IRRITABLE BOWEL SYNDROME

General Information

DEFINITION--An irritative and inflammatory disorder of the intestine. It is not contagious, inherited or cancerous.

BODY PARTS INVOLVED--Small and large intestines.

SEX OR AGE MOST AFFECTED--Often begins in adolescents or young adults; twice as likely to affect women as men.

SIGNS & SYMPTOMS--

The following symptoms usually begin in early adult life. Episodes may last for days, weeks or months.

• Cramp-like pain in the middle or to one side of the lower abdomen. Pain is usually relieved with bowel movements.
• Nausea; bloating and gas; headache; rectal pain; backache.
• Occasional appetite loss that may lead to weight loss.
• Diarrhea or constipation, usually alternating; fatigue; depression; anxiety; concentration difficulty.

CAUSES

> Unknown. May be related to stress and emotional conflict that results in anxiety, anger, guilt or depression. Situations that often precede an attack include: obsessive worry about everyday problems; marital tension; fear of loss of a beloved

person or object; death of a loved one.

• Symptoms may also be triggered by eating, though no specific food has been identified as responsible.

RISK INCREASES WITH

• Stress; improper diet; smoking; excess alcohol consumption; use of drugs.
• Fatigue or overwork; poor physical fitness.
• Family history of similar bowel problems.

HOW TO PREVENT--Reduce stress or try to modify your response to it (see How to Cope with Stress in Appendix) and pay attention to good diet habits.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Laboratory studies, including stool studies, to exclude other disorders such as lactose intolerance, ulcers, parasites, enzyme deficiency and ulcerative colitis.
• X-ray of the colon (barium enema).
• Sigmoidoscopy (See Glossary).

APPROPRIATE HEALTH CARE

• Self-care.
• Doctor's treatment.

POSSIBLE COMPLICATIONS--Psychological fixation on bowel function, leading to psychologic disability.

PROBABLE OUTCOME--The condition is usually recurrent throughout life. Symptoms decrease or may disappear for periods of time. It is not life-threatening and doesn't progress to cancer or inflammatory disease.

How To Treat

GENERAL MEASURES--

• Warm heat to the abdomen (compresses, hot-water bottle or heating pad) may help ease discomfort.
• Reduce stress in your life. Try techniques that can help you relax (meditation, self-hypnosis or biofeedback). Keep a stress diary so you know who or what may bring on symptoms.
• Quit smoking. Nicotine may contribute to the problem.

MEDICATION--Medication may help but it will not cure this disorder. Your doctor may prescribe:

• Antispasmodics to relieve severe abdominal cramps.
• Short-term tranquilizers to reduce anxiety.
• Other drugs including bulk-producing agents, constipating agents, anticholinergics, antiflatulents and lactose for milk intolerance.

ACTIVITY--No restrictions. Good physical fitness improves bowel function and helps reduce stress.

DIET--

• Increase fiber in the diet to promote good bowel function (see High Fiber Diet in Appendix). Add fiber to your diet slowly to give the body time to adjust.
• Don't eat foods or drinks that aggravate symptoms. Coffee or milk may be a major cause of symptoms in some people. Keep a food diary so you can find out which foods aggravate symptoms.
• Avoid gas-producing and spicy foods.
• Avoid large meals, but eat regularly.
• Limit alcohol consumption.

Call Your Doctor If

• Fever develops.
• Stool is black or tarry-looking.
• You begin vomiting.
• Unexplained weight loss of 5 pounds or more occurs.
• Symptoms don't improve despite treatment.