Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome (IBS), also known as spastic colon or mucous colitis is a functional bowel disorder afflicting both men and women from as young as pre-teen into the 70s.  It is not defined by any one characteristic, but instead is generally defined by a combination of factors including abdominal pain, diarrhea and constipation. Weight loss, bleeding and nocturnal symptoms are not typical and their presence should suggest the need to rule out an alternate cause.  Diagnostic testing with labs, imaging and endoscopy basically serve to rule out a defined cause of abdominal symptoms such as inflammatory bowel disease or diverticulitis as there is no test that is diagnostic of the condition.  IBS can be transient, though may be chronic and have periods of being quiescent mixed with periods of significant distress.  It is often triggered by stressful situations, though infectious causes, dietary indiscretions and changes in life situation may cause a flare of symptoms.  As with most diseases, there is a spectrum of the illness and many patients have a very mild course, while others can at times be quite infirmed.  Management is generally symptomatic with treatment aimed at the pain, diarrhea or constipation.  Diet is a key portion of management, though there is no foolproof diet that will prevent symptoms.  Medications to treat spasms, diarrhea and constipation are often required and anti-depressants often are useful to help modulate symptoms.  Unfortunately, there is no “one size fits all” approach so the best approach is one that is individualized as each patient is the expert on their own condition and their own responses to therapy.  

Open and honest communication with your provider is key to managing an individual’s symptoms and ensuring the best possible outcome.

Dr. Edward Croen