Irritable  Bowel Syndrome

What is irritable bowel syndrome? 
Irritable bowel syndrome (IBS) is a problem with the intestines. In people with IBS, the intestines squeeze too hard or not hard enough and cause food to move too quickly or too slowly through the intestines. (The large intestine is also called the colon.) 
IBS is also called functional bowel syndrome, irritable colon, spastic bowel and spastic colon. It's not the same as inflammatory bowel diseases like ulcerative colitis. 
What causes IBS?
The underlying cause of this disorder is an abnormality in the way the intestinal muscles contract. These muscles, which form the outer layer of the intestine, work automatically to move food products along the intestine to the rectum and out the anus. IBS is a disorder of the function of the intestinal muscles. Even when the muscles appear normal under a microscope, they may not function normally, contracting too forcefully or weakly, too slowly or rapidly, at certain times. Although there is no physical obstruction, a patient may perceive cramps or functional blockage

What are the symptoms of IBS? 
The following lists common symptoms of IBS. 
The symptoms may get worse when you're under stress, such as when you travel, attend social events or change your daily routine. Your symptoms may also get worse if you don't eat right or after you've eaten a big meal. Some people are bothered by certain foods. Women who have IBS may notice symptoms during their menstrual periods. 
Common symptoms of IBS
Bloating and gas 
Constipation 
Diarrhea, especially after eating or first thing in the morning 
Feeling like you still need to have a bowel movement after you've already had one 
Feeling a strong urge to have a bowel movement 
Abdominal pain and cramping that may go away after having a bowel movement 
How is IBS diagnosed? 
Your doctor may start by asking you questions about your symptoms. If your symptoms have had a pattern over time, the pattern may make it clear to your doctor that IBS is the cause. 
If your symptoms have just started, something else may be the cause. Your doctor may need to do some tests to make sure that your symptoms aren't caused by something other than IBS. 
How is IBS treated? 
The best way to handle IBS is to eat a healthy diet, avoid foods that seem to make you feel worse and find ways to handle your stress. 
Why may fiber be helpful? 
Fiber can be helpful because it improves how the intestines work. There are 2 types of fiber: soluble and insoluble. (Soluble means it dissolves in liquid.) Soluble fiber helps both diarrhea and constipation. Insoluble fiber may make diarrhea worse. 
Insoluble fiber is in fruits, vegetables, whole grain breads and cereals. Psyllium (a natural vegetable fiber) and oat bran are soluble fibers. You can buy psyllium (some brand names: Fiberall, Metamucil, Perdiem) at the store. Oat bran is in some cereals, bread or muffins. You can also add it to other foods. 
Increase the fiber in your diet slowly. Some people feel bloated and have gas if they increase how much fiber they eat too quickly. Gas and bloating usually improve as you get used to eating more fiber. 
Do certain foods cause IBS? 
No. Foods don't cause IBS. But some foods may make you feel worse. Foods that may make symptoms worse include foods high in fat or caffeine. Fat and caffeine can cause your intestines to contract, which may cause cramping. If gas is a problem for you, you might want to avoid foods that tend to make gas worse. These include beans, cabbage and some fruits. 
Keeping a diary of what you eat and what your symptoms are for a few weeks may be a good way to find out if a food bothers you. If you think a food makes you feel worse, try not eating it. But don't cut out foods unless they have caused you problems more than once. 
What about milk and milk products? 
If milk and other dairy products bother you, you may have lactose intolerance. Lactose intolerance means that your body can't digest the sugar in milk. This sugar is called lactose. 
Dairy products may seem to make IBS symptoms worse if you're lactose intolerant. If this seems to be the case, you may need to limit the amount of milk and milk products in your diet. Talk to your family doctor if you think you have trouble digesting dairy products. 
Tips on controlling IBS
Eat a varied diet and avoid foods high in fat. 
Drink plenty of water. 
Try eating 6 small meals a day rather than 3 larger ones. 
Learn new and better ways to deal with your stress. 
Avoid using laxatives. You may become dependent on them and 
your intestines may become weakened. 

from: The “AAFP Family Health Facts” series

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