Irritable Bowel Syndrome: Cramping, Bloating, Bowel Changes and When to Be Seen

What it involves

MedlinePlus describes irritable bowel syndrome, or IBS, as a disorder that leads to pain in the abdomen and changes in bowel movements. It is not the same as inflammatory bowel disease, and MedlinePlus says IBS does not cause permanent harm to the intestines or lead to a serious disease such as cancer.

Who this is for

• Patients with belly pain and cramps that return for months
• Patients whose bowel habits alternate between diarrhea and constipation
• Patients with gas and bloating that seem to follow certain foods or stress
• Patients who want to be sure nothing more serious is behind their symptoms

What to expect

• Questions about the pain, stool changes, how long they have lasted, and what makes them better or worse
• An exam and, if a provider needs it, blood or stool tests to look for other problems
• A review of warning signs such as blood in the stool, unintended weight loss, or symptoms starting after age 50
• A plan covering food, stress, sleep, and medicines, and a referral for further testing if needed

What IBS feels like

MedlinePlus lists abdominal pain and cramps, gas, fullness, bloating, and a change in bowel habits as the main symptoms. It says pain and other symptoms often reduce or go away after a bowel movement, and the pain should not wake you from sleep. Symptoms must be present at least 3 days a month for 3 months or more for IBS to be diagnosed. Symptoms may flare for a few weeks and then settle, or be present most of the time.

Diarrhea, constipation, or both

MedlinePlus describes IBS with diarrhea, with frequent loose watery stools and an urgent need to go, IBS with constipation, with hard stools, fewer movements, and straining, and a mixed type that swings between the two. Each of these has its own guide: persistent diarrhea, constipation, and bloating and gas. The abdominal pain guide covers pain more broadly.

What may trigger it

MedlinePlus says the reasons IBS develops are not clear. It can follow a bacterial or parasitic infection of the intestines, and stress is another trigger. It explains that signals between the gut and the brain affect bowel function, and that the nerves can become more active during stress, making the intestines more sensitive. About 10 to 15 percent of people in the United States have IBS symptoms, and it is twice as common in women as in men.

Symptoms that are not IBS

MedlinePlus says blood in the stool and unintentional weight loss are not part of IBS, and anyone with them should work with a provider to find out why. Other conditions that can look similar include celiac disease, Crohn disease, ulcerative colitis, bacterial overgrowth of the small intestine, and colon cancer, though cancer rarely causes typical IBS symptoms without other signs. The unintentional weight loss guide explains why weight loss is taken seriously.

How a provider sorts it out

There is no test that diagnoses IBS, per MedlinePlus, and most of the time a provider can diagnose it from symptoms. Tests it lists to check for other problems include blood tests for celiac disease or anemia, stool tests for blood, infection, or inflammation, and a breath test for bacterial overgrowth. A colonoscopy may be recommended if symptoms began at age 50 or later, or if there is weight loss, bloody stool, or abnormal blood tests. The colorectal screening guide explains screening separately.

Managing symptoms

MedlinePlus says the goal is to relieve symptoms and that lifestyle changes can help, such as regular exercise and better sleep habits. No one diet fits everyone, but cutting back on caffeine, tea, and colas, eating smaller meals, and adjusting fiber may help. Probiotics are listed, and a provider may suggest medicines for cramps, diarrhea, or constipation, so talk with one before taking over-the-counter products. Therapy or medicine for anxiety or depression can help too. Lactose can mimic IBS, as the lactose intolerance guide explains.

Sources

• MedlinePlus — Irritable bowel syndrome
• MedlinePlus — Irritable Bowel Syndrome (health topic)