Irritable bowel syndrome (IBS) is a common problem with the intestines. In people with IBS, the intestines squeeze too hard or not hard enough and cause food to move too quickly or too slowly through the intestines. IBS usually begins around age 20 and is more common in women.IBS is also called functional bowel syndrome, irritable colon, spastic bowel and spastic colon. It’s not the same as inflammatory bowel diseases like ulcerative colitis.

What are the symptoms of IBS?

The box to the right lists common symptoms of IBS.The symptoms may get worse when you’re under stress, such as when you travel, attend social events or change your daily routine. Your symptoms may also get worse if you don’t eat enough healthy foods or after you’ve eaten a big meal. Some people are bothered by certain foods. Women who have IBS may notice more frequent symptoms during their menstrual periods.

How is IBS diagnosed?

Your doctor may start by asking you questions about your symptoms. If your symptoms have had a pattern over time, the pattern may make it clear to your doctor that IBS is the cause.

If your symptoms have just started, something else may be the cause. Your doctor may need to do some tests, such as a blood test or colonoscopy, to make sure that your symptoms aren’t caused by something other than IBS.

How is IBS treated?

The best way to handle IBS is to eat a healthy diet, avoid foods that seem to make you feel worse and find ways to handle your stress.

Why may fiber be helpful?

Fiber can be helpful because it improves how the intestines work. There are 2 types of fiber:

• Soluble fiber helps both diarrhea and constipation. It dissolves in water and forms a gel-like material. Many foods contain soluble fiber such as apples, beans and citrus fruits. Psyllium, a natural vegetable fiber, is a also a soluble fiber. You can buy psyllium supplements (some brand names: Fiberall, Metamucil, Perdiem) to drink and you can add it to other foods.
• Insoluble fiber helps constipation by moving material through your digestive system and adding bulk to your stool. Insoluble fiber is in whole grain breads, wheat bran and many vegetables.

Increase the fiber in your diet slowly. Some people feel bloated and have gas if they increase their fiber intake too quickly. Gas and bloating usually improve as you get used to eating more fiber. The best way to increase your fiber intake is eat a wide variety of high fiber foods. For more information, read the handout, “Fiber: How to Increase the Amount in Your Diet.”

Do certain foods cause IBS?

No. Foods don’t cause IBS. But some foods may make you feel worse. Foods that may make symptoms worse include foods high in fat or caffeine. Fat and caffeine can cause your intestines to contract, which may cause cramping. Alcohol and chocolate may also make you feel worse. If gas is a problem for you, you might want to avoid foods that tend to make gas worse. These include beans, cabbage and some fruits.

Keeping a diary of what you eat and what your symptoms are for a few weeks may be a good way to find out if a food bothers you. If you think a food makes you feel worse, don’t eat it. But don’t cut out foods unless they have caused you problems more than once.

What about milk and milk products?

If milk and other dairy products bother you, you may have lactose intolerance. Lactose intolerance means that your body can’t digest lactose (the sugar in milk).

Dairy products may seem to make IBS symptoms worse if you’re lactose intolerant. If this seems to be the case, you may need to limit the amount of milk and milk products in your diet. Talk to your family doctor if you think you have trouble digesting dairy products.

How can stress affect IBS?

Stress may trigger symptoms in people with IBS. Talk to your family doctor about ways to deal with stress, such as exercise, relaxation training or meditation. He or she may have some suggestions or may refer you to someone who can give you some ideas. Your doctor may also suggest that you talk to a counselor about things that are bothering you.

Can my doctor prescribe medicine for IBS?

There is no cure for IBS. However, if you’re having bad symptoms, your doctor may prescribe medicine to help you manage or lessen your symptoms.

For example, antispasmodic medicines may be prescribed to reduce cramping if your main symptom is pain. Hyoscyamine (some brand names: Anaspaz, Cystospaz, Levsin) and dicyclomine (some brand names: Bentyl, Di-Spaz) help relax the spasms in the colon. Heating pads and hot baths can also be comforting.

When diarrhea is a frequent problem, medicine such as loperamide (brand name: Imodium) may help.

Your doctor may give you tranquilizers or sedatives for short periods to treat anxiety that may be making your symptoms worse. Your doctor may prescribe an antidepressant for you if your symptoms are severe and you are feeling depressed.

Will IBS get worse over time?

No. While IBS will probably recur throughout your life, it won’t get worse. It doesn’t cause cancer or require surgery, and it won’t shorten your life.

What if IBS interferes with my daily activities?

IBS may have caused you to avoid doing certain things, like going out or going to work or school. While it may take some time for your efforts to pay off, you may find new freedom by following a plan that includes a healthy diet, learning new ways to deal with your stress and avoiding foods that may make your symptoms worse.