What is irritable bowel syndrome (ibs)?

Irritable bowel syndrome (IBS) is a disorder of the intestines. It causes belly pain, cramping or bloating, and diarrhea or constipation. IBS is a long-term problem, but there are things you can do to reduce your symptoms.

Your symptoms may be worse or better from day to day, but your IBS won't get worse over time. IBS doesn't cause more serious diseases, such as inflammatory bowel disease or cancer.

The main symptoms of IBS are belly pain with constipation or diarrhea. Other common symptoms are bloating, mucus in the stools, and a feeling that you haven't completely emptied your bowels.

Many people with IBS go back and forth between having constipation and having diarrhea. Most people have one of these more often than the other.

IBS is quite common, but most people's symptoms are so mild that they never see a doctor for treatment. Some people may have troublesome symptoms, especially stomach cramps, bloating, and diarrhea.

Because there are no structural problems in the intestines of people who have IBS, some people may think this means that the symptoms "are all in their head." This isn't true. The pain, discomfort, and bloating are real.

Most of the time, doctors can diagnose IBS from the symptoms. Your doctor will ask you about your symptoms and past health and will do a physical exam.

In some cases, you may need other tests, such as stool analysis or blood tests. These tests can help your doctor rule out other problems that might be causing your symptoms. People with diarrhea as part of their symptoms usually need testing. What tests you need depend on your symptoms and your age.

Tests may include a blood test for celiac disease and a complete blood count. Other tests can include stool tests for colon inflammation and infection. A colonoscopy is sometimes done.

Treatment for IBS depends on your symptoms and how much they affect your daily life. You may need to try a few things before you find what works best for you.

You will monitor your symptoms and work with your doctor to find which foods, activities, and experience make you feel worse. You avoid foods that trigger your symptoms. Some people do well on a diet called a low-FODMAP diet. Being active can help some people. So can managing stress. A type of counseling called cognitive behavior therapy (CBT) can help with pain. Some people need physical therapy.

If these things don't help enough, your doctor may recommend medicines. They can help with constipation or diarrhea. Others, like certain antidepressants, can help with pain.

• Keep track of foods and symptoms.
  • Keep a food diary to track what you eat. Also record when you have symptoms and what they are. There are phone apps that can help, or you can just write it down.
  • A food diary can help you figure out if certain foods trigger symptoms and if cutting out certain foods helps.
  • When you make changes to your diet, plan on it taking about 6 weeks to know if the changes help.
• To reduce pain, gas, and bloating:
  • Try adding soluble fiber every day. This is the kind that dissolves in water. Some foods with soluble fiber are oats and fruit without skin. Some supplements you can try are Benefiber and Citrucel.
  • Try a low-FODMAP diet. FODMAPs are types of carbohydrates that can make IBS symptoms worse. Your doctor or a registered dietitian can help you with this diet.
• To reduce constipation:
  • Talk to your doctor or a dietitian about whether you should increase how much fiber you eat. If they suggest more fiber:
    • Try soluble fiber first.
    • If they recommend more insoluble fiber, go slow. Add a little bit at a time. Insoluble fiber is in fruits and vegetables with skin, most whole grains, and beans.
  • Drink plenty of fluids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • Get some exercise every day. Build up slowly to 30 to 60 minutes a day on 5 or more days of the week.
  • Schedule time each day for a bowel movement. Having a daily routine may help. Take your time and do not strain when having a bowel movement.
• To reduce diarrhea, limit or avoid:
  • Alcohol.
  • Caffeine, which is found in coffee, tea, cola drinks, energy drinks, and chocolate.
  • Nicotine from smoking or chewing tobacco.
  • Gas-producing foods, such as beans, broccoli, cabbage, or apples.
  • Dairy products that contain lactose (milk sugar), such as ice cream or milk.
  • Foods and drinks high in sugar, especially fruit juice, soda, candy, and other packaged sweets (such as cookies).
  • Foods high in fat, including bacon, sausage, butter, oils, and anything deep-fried.
  • Sugar alcohols like sorbitol, xylitol, mannitol, and isomalt. These are artificial sweeteners found in some sugarless candies and chewing gum.
• Take medicines exactly as directed.
• If you are in counseling to help with pain, follow your treatment plan carefully.
• If you are getting physical therapy to help with your bowel movements, make sure you do your home exercises.
• If stress makes your symptoms worse, look for ways to reduce stress.