What Is Irritable Bowel Syndrome (IBS) or Spastic Colon?
Irritable bowel syndrome (IBS) is a diagnosis commonly given to people with chronic diarrhea or constipation or both, in whom no organic bowel disease was found after thorough investigation, and who have no rectal bleeding or weight loss (2).
Spastic colon is an old term for IBS.
Causes and Mechanism of IBS
The colon muscles of a person with IBS begin to spasm after only mild stimuli, like certain foods, medicines, or stress, which wouldn’t normally cause problems in other people (1). Some people diagnosed with IBS also have excessively sensitive stomach or small intestine.
The exact cause of IBS is not known; IBS tends to run in families so genetic or social predisposition may exist. IBS may be triggered by psychological stress, certain foods, infection, major disease or bowel surgery.
Symptoms of IBS
Most people with IBS are from 6 month to 40 years old. Symptoms of IBS may include:
- Alternating diarrhea (loose bowel movements) and constipation, from which one can dominate
- Bloating and gas
- Painful abdominal cramps or urgency after the meal or stress event
- Symptoms are typically relieved by a bowel movement
- Mucus in the bowel movement
NOTE: There is no fever, bowel bleeding, persistent severe abdominal pain, or weight loss in IBS. If any of these symptoms appear, this is not IBS and other bowel disorders should be considered.
‘Functional diarrhea‘, also called painless or nervous diarrhea, is like IBS but without abdominal pain.
Diagnosis of IBS
Diagnosis of IBS is made after exclusion of other diseases by physical examination, blood and stool tests, colonoscopy, upper endoscopy, and eventual x-ray of abdomen. Small intestinal bacterial overgrowth (SIBO), fructose malabsorption, lactose intolerance, and celiac disease, which may mimic IBS, should be excluded by investigations. Diagnosis of IBS may be given when no organic disease was found in a person with abdominal discomfort and changed bowel habit lasting at least 12 weeks in the last 12 months (2).
Appropriate Diet in IBS
It is recommended to divide meals into small portions to reduce irritability of the food. There’s no rules which foods to eat, but lists of common foods to avoid in IBS exist. Some affected by IBS recommend starting a day with foods high in soluble fiber, like oat bran. Keeping a diary of ingested foods, drinks, medications and stressful events may help you find out what causes your symptoms.
IBS and Coping With Stress
Both excessive stress, or avoiding “due stress” may trigger IBS. Non-solved emotional issues can elevate the tone of autonomic nerves that innervate the bowel thus making it excessively irritable. Learning which work and relationships bring joy and peace in your life, accepting ones they do and refusing those they don’t may help you in coping with stress. Advice from a wise person you trust can also help a lot.
Is There any Medication or Other Cure for IBS?
Avoiding irritant foods and coping with stress is the basic of curing IBS. Antidepressant drugs, fiber supplements, antispasmodic drugs or anti-diarrheal drug loperamide are not effective therapy for IBS (3).
Prognosis of IBS
IBS tends to cease with age (it is rare after age of 40) and it does not develop into bowel inflammation or cancer.
- SIBO and IBS (ncbi.nlm.nih.gov)
- Diagnostic criteria for IBS (ibs-irritable-bowel-syndrome.com.au)
- Drug therapy for IBS (acg.gi.org)
Article reviewed by Dr. Greg. Last updated on January 1, 2013