By Alan S. Peterson, MD
Walter L. Aument Family Health Center
Irritable Bowel Syndrome is a common gastrointestinal problem that leads to abdominal pain or cramps that are often relieved or improved by having a bowel movement. Patients with IBS often have problems with constipation (infrequent or difficult bowel movements), diarrhea, or both. They may feel an urgent need to move the bowels, particularly in times of stress. Other symptoms can include gasiness, bloating, or mucus in the stools.
IBS can be suspected when you have a pattern of typical symptoms and no other conditions to explain them. Your doctor will take a complete medical history paying careful attention to your symptoms. Your doctor will do an exam to look for any signs of other diseases. Some other lab tests, including stool blood tests might be ordered. Sometimes a sigmoidoscopy or a colonoscopy is suggested, during which a flexible tube in inserted through the rectum to look inside the colon.
Some patient’s symptoms seem to be made worse by certain foods. Keeping a diary can help to see if there are any foods that you might need to avoid. Some examples are caffeine, alcohol, fatty foods, and sorbitol (found in some diabetic diet products). Adding fiber to your diet can sometimes be helpful, particularly for constipation. For those that have diarrhea with IBS, some fiber can be helpful, but too much can be a problem in some patients.
For those who have diarrhea with irritable bowel syndrome, loperamide (brand name: Imodium) can help, and can be taken as needed, as long as your physician agrees. One of the most beneficial non-prescription medications for IBS is that of soluble fiber found in oat bran and psyllium-containing products (like Metamucil). These can help both diarrhea and constipation in IBS. Some patients with IBS can have significant stomach pain and may benefit from a drug such as Bentyl or some other anti-spasmodic drug that helps with spasms.
Certain kinds of antidepressants can also be helpful, even if the patients are not depressed. On the other hand, it is true that many patients with IBS have depression or anxiety, and this should be treated as well. Treatments such as stress management or relaxation techniques might also help some patients.
The good news is that IBS, although it is painful and can be disturbing with its symptoms especially of diarrhea and/or constipation, does not lead to colon cancer or colitis or any other serious gastrointestinal disease. Of course, your physician may want to rule out colon cancer that can be found in any patient. The diagnosis, however, of IBS does not lead to an increased risk in bowel cancer.
The key to living with IBS is learning to control it and not letting it control you. For more information about IBS, see the Irritable Bowel Syndrome Self-help Group web site at www.ibsgroup.org.
Dr. Peterson is a doctor of Family and Community Medicine at the Walter L. Aument Family Health Center, 317 S. Chestnut St., Quarryville.