with IBS?

People with IBS often have other health problems, including:

• Fibromyalgia, endometriosis, chronic fatigue syndrome, migraines, sleep disorders and chronic pelvic pain.
• Digestive diseases, such as dyspepsia and gastroesophageal reflux disease.
• Anxiety, depression, posttraumatic stress syndrome and somatic symptom disorder.

How IBS treated?

Treatments can involve dietary and lifestyle changes, exercise, medicines, probiotics, and cognitive behavior therapies. You may have to try a few treatments to see what works best. 

Diet changes include eating more fiber, refraining from dairy products to rule out lactose intolerance, avoiding gluten and following a special eating plan to reduce or avoid certain foods that contain carbohydrates that are difficult to digest. These include a wide range of fruits, vegetables, dairy products, wheat and rye products, honey, foods with high-fructose corn syrup, and artificial sweeteners ending in “–ol,” such as sorbitol, mannitol, xylitol, and maltitol. If IBS symptoms subside, the restricted foods may be slowly reintroduced to your diet.

Increasing physical activity, reducing stress through exercise or psychotherapy, and getting enough sleep also help IBS symptoms. Medicines can relieve IBS symptoms, and your doctor may also recommend probiotics. These are live microorganisms, most often bacteria, that are similar to microorganisms normally found in the digestive tract. Several studies have shown promise in treating IBS with probiotics. Rachel Ayers, NP, joined CMA Gastroenterology in 2019 after 13 years of caring for patients at Cayuga Medical Center’s endoscopy unit. She can be reached at CMA Gastroenterology, 2 Ascot Place, Ithaca, (607) 339-0788.