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Introduction

Irritable bowel syndrome (IBS) is one of the most common disorders that doctors see. Yet it's also one that many people aren't comfortable talking about. Irritable bowel syndrome is characterized by abdominal pain or cramping and changes in bowel function — including bloating, gas, diarrhea and constipation — problems most people don't like to discuss. What's more, for many years irritable bowel syndrome was considered a psychological rather than a physical problem.

Up to one in five American adults has irritable bowel syndrome. The disorder accounts for more than one out of every 10 doctor visits. For most people, signs and symptoms of irritable bowel disease are mild. Only a small percentage of people with irritable bowel syndrome have severe signs and symptoms.

Fortunately, unlike more serious intestinal diseases such as ulcerative colitis and Crohn's disease, irritable bowel syndrome doesn't cause inflammation or changes in bowel tissue or increase your risk of colorectal cancer. In many cases, you can control irritable bowel syndrome by managing your diet, lifestyle and stress.

Signs and symptoms

The signs and symptoms of irritable bowel syndrome can vary widely from person to person and often resemble those of other diseases. Among the most common are:

  • Abdominal pain or cramping
  • A bloated feeling
  • Gas (flatulence)
  • Diarrhea or constipation - people with IBS may also experience alternating bouts of constipation and diarrhea
  • Mucus in the stool

Like many people, you may have only mild signs and symptoms of irritable bowel syndrome. Sometimes these problems can be disabling, however. In some cases, you may have severe signs and symptoms that don't respond well to medical treatment. Because symptoms of irritable bowel syndrome can be present with other diseases, it's best to discuss these symptoms with your doctor.

For most people, IBS is a chronic condition, although there will likely be times when the signs and symptoms are worse and times when they improve or even disappear completely.

Causes

No one knows exactly what causes irritable bowel syndrome. The walls of the intestines are lined with layers of muscle that contract and relax as they move food from your stomach through your intestinal tract to your rectum. Normally, these muscles contract and relax in a coordinated rhythm. But if you have irritable bowel syndrome, the contractions are stronger and last longer than normal. Food is forced through your intestines more quickly, causing gas, bloating and diarrhea. In some cases, however, the opposite occurs. Food passage slows, and stools become hard and dry.

Some researchers believe IBS is caused by changes in the nerves that control sensation or muscle contractions in the bowel. Others believe the central nervous system may affect the colon. And because women are two to three times as likely as men to have IBS, researchers believe that hormonal changes also play a role. Also, many women find that signs and symptoms are worse during or around their menstrual periods.

Triggers bother some, not others

For reasons that still aren't clear, if you have IBS you probably react strongly to stimuli that don't bother other people. Triggers for IBS can range from gas or pressure on your intestines to certain foods, medications or emotions. For example:

  • Foods. Many people find that their signs and symptoms worsen when they eat certain foods. For instance, chocolate, milk and alcohol might cause constipation or diarrhea. A survey found that almost two out of three people with IBS felt a dietary allergy or intolerance was to blame for their IBS. The role of food allergy or intolerance in irritable bowel syndrome hasn't been well studied. And some researchers suspect that rather than food being a trigger, the actual process of eating may be the trigger because chewing stimulates the colon.

    If you experience cramping and bloating mainly after eating dairy products, food with caffeine, or sugar-free gum or candies, the problem may not be irritable bowel syndrome. Instead, your body may not be able to tolerate the sugar (lactose) in dairy products, caffeine or the artificial sweetener sorbitol.
  • Stress. If you're like most people with IBS, you probably find that your signs and symptoms are worse or more frequent during stressful events, such as a change in your daily routine or family arguments. But while stress may aggravate symptoms, it doesn't cause them.
  • Other illnesses. Sometimes another illness, such as an acute episode of infectious diarrhea (gastroenteritis) can trigger IBS.

Risk factors

Many people have occasional symptoms of irritable bowel syndrome, but you're more likely to have IBS if you're young and female. IBS typically begins around age 20. Overall, two to three times as many women as men have the condition. People with IBS often report that family members also have the disorder, suggesting a possible genetic cause.

When to seek medical advice

Although as many as one in five American adults has signs and symptoms of irritable bowel syndrome, fewer than half seek medical help. Yet it's important to see your doctor if you have a persistent change in bowel habits or if you have any other symptoms of IBS.

Your doctor may be able to help you find ways to relieve symptoms as well as rule out other more serious colon conditions, such as ulcerative colitis and Crohn's disease, which are forms of inflammatory bowel disease, and colon cancer. He or she can also help you avoid possible complications from problems such as chronic diarrhea.

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