What I need to know about

Irritable Bowel Syndrome

NATIONAL INSTITUTES OF HEALTH

National Digestive Diseases Information Clearinghouse

U.S. Department

of Health and

Human Services

What I need to know about

Irritable Bowel Syndrome

NATIONAL INSTITUTES OF HEALTH

National Digestive Diseases Information Clearinghouse

U.S. Department

of Health and

Human Services

Contents

What is IBS? ............................................................. 1

Does stress cause IBS? ............................................ 3

What are the symptoms of IBS? ............................. 4

How is IBS diagnosed? ............................................ 5

Medical Tests for IBS ........................................... 6

What is the treatment? ............................................ 7

Diet Changes ........................................................ 8

Medicine ............................................................. 13

Stress Relief ........................................................ 14

Points to Remember .............................................. 15

Glossary .................................................................. 16

For More Information ........................................... 17

Acknowledgments .................................................. 18

What is IBS?

Irritable bowel syndrome, or IBS, is a problem

that affects mainly the bowel,* which is also called

the large intestine. The bowel is the part of the

digestive system that makes and stores stool.

The word syndrome means a group of symptoms.

IBS is a syndrome because it can cause several

symptoms. For example, IBS causes cramping,

bloating, gas, diarrhea, and constipation.

bowel

(large intestine)

Words in bold type are defined in the glossary on

page 16.

IBS can be painful. But it does not damage the

bowel or cause any other diseases.

IBS is not a disease. It’s a functional disorder, which

means that the bowel doesn’t work as it should.

With IBS, the nerves and muscles in the bowel

are extra-sensitive. For example, the muscles

may contract too much when you eat. These

contractions can cause cramping and diarrhea

during or shortly after a meal. Or the nerves can

be overly sensitive to the stretching of the bowel

(because of gas, for example). Cramping or pain

can result.

Foods that tend to cause symptoms include milk

products, chocolate, alcohol, caffeine, carbonated

drinks, and fatty foods. In some cases, simply

eating a large meal will trigger symptoms.

Women with IBS often have more symptoms

during their menstrual periods.

Does stress cause IBS?

Emotional stress will not cause a person to develop

IBS. But if you already have IBS, stress can trigger

symptoms. In fact, the bowel can overreact to all

sorts of things,

including food,

exercise, and

hormones.

What are the symptoms of IBS?

The main symptoms of IBS are

●

crampy pain in the stomach area (abdomen)

●

painful diarrhea or constipation

Most people have either diarrhea or constipation,

but some people have both.

Other symptoms are

●

mucus in the stool

●

swollen or bloated abdomen

●

the feeling that you have not finished a bowel

movement

How is IBS diagnosed?

The doctor will suspect that you have IBS because

of your symptoms. But the doctor may do medical

tests to make sure you don’t have any other

diseases that could cause the symptoms.

Medical Tests for IBS

●

Physical exam

●

Blood tests

●

X ray of the bowel: This x-ray test is called a

barium enema or lower GI (gastrointestinal)

series. Barium is a thick liquid that makes the

bowel show up better on the x ray. Before

taking the x ray, the doctor will put barium

into your bowel through the anus.

●

Endoscopy: The doctor inserts a thin tube into

your bowel. The tube has a camera in it, so the

doctor can look at the inside of the bowel to

check for problems.

What is the treatment?

IBS has no cure, but you can do things to relieve

symptoms. Treatment may involve

●

diet changes

●

medicine

●

stress relief

You may have to try a combination of things to

see which works best for you.

Diet Changes

Some foods make IBS worse.

Here are some foods that may cause symptoms:

●

fatty foods like french fries

●

milk products like cheese or ice cream

●

chocolate

●

alcohol

●

caffeine (found in coffee and some sodas)

●

carbonated drinks like soda

These foods may make IBS worse.

If certain foods cause symptoms, you should eat

less of them or stop eating them.

To find out which foods are a problem, write down

this information:

●

what you eat during the day

●

what symptoms you have

●

when symptoms occur

●

what foods always make

you feel bad

Take your notes to the doctor to see if you should

stop eating certain foods.

Some foods make IBS better.

Fiber reduces IBS symptoms—especially consti-

pation—because it makes stool soft, bulky, and

easier to pass. Fiber is found in bran, bread,

cereal, beans, fruit, and vegetables.

Add foods with fiber to your diet a little at a time

to let your body get used to them. Too much

fiber all at once might cause gas, which can

trigger symptoms in a person with IBS.

Here are some examples of foods with fiber:

Fruits Vegetables

Apples

Peaches

Broccoli, raw

Cabbage

Carrots, raw

Peas

Kidney beans

Lima beans

Whole-grain

bread

Whole-grain

cereal

Breads, cereals,

and beans

Besides telling you to eat more foods with fiber,

the doctor might also tell you to get more fiber by

taking a fiber pill or drinking water mixed with a

special high-fiber powder.

How much you eat matters, too.

Large meals can cause cramping and diarrhea in

people with IBS. If this happens to you, try eating

four or five small meals a day. Or, have your usual

three meals, but eat less at each meal.

Medicine

If necessary, the doctor might give you medicine

to help with symptoms:

●

laxatives: to treat constipation

●

antispasmodics: to slow contractions in the

bowel, which helps with diarrhea and pain

●

antidepressants: to help those who have

severe pain

You must follow your

doctor’s instructions

when you use these

medicines.

Otherwise, you

could become

dependent on

them.

Stress Relief

Does stress trigger your symptoms? Learning to

reduce stress can help. With less stress, you may

find that you have less cramping and pain. Also,

you may find it easier to manage your symptoms.

Meditation, exercise,

and counseling are

some things that might

help. You may need

to try different activ-

ities to see what works

best for you.

Points to Remember

●

IBS is a functional disorder in which the bowel

doesn’t work as it should.

●

IBS can cause cramping, bloating, gas,

diarrhea, and constipation.

●

IBS doesn’t damage the bowel.

●

The doctor will diagnose IBS based on your

symptoms. You might have some medical tests

to rule out other diseases.

●

Stress doesn’t cause IBS, but it can trigger

symptoms.

●

Fatty foods, milk products, chocolate,

caffeine, carbonated drinks, and alcohol can

trigger symptoms.

●

Eating foods with fiber and eating smaller

meals can reduce symptoms.

●

Treatment for IBS may include medicine,

stress relief, or changes in eating habits.

Glossary

Abdomen (AB-doh-men): The area of the

stomach.

Barium enema (BAR-ee-um EN-uh-muh): An

x ray of the bowel using a liquid called barium to

make the bowel show up better. This test is also

called a lower GI (for gastrointestinal) series.

Bowel: The part of the digestive system that makes

and stores stool. It is also called the large

intestine.

Endoscopy (en-DAH-skuh-pee): A test to look at

the inside of the bowel.

Functional: Refers to how something works.

Mucus: A clear, sticky discharge. It might look

white.

Syndrome (SIN-drome): A group of symptoms.

For More Information

International Foundation for Functional

Gastrointestinal Disorders (IFFGD)

P.O. Box 170864

Milwaukee, WI 53217–8076

Phone: 1–888–964–2001 or (414) 964–1799

Fax: (414) 964–7176

Email: iffgd@iffgd.org

Internet: www.iffgd.org

Also, the National Digestive Diseases Information

Clearinghouse (NDDIC), which prepared this

booklet, has a fact sheet on IBS. You can get a

copy by contacting

NDDIC

2 Information Way

Bethesda, MD 20892–3570

Phone: 1–800–891–5389 or (301) 654–3810

Fax: (301) 907–8906

Email: nddic@info.niddk.nih.gov

Internet: www.niddk.nih.gov

Acknowledgments

The National Digestive Diseases Information

Clearinghouse thanks those listed below for their

participation in developing this publication.

Content Review

Nancy Norton

President

International Foundation for Functional

Gastrointestinal Disorders

Milwaukee, WI

Douglas A. Drossman, M.D.

Co-Director

UNC Center for Functional GI and

Motility Disorders

University of North Carolina

Chapel Hill, NC

Field Testing Facilitation

Salvation Army, SE Corps

Washington, DC

National Digestive Diseases

Information Clearinghouse

2 Information Way

Bethesda, MD 20892–3570

Phone: 1–800–891–5389 or (301) 654–3810

Fax: (301) 907–8906

Email: nddic@info.niddk.nih.gov

The National Digestive Diseases Information

Clearinghouse (NDDIC) is a service of the National

Institute of Diabetes and Digestive and Kidney Diseases

(NIDDK). The NIDDK is part of the National Institutes of

Health under the U.S. Department of Health and Human

Services. Established in 1980, the clearinghouse provides

information about digestive diseases to people with

digestive disorders and to their families, health care

professionals, and the public. NDDIC answers inquiries,

develops and distributes publications, and works closely

with professional and patient organizations and

Government agencies to coordinate resources about

digestive diseases.

Publications produced by the clearinghouse are carefully

reviewed by both NIDDK scientists and outside experts.

This publication is not copyrighted. The clearinghouse

encourages users of this booklet to duplicate and

distribute as many copies as desired.

This booklet is also available at www.niddk.nih.gov

under “Health Information.”

U.S. DEPARTMENT OF HEALTH

AND HUMAN SERVICES

National Institutes of Health

National Institute of Diabetes and

Digestive and Kidney Diseases

NIH Publication No. 03–4686

April 2003