IBS (Irritable Bowel Syndrome): Key Q&A

How common is IBS?
Irritable bowel syndrome is a very common disorder. According to the National Institutes of Health, one in five Americans have the disorder, making it one of the most common disorders diagnosed by doctors. IBS affects more than 58 million people in the United States, according to the American College of Gastroenterology. It occurs more frequently in women than in men and typically begins around age 20.

Is IBS a disease?
No. Irritable bowel syndrome is not a disease, as no identifiable physical abnormality or intestinal damage can be found in people who have it. Instead, it is considered a functional disorder because it involves the failure of the large intestine to function as it should. No single cause of IBS has been identified. Rather, IBS appears to involve unusual sensitivity and muscle activity in the large intestine. This affects the movement of stool and gas through the small and large intestines, causing a variety of symptoms to occur. Stress, emotions and diet can trigger symptoms in people with IBS.

Does IBS lead to serious complications or death?
No. Irritable bowel syndrome does not permanently harm your large intestine, cause cancer or intestinal bleeding, or lead to other serious diseases. It is not related to inflammatory bowel diseases such as Crohn's disease and ulcerative colitis, both of which cause inflammation and ulcers within the digestive tract. Very few people with IBS are later diagnosed with some other gastrointestinal condition. In addition, people with IBS tend to live as long as those in the general population.

Are there different types of IBS?
Yes. The type of irritable bowel syndrome you have is identified by your predominant symptoms. Most people have the alternating type. If you have this type, you alternate between episodes of diarrhea and constipation. Approximately 30 percent of people with IBS have the diarrhea-predominant type, according to the International Foundation for Functional Gastrointestinal Disorders. This type is characterized by abrupt episodes of diarrhea upon waking, or during or immediately after eating. Approximately 20 percent of people with IBS have the constipation-predominant type. This occurs when periodic constipation and pain in the lower abdomen are the primary symptoms. Eating often triggers these symptoms.

What are the most common symptoms of IBS?
Abdominal pain that occurs with diarrhea, constipation or both is the most common symptom of irritable bowel syndrome. The pain occurs in episodes, not continually, and is often relieved with a bowel movement. Individuals with IBS may also experience the sensation of incomplete defecation after a bowel movement. Other symptoms of IBS include cramping, bloating, gas, heartburn, nausea and difficulty swallowing. Symptoms of this chronic condition can recur throughout life.

Do the symptoms of IBS wake you up at night?
Not usually. Symptoms of irritable bowel syndrome almost always occur while you are awake. It is rare for symptoms such as diarrhea or abdominal pain to wake women with IBS from sleep. When such symptoms do rouse you, they may indicate the presence of other medical problems.

Can any one test confirm the diagnosis of IBS?
No. There is no specific diagnostic test used to identify irritable bowel syndrome. Instead, tests may be used to rule out other conditions as the cause of your symptoms. These may include lactose intolerance, infection, diverticulosis, thyroid disorders, inflammatory bowel diseases and cancer. Tests may be selected based on your symptoms and the likelihood of other causes of symptoms, as well as the cost and safety of each test. Commonly performed tests include blood and fecal tests, lactose intolerance tests, endoscopy and various forms of X-ray.

Can IBS be cured?
IBS is usually considered curable. However, the natural history of IBS is usually variable and worse with stress or certain diets. Diarrhea-predominant IBS tends to be less severe with age.

Are any medications useful in the treatment of IBS?
Yes. A variety of medications are available to treat the symptoms of irritable bowel syndrome. Consult your doctor before using any drug, including over-the-counter medication, since it may interfere with current medicines or may have serious side effects. Some medications may not be effective for all people with IBS. As a general rule, medications are used if IBS symptoms do not respond to dietary changes and/or stress management, and they are most often used for moderate to severe IBS symptoms. Medications that may be particularly useful for women with IBS include antispasmodics, antidepressants, tranquilizers, antidiarrheals, fiber supplements and certain IBS-specific drugs.

Are there any surgeries available for IBS?
No. Surgery does not cure irritable bowel syndrome. You should obtain a second opinion before considering any type of surgery. Studies have shown that individuals with IBS sometimes undergo the unnecessary removal of their gallbladder and appendix, as well as hysterectomy and back surgery, with no permanent relief of their IBS symptoms.