| Irritable bowel syndrome (IBS) is the most | | | | Serotonin, a chemical present in both the brain |
| common diagnosis (25-50%) given to people | | | | and the gut, has been suspected. An imbalance in |
| referred to stomach and intestine specialists. It is | | | | serotonin has been blamed for IBS. Serotonin |
| reported to affect between 10-15% of people in | | | | increases the contractions of the intestine. Several |
| the U.S. However, it cannot be diagnosed by any | | | | medications that either increase or decrease |
| specific tests. It is diagnosed by criteria. The | | | | serotonin have been developed to treat |
| criteria are called the Rome II diagnostic criteria | | | | constipation or diarrhea predominant IBS. |
| because a group of doctors meet periodically to | | | | More recently, research has been focusing on the |
| establish rules for labeling intestinal conditions that | | | | common report of many people with IBS of a |
| have no diagnostic tests. | | | | distinct time that their IBS symptoms began, |
| These conditions are called syndromes because | | | | often after some type of intestinal infection such |
| they don't meet the definition for a disease. They | | | | as food poisoning, traveler's diarrhea or |
| don't have a specific known cause and/or | | | | gastroenteritis. This "post-infectious" theory has |
| diagnostic test(s). They are often referred to as | | | | lead to theories of bowel injury and/or alterations |
| "functional" problems. The cause of the functional | | | | in bacteria in the intestine. An imbalance of "good |
| problem in IBS is not known. By definition there is | | | | and bad" bacteria in the intestine is a theory. |
| no abnormality that can be seen on a biopsy, | | | | Some are treating people with antibiotics and/or |
| x-ray, blood or stool test. The diagnosis is made | | | | probiotics. Antibiotics kill bacteria. Probiotics are live |
| by applying criteria after exclusion of other | | | | bacteria that are "good bacteria" like acidophilus |
| conditions or diseases of the intestine. There is | | | | and lactobacillus that can be taken as pill, capsule, |
| not a universally agreed upon consensus for what | | | | powder or eaten or drank in yogurt or milk. |
| constitutes an adequate evaluation to exclude | | | | Food intolerances have been proposed as a cause |
| other causes. | | | | of IBS by some, especially in Europe, but have |
| For IBS the criteria required to make the | | | | not been accepted by most doctors in the U.S. |
| diagnosis is the presence of abdominal pain or | | | | Trials of elimination diets, with or without the use |
| discomfort that has been present for at least 3 | | | | of food allergy or antibody tests have been |
| months in the past year (not necessarily | | | | reported in a few studies or a lot of testimonials |
| consecutively) and has at least two out of three | | | | to be helpful. |
| of the following features: | | | | Lactose intolerance is a common condition that |
| 1. The pain or discomfort is relieved with a bowel | | | | can cause symptoms that may be misdiagnosed |
| movement. | | | | as IBS and resolve with avoidance of lactose. |
| 2. The beginning of pain or discomfort is | | | | Undiagnosed colitis or Crohn's disease can be a |
| associated with a change in frequency of bowel | | | | cause of symptoms that can be diagnosed by |
| movements. | | | | colonoscopy with biopsy of the intestine. Blood |
| 3. The beginning of pain or discomfort is | | | | tests for colitis and Crohn's disease also now |
| associated with a change in the appearance or | | | | exist. |
| consistency (hardness or softness) or stools. | | | | More recently, undiagnosed Celiac disease has |
| There are other symptoms that doctors use to | | | | emerged as a cause of what had been previously |
| support the diagnosis of IBS and to further divide | | | | been diagnosed as IBS in as many of 20% of |
| it into three different categories. The three | | | | people. Those with a diagnosis of IBS should be |
| categories are determined by whether there is a | | | | screened for Celiac disease, as it is a common |
| predominant stool pattern of diarrhea or | | | | condition, affecting 1 in 100 people. The |
| constipation or is the stool pattern alternating | | | | symptoms of abdominal pain, bloating, gas and |
| diarrhea and constipation. The supporting | | | | diarrhea are common symptoms of Celiac disease |
| symptoms are as follows. | | | | and it is now known that untreated Celiacs can be |
| 1. 3 bowel movements per day (diarrhea) | | | | constipated. Gluten free diet relieves these |
| 3. Hard or lumpy stools | | | | symptoms in people who are gluten sensitive. |
| 4. Loose, mushy or watery stools | | | | Further information about irritable bowel |
| 5. Straining during a bowel movement | | | | syndrome, food intolerance, colitis, Crohn's |
| 6. Urgency, or the sense that you need to rush | | | | disease, lactose intolerance and Celiac disease |
| to the bathroom to have a bowel movement | | | | may be found at |
| 7. Feeling of incomplete emptying after a bowel | | | | If you have symptoms suggestive of IBS or |
| movement | | | | have been diagnosed as having IBS it is important |
| 8. Passage of mucus or whitish material during a | | | | that you have an evaluation by a physician and |
| bowel movement | | | | other causes including colitis, Crohn's disease, |
| 9. Feeling of abdominal fullness, bloating or swelling | | | | lactose intolerance, and Celiac disease are |
| Therefore, the diagnosis is made by a report of | | | | excluded. Food intolerance should also be |
| the symptoms and the doctor excluding other | | | | considered. Minimum evaluation should include a |
| causes. The extent to which other conditions are | | | | blood count, stool tests for blood and pus cells, |
| excluded is highly variable and doctor dependent. | | | | screening lab tests for Celiac disease, colitis, |
| Self-diagnosis of IBS should be avoided because | | | | Crohn's and a colonoscopy. Talk to your doctor |
| serious conditions can cause symptoms that | | | | about the diagnosis and how other causes can be |
| mimic IBS. | | | | or have been excluded before accepting the |
| Theories of the cause of IBS are not proven. | | | | diagnosis of IBS. |