IBS is common, but still may be underdiagnosed
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Dear Doctors: I’ve had gas and cramping ever since I started college. I really didn’t think anything of it until it got worse over the summer. I went to the doctor, and he says I probably have IBS. Will it ever go away? I’ve been told to change my diet and try to have less stress.
Dear Reader: You’ve been diagnosed with irritable bowel syndrome, which is often shortened to IBS. The word “syndrome” indicates that it is a group of symptoms that occur together, and is not a disease. When someone has IBS, it means that something is amiss with how their bowels work. This can result in the chronic gas and abdominal pain that you experienced, as well as bloating, constipation, diarrhea and changes to the appearance and frequency of bowel movements.
IBS is a common disorder that occurs in between 10% and 15% of the population. However, because many who are affected don’t seek medical care, it is estimated that up to three-fourths of cases go undiagnosed. The syndrome, which is seen more often in women than men, generally occurs before age 50. It’s uncommon for someone to develop it later in life. Symptoms can range from mild enough to be considered nothing more than a nuisance to serious enough to affect quality of life. People living with more severe IBS may miss work, school and social engagements, and have to tailor their lives to accommodate the effects of the symptoms.
Although the causes of IBS are not known, ongoing research points to a gut-brain connection. This may occur via certain chemicals within the gut, which act as signaling agents between the intestines and the brain. There is also evidence that having had a bowel infection that didn’t fully resolve may play a role in developing IBS. Newer research is looking into potential links between IBS and specific microbiota within the gut.
IBS is not life-threatening. It doesn’t cause changes to bowel tissue, and it is not linked to, nor does it increase the risk of, colorectal cancer. There are no diagnostic tests for IBS. Instead, it’s identified by the cluster of symptoms that arise, along with a detailed medical history. IBS is further divided into sub-types, depending on whether or not the person experiences diarrhea, constipation or a combination of the two.
Other diseases, including Crohn’s disease, celiac disease and some types of cancer, can present with similar symptoms to IBS, so additional tests may be required to rule those out. These can include blood tests, stool exams and stool cultures.
Treatment often begins with lifestyle changes and may also include medications. Stress reduction is indeed an important part of IBS treatment, as stress appears to have a role in the condition. You’ll also be asked to become aware of any foods that appear to set off or worsen symptoms, and to avoid them. Medications, including antispasmodics, those to control diarrhea or constipation, and two FDA-approved IBS drugs, may also be prescribed. Although symptoms may come and go, for most people, IBS is a lifelong condition.
