Irritable bowel syndrome (IBS) is a chronic condition of the digestive tract that is associated with abdominal pain and irregular bowel movements. Some patients have diarrhea predominant IBS while other patients suffer from constipation predominant IBS. There are patients with a mixed type IBS who alternate between episodes of diarrhea and constipation.
The exact cause of irritable bowel syndrome is unknown. It has been found to commonly occur after a severe gastrointestinal tract infection. Also, it is believed that the gut microbiome may be altered in patients with IBS, possibly leading to excess production of intestinal gases. Furthermore, patients with IBS have gastrointestinal tracts that are believed to be more sensitive to stimuli so that normal gas and movements of the intestines are perceived as painful. It is also well known that there is a strong connection between the nervous systems of the brain and the gut. As a result, many patients with IBS tend to have symptoms at times of high anxiety and stress.
• Abdominal discomfort or pain
• Bloating and abdominal distention
• Frequent belching
• Excessive gas
Large volume diarrhea, bloody stools, night-time diarrhea and unexplained weight loss are not common in IBS. When these symptoms are present, alternative diagnoses should be excluded.
There is no single test to diagnose IBS. A thorough history and physical examination are important first steps. Lab testing is generally performed which frequently includes a complete blood count, markers of inflammation and a celiac disease panel. Stool testing is often performed to rule out inflammation and infection, particularly in the setting of diarrhea. Diagnostic procedures, such as endoscopy and colonoscopy, are not always necessary but may be recommended, especially in patients over the age of 40.
There are a number of different treatments and therapies for IBS. Treatment is typically directed at the predominant symptom. Constipation can be treated using a variety of medications including fiber supplements, stool softeners and laxatives. Diarrhea can be treated usings anti-diarrheals, an antibiotic called rifaximin (Xifaxan®) or a medication used to decrease bowel activity called eluxadoline (Viberzi®). Abdominal pain symptoms can be treated using antispasmodic medications or by using antidepressants which target the nervous system of the gut. Dietary modifications can include increasing dietary fiber and limiting the consumption of gas-forming foods (low FODMAP diet). There is no standard approach to treatment so it is important to discuss your symptoms with your doctor to determine what works best for you.
The information provided above is meant to be used as an informative guide for patients. For precise and individualized recommendations, please consult with one of our board certified gastroenterologists to discuss your symptoms.
For additional information or to book an appointment at the Gastroenterology Center of New York, please feel free to reach out to our dedicated team by calling us at 718-210-2960. You can also schedule online or reach out to us via the Contact Us form.