Irritable Bowel Syndrome: What is it exactly?

Answering some common questions about IBS and possible solutions

Abdominal pain and digestive issues are often uncomfortable to talk about, but irritable bowel syndrome (IBS) affects a large number of people. For example, a recent review in the United States1, estimated that between 10 to 15 percent of adults there complain of the disorder. The figures for the UK are likely to be very similar. Here are some of the more commonly asked questions about IBS:

What is irritable bowel syndrome?

Irritable bowel syndrome (IBS) is a group of symptoms that occur together, including repeated pain in your abdomen and changes in your bowel movements, which may be diarrhoea, constipation, or both. With IBS, you have these symptoms without any visible signs of damage or disease in your digestive tract.

IBS is a functional gastrointestinal (GI) disorder. Functional GI disorders, which doctors now call disorders of gut-brain interactions, are related to problems with how your brain and your gut work together. These problems can cause your gut to be more sensitive and change how the muscles in your bowel contract. If your gut is more sensitive, you may feel more abdominal pain and bloating. Changes in how the muscles in your bowel contract lead to diarrhoea, constipation, or both.

Does IBS have another name?

In the past, doctors called IBS colitis, mucous colitis, spastic colon, nervous colon, and spastic bowel.

Are there different types of IBS?

Three types of IBS are based on different patterns of changes in your bowel movements or abnormal bowel movements. Sometimes, it is important for your doctor to know which type of IBS you have, although your doctor may still diagnose IBS even if your bowel movement pattern does not fit one particular type. The three types of IBS are:

IBS with constipation (IBS-C)
With IBS-C, on days when you have at least one abnormal bowel movement
more than a quarter of your stools are hard or lumpy and
less than a quarter of your stools are loose or wateryIBS with diarrhea (IBS-D)
In IBS-D, on days when you have at least one abnormal bowel movement
more than a quarter of your stools are loose or watery and
less than a quarter of your stools are hard or lumpyIBS with mixed bowel habits (IBS-M)
In IBS-M, on days when you have at least one abnormal bowel movement
more than a quarter of your stools are hard or lumpy and
more than a quarter of your stools are loose or watery

Bear in mind that many people with IBS have normal bowel movements on some days and abnormal bowel movements on other days.

Who is more likely to develop IBS?

Women are up to two times more likely than men to develop IBS.1 People younger than age 50 are more likely to develop IBS than people older than age 50.2

Factors that can increase your chance of having IBS include:

  • having a family member with IBS
  • a history of stressful or difficult life events
  • having a severe infection in your digestive tract

What triggers IBS?

Whilst factor like stress make it more likely that a person will develop IBS, the immediate triggers to the condition are uncertain, and seem to vary. Likely triggers include the development of food sensitivities or intolerances, changes in gut bacteria (for example after treatment with a course of antibiotics) and carbohydrate malabsorption.

What other health problems do people with IBS have?

People with IBS often have other health problems, including1

  • certain conditions that involve chronic pain, such as fibromyalgia , chronic fatigue syndrome and chronic pelvic pain
  • certain digestive diseases, such as dyspepsia and gastro-oesophageal reflux disease
  • certain mental disorders, such as anxiety , depression and somatic symptom disorder

What treatments will help my IBS?

A range of lifestyle changes can keep people with IBS comfortable. These may include altering diet to avoid large and high-fat meals or any other known trigger foods. Adding probiotics and increasing fibre intake are also helpful to many.

Learning to relax, managing stress, improving sleeping habits and getting more exercise are also know to be beneficial.

When should you see a doctor?

It’s always advisable to see your general practitioner if you have symptoms suggestive of IBS, in order to confirm the diagnosis and rule out any other possible causes of your symptoms.

Symptoms which are not commonly associated with IBS and which should prompt an immediate visit to the doctor include significant or progressive abdominal pain, weight loss, rectal bleeding or bloody diarrhoea. Episodes of diarrhoea that wake you from sleep should also be further investigated.

You should also see your doctor if you have symptoms suggestive of IBS and also a family history of inflammatory bowel diseases like Crohn’s or ulcerative colitis, or you have suffered from anaemia, vitamin deficiencies or electrolyte disturbances.

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References:
[1] Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: a clinical review. Journal of the American Medical Association. 2015;313(9):949–958.
[2] Lacy BE, Mearin F, Chang L, et al. Bowel disorders. Gastroenterology. 2016;150(6):1393–1407.
Source Material:
National Institute of Diabetes and Digestive and Kidney Diseases and Dr. Stephanie A. McAbee, from the Vanderbilt University Medical Centre Digestive Disease Unit.
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