If you were recently diagnosed with irritable bowel syndrome (IBS), you may have some questions about what it means for your health. Is it a form of inflammatory bowel disease? Can it lead to other diseases, such as cancer? We asked Matilda N. Hagan, M.D., of the Institute for Digestive Health and Liver Disease at Mercy Medical Center in Baltimore, to help identify some important—but not always known—facts.
- Technically, IBS is not considered a disease. IBS is a gastrointestinal (GI) condition. Affected patients typically have abdominal pain associated with change in the frequency and/or consistency of their stools, with no clear underlying cause. IBS is considered a functional disorder because the digestive system is not working properly. While it is a medically recognized condition, it is not technically considered a disease because while it causes symptoms such as cramping, bloating, gas, diarrhea and/or constipation, it does not cause lasting damage.
- There are different types of IBS. The condition doesn’t look the same in every patient: "There are three types of IBS: diarrhea predominant, constipation predominant, and mixed type, which features both diarrhea and constipation," explains Hagan. But that’s not the only difference: Some people with IBS may experience flare-ups of their symptoms more frequently than others; the intensity of symptoms can also vary from patient to patient.
- IBS is not uncommon. The condition is estimated to affect about 15% of the population. However, "True incidence is hard to know, since only a fraction of people with IBS see health care providers," says Hagan. In fact, she says, in most gastroenterology (GI) practices, one-third or more of patient population may be affected. Women are twice as likely as men to have IBS, for reasons that are still unclear.
- IBS is not IBD. Inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, is a group of diseases that cause inflammation in the digestive system. With IBD, there are clear changes in the lining of the intestines that are visible through endoscopy or colonoscopy, routine tests used to view the digestive tract via a flexible tube inserted into the throat (endoscopy) or anus (colonoscopy). Video capsules (a tiny camera in the form of a pill that you swallow) may also be used to look for signs of disease. Hagan explains that people with IBS who undergo these tests usually have normal results—meaning no abnormalities or inflammation in the digestive tract—and no IBD.
- IBS does not increase your risk of colon cancer. While IBS may cause a great deal of pain and discomfort, it does not cause the harmful inflammation that can lead to disease complications and colon cancer. Additionally, with IBS, patients don’t experience the more serious symptoms such as weight loss, vitamin deficiencies, bloody diarrhea, blood clots, skin rashes, abscesses, or serious infections seen with IBD, says Hagan.
- Stress does not cause IBS. Stress is a common trigger for IBS, as are certain foods, which vary from person to person. And while both stress and trigger foods can contribute to IBS flare-ups, neither cause it. So what does? "Current theories include 'visceral hypersensitivity,' in which affected intestines are more sensitive to typical functions of the gut, such as transit of food and gas," explains Hagan. An imbalance of bacterial organisms [very small living things] the gut may also play a role, as well as dietary issues like food intolerances. Genetics may also contribute to the condition, since people with IBS often report other affected family members.
- There are no tests to diagnose IBS. Health care providers make a diagnosis based on symptoms—and by ruling out other conditions (including IBD), which share similar characteristics. So you may undergo tests to rule out IBD, but there are no definitive diagnostic tools for IBS. Note that if you have persistent abdominal pain and changes in bowel habits, Hagan recommends you see your doctor: "If you have unexplained weight loss, blood in your stool, or waking up in the middle of the night to move your bowels, heed these signs of a more serious condition and promptly get evaluated," she advises.
- Lifestyle changes may help. Just like the diagnosis, treatment for IBS is symptom-based. Medications may help, but changes such to diet and exercise routines have a great impact on the condition: "High stress environments seem to worsen symptoms. Therefore stress management techniques, including regular exercise, may be helpful," explains Hagan. Also helpful: avoiding foods that trigger your symptoms, and making food choices that balance your bowel habits. In addition, over-the-counter medications can address diarrhea; constipation can be controlled with regimens to allow regular bowel movements, and non-narcotic, non-steroidal anti-inflammatory drugs (NSAIDs) can address pain.
If you have IBS, work with your health care provider to help you create a personalized plan to manage flare-ups.
Matilda N. Hagan, M.D., reviewed this article.
Sources
Matilda N. Hagan, M.D., The Melissa L. Posner Institute for Digestive Health and Liver Disease at Mercy Medical Center in Baltimore. Email interview, April 7, 2015.
"Irritable Bowel Syndrome: Definition and Facts for Irritable Bowel Syndrome." National Institute of Diabetes and Digestive and Kidney Diseases. Accessed March 30, 2015.
