Irritable Bowel Syndrome (IBS)

Question 1

What is IBS?

Answer

IBS is what doctors call a functional bowel disorder because it affects how your bowels work. IBS involves a change in bowel habits that lasts for more than three months but without symptoms, such as weight loss, rectal bleeding or bowel symptoms that wake you up at night, which would then suggest a more serious health issue.

Question 2

How common is IBS?

Answer

IBS affects up to one-fifth of the U.S. population, although only a small fraction of those individuals seek treatment for their symptoms.

For some people, IBS may go away on its own. But for most people, IBS becomes a chronic condition.

Question 3

At what age do IBS symptoms usually appear?

Answer

IBS symptoms can appear for the first time in people of all ages, from children to older adults. However, most people first notice IBS symptoms in their 20s, 30s and 40s.

Question 4

What are IBS symptoms?

Answer

IBS can include a whole spectrum of symptoms. The three types of IBS are categorized by their main symptoms. They are:

IBS-C, which primarily involves constipation
IBS-D, which primarily involves diarrhea
IBS-M, for mixed symptoms including both diarrhea and constipation

People with IBS may also have abdominal pain, cramps, bloating and gas.

Question 5

Is IBS more common in women?

Answer

Yes, about two-thirds of people with IBS are women. Some women with IBS notice that their symptoms get worse around their menstrual cycle. Although hormone changes don’t actually cause IBS, they may aggravate symptoms.

Question 6

Do women have different IBS symptoms than men?

Answer

Women with IBS may have pelvic pain. Some women with IBS also have fibromyalgia, a condition associated with widespread pain.

Question 7

What causes IBS?

Answer

The cause of IBS is unknown, but there are many theories. One is that a change in the normal bacteria of the intestines may trigger IBS. Another theory is that a sensitivity to food additives may cause IBS in some people. Still another theory is that people may develop IBS if their intestines are hypersensitive to normal movements of the bowel, or what’s known as visceral hyperalgesia.

Question 8

Does stress cause IBS?

Answer

Most of us have been in stressful situations and felt the effects on our digestive system. So, it’s not surprising that in some people with IBS, stress can also aggravate symptoms.

We know that the digestive system has its own nervous system that is influenced by the brain. Some researchers call this the “mind-gut connection.”

Certain medications, including drugs that slow down activity in the intestines, can help people whose IBS symptoms get worse with stress. A few sessions with a GI psychologist may also be helpful.

Question 9

Does IBS increase the risk for more serious diseases like colon cancer or inflammatory bowel disease (IBD)?

Answer

No, IBS doesn’t raise your risk for colon cancer or IBD. But IBS can affect your quality of life. However, treatment can help.

Question 10

Can you have IBS and IBD at the same time?

Answer

Yes, some people with IBD may also have IBS symptoms at some point in their lives. Part of the reason is that IBS is quite common, and some people will have an overlap of both conditions.

Question 11

When should you see a doctor for IBS?

Answer

If you notice a change in your bowel habits, visiting your primary care physician or a gastroenterologist is often a good idea. That’s because you want to be certain that you actually have IBS and not a more serious condition, such as colon cancer. This is especially important if you are age 45 or older, which raises your cancer risks.

See a doctor right away if you have:

Rectal bleeding
Unexplained weight loss
Diarrhea that wakes you up at night

If you already know you have IBS but find that it affects your quality of life, seeing a doctor may help you find relief from your symptoms.

Question 12

How is IBS diagnosed?

Answer

Gastroenterologists diagnose IBS by understanding your history and ordering tests to make sure that other problems, like inflammation, infection or cancer, aren’t causing your symptoms. For example, to rule out celiac disease, you may have a blood test. If you have a positive test, you may also have an endoscopy to get a biopsy of the small bowel to determine if you have celiac disease.

As doctors, we recognize that diagnosing IBS can be deeply frustrating for some patients, who sometimes undergo many tests and physical examinations, only to be told that there is “nothing wrong” with their intestines. But for many patients, knowing that their symptoms are only from IBS can be reassuring.

Question 13

What are the criteria for getting tested for IBS?

Answer

Your doctor may recommend getting tested for IBS if you have a change in your bowel habits that has bothered you at least once a week for the past three months.

Question 14

What procedures and tests will I need to diagnose IBS?

Answer

No single test for IBS is available, so doctors make the diagnosis by ruling out more serious problems. In addition to doing an exam and taking your medical history, your doctor may order several tests to make the diagnosis, including:

Blood tests, which can help determine if you have food allergies that might cause your symptoms
Stool test, which can check for infections or other diseases
Hydrogen breath test, which can determine if you have lactose intolerance
Endoscopy, which examines your upper digestive tract and can rule out celiac disease
Colonoscopy, which examines your colon to check for more serious health issues like cancer or inflammatory bowel disease

Question 15

Can IBS be seen in a colonoscopy?

Answer

No. In someone with IBS, the colon will look normal during a colonoscopy. However, having a colonoscopy can help rule out other problems like inflammatory bowel disease, also known as IBD, that can mimic IBS.

Question 16

What happens if IBS goes untreated?

Answer

Although untreated IBS won’t lead to more serious conditions like IBD or cancer, it can affect your quality of life. If diarrhea, constipation or other digestive symptoms are disrupting your life, seeing an IBS expert may provide some relief.

Question 17

What types of medicines can treat IBS?

Answer

Different drugs are approved to treat IBS-D (primarily diarrhea) and IBS-C (primarily constipation). Typically, for patients with IBS-M (mixed symptoms), doctors focus on treating the constipation, because it often triggers the diarrhea.

At UChicago Medicine, we select the most appropriate medicines as part of an individualized treatment plan based on your specific symptoms and goals.

Some prescription medications to treat IBS include:

Anti-spasm medications, which can slow down intestinal activity
Antidepressants, which may reduce pain
Antidiarrheal drugs
Antibiotics
Medications that increase intestinal lubrication to prevent constipation

Over-the-counter medications that include peppermint can help break down gas in the digestive system to ease symptoms.

Question 18

Can probiotics help IBS?

Answer

Many probiotics are on the market, but most scientific studies have not shown them to be effective against IBS. Although probiotics are usually harmless, they can be expensive. So, if probiotics don’t seem to lessen your symptoms after a few weeks, you may want to stop taking them and save your money.

Question 19

Should I avoid certain foods if I have IBS?

Answer

Dietary changes can make a difference in IBS, depending on what symptoms you have. For example, if you have IBS-D with a lot of gas and bloating, reducing fiber in your diet can ease symptoms. If you have IBS-D and are lactose intolerant, reducing milk products can be helpful.

A low-FODMAP diet, which reduces wheat, dairy and certain fruits and vegetables, also may help reduce gas in some people with IBS.

Eliminating products with high-fructose corn syrup may also help some people reduce their IBS symptoms.

We recommend examining what you eat using techniques like the elimination diet to better understand how certain foods affect with your symptoms.

Question 20

Can surgery help IBS?

Answer

No, there is no surgery for IBS. However, most people with IBS find relief with medications and other strategies.

Question 21

What other strategies can be helpful for IBS?

Answer

Some people with IBS find that psychological support can help reduce their symptoms. This may include learning deep breathing and muscle relaxation techniques to improve the body’s relaxation response. At UChicago Medicine, we are among a select group of centers in the United States with expertise in GI psychology and clinicians who can offer these types of specialized resources.