Irritable Bowel Syndrome or IBS is a functional disorder of the bowel characterized by abdominal pain or discomfort associated with altered bowel movements. Bowel movements may tend towards constipation, diarrhea, or alternating constipation and diarrhea. Often there is bloating, excessive gas, and mucus in the stool.
IBS is a common disorder affecting up to 10-15% of adults. IBS is more common in women than men. IBS symptoms can be mild, moderate, or severe and in the worst cases can significantly affect quality of life.
IBS in the past was considered a “diagnosis of exclusion”. In other words it was a waste basket you were thrown into when you had abdominal pain and altered bowel movements – when no other known structural, biochemical, or infectious cause could be determined.
The Rome criteria outline the most common symptoms of IBS. The cardinal feature of IBS is abdominal pain or discomfort associated with altered bowel movements.
These criteria are used in concert with red flag symptoms that would point towards another diagnosis other than IBS. If you have some of these red flag symptoms more testing may be recommended.
Testing for IBS might include blood tests for thyroid function and celiac disease, visualization of the intestinal tract through endoscopy, examination of the stool, or breath tests to rule out such things as lactose intolerance or small intestinal bacterial overgrowth (SIBO). Your healthcare practitioner will determine which tests might be appropriate in your individual situation.
The treatment of IBS will vary from one individual to another. Conventional treatment options might include things as anti-spasmodics, fiber, low dose antidepressants, dietary manipulation, and in some cases psychological counseling.
A functional medicine approach would strive to look for the root cause of the problem and seek to remove any aggravating factors. Examples might include eliminating gluten or any “bad bacteria” in the gut. Also strive to reestablish a balance between the “good bacteria” and the “bad bacteria” while at the same time try to establish a normal terrain in the gastrointestinal tract.
IBS is a common disorder with significant adverse effect on quality of life. There is a significant economic burden associated with IBS as it is felt to be second only to the common cold as a cause of work absenteeism.
About the Author: Dr. Gerard Guillory, MD is Board Certified in Internal Medicine and has published two books on Irritable Bowel Syndrome (IBS).