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Irritable bowel syndrome (IBS) is a common disorder of the intestines affecting perhaps 20% of the adult population that leads to pain, gassiness, bloating, and changes in bowel habits. Symptoms include constipation, diarrhea, or a painful but unsuccessful urge to move the bowels.
Through the years, IBS has been called by many names - colitis, mucous colitis, spastic colon, spastic bowel, and functional bowel disease. Most of these terms are inaccurate. Colitis, for instance, means inflammation of the large intestine (colon). IBS, however, does not cause inflammation and should not be confused with another disorder, ulcerative colitis.
Often IBS is just a mild annoyance, but for some people it can be disabling. They may be unable to go to social events, to go to work, or to travel even short distances.
The colon, which is about 6 feet long, connects the small intestine with the rectum and anus. The major function of the colon is to absorb water and salts from digestive products that enter from the small intestine. Two quarts of liquid matter enter the colon from the small intestine each day. This material may remain there for several days until most of the fluid and salts are absorbed into the body. The stool then passes through the colon by a pattern of movements to the left side of the colon, where it is stored until a bowel movement occurs. Movements of the colon propel the contents slowly back and forth but mainly toward the rectum. A few times each day strong muscle contractions move down the colon pushing fecal material ahead of them. Some of these strong contractions result in a bowel movement.
Ordinary events such as eating and distention from gas or other material in the colon can cause the colon to overreact in a person with IBS, or certain medicines and foods may trigger spasms. Sometimes the spasm delays the passage of stool, leading to constipation. Chocolate, milk products and large amounts of alcohol are frequent offenders. Caffeine causes loose stools in many people, but it is more likely to affect those with IBS. Researchers also have found that women with IBS may have more symptoms during their menstrual periods, suggesting that reproductive hormones may exacerbate the problem. People with IBS sometimes pass mucus with their bowel movements.
Causes & Development
Researchers at Cedars-Sinai Medical Center in Los Angeles think they may have identified the cause of this mysterious and very common condition, and found an effective way to treat it. The Cedars-Sinai researchers found that 78% of the IBS patients they tested had what they called small intestinal bacterial overgrowth (SIBO), a condition in which excessive amounts of bacteria are present in the small intestine.
The researchers treated the patients who tested positive for SIBO with a 10-day course of antibiotics. Tests at the end of that time found that 25 of 47 patients had no bacterial overgrowth present, and that 12 of them had no IBS symptoms, while the symptoms were "significantly reduced" in the other 13. The symptoms were also reduced in the patients in which some SIBO was still detected, suggesting that if treatment had been continued until it was completely eliminated, perhaps with an alternative antibiotic, better results would have been obtained.
Signs & Symptoms
Bleeding, fever, weight loss, and persistent severe pain are not symptoms of IBS but may indicate other problems.
Eating causes contractions of the colon and normally this response may cause an urge to have a bowel movement within 30 to 60 minutes after a meal. In people with IBS, the urge may come sooner and be accompanied by cramps and diarrhea. The strength of the response is often related to the number of calories consumed, particularly the amount of fat in a meal. Fat in any form (animal or vegetable) is a strong stimulus of colonic contractions.
Treatment & Prevention
Most people with IBS, however, are able to control their symptoms through medications prescribed by their physicians, diet and stress management.
For many people, eating a proper diet lessens IBS symptoms. Before changing your diet, it is a good idea to keep a journal noting which foods seem to cause distress.
Complications
IBS causes a great deal of discomfort and distress, but it does not cause permanent harm to the intestines and does not lead to intestinal bleeding of the bowel, serious organic diseases or to cancer. No link has been established between IBS and inflammatory bowel diseases such as Crohn's disease or ulcerative colitis.
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Signs, symptoms & indicators of IBS (Irritable Bowel Syndrome):
Conditions that suggest IBS (Irritable Bowel Syndrome):
Risk factors for IBS (Irritable Bowel Syndrome):
Recommendations and treatments for IBS (Irritable Bowel Syndrome): | | | | | Amino Acid / Protein |  Glutamine | The enterocytes of the small intestines are the body's largest consumers of glutamine, accounting for about 40-50% of glutamine consumption. |
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Botanical |
 Peppermint Oil
Fennel| | Other herbs and products used with varying success include: fennel, dandelion, skullcap, licorice, peppermint, valerian, slippery elm, cranberry, glutamine, MSM, magnesium, and gamma-oryzanol. |
Licorice Root
Valerian Root
Cranberry Juice
Gamma Oryzanol
European Skullcap
Marijuana| | There are quite a few people who use marijuana to control the symptoms of abdominal pain and nausea associated with irritable bowel syndrome. Some make the claim that this helps more than any other thing they have tried. |
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Diet |
High/Increased Fiber Diet| | Dietary fiber may lessen IBS symptoms in many cases. High-fiber diets may cause gas and bloating, but within a few weeks these symptoms often go away as the body adjusts to the diet: IBS can be treated in most cases simply by increasing the intake of dietary fiber and eliminating food allergies.
The synthetic polymers methylcellulose and polycarbophil have been found to be the most effective fibers or bulk-forming laxatives for use in the treatment of Irritable Bowel Syndrome (IBS). Neither are found naturally in food sources. Methylcellulose is used as a food additive/thickener. Both are available over the counter in commercial products such as Citrucel (methylcellulose) and Fibercon (polycarbophil), among others. |
Smaller, More Frequent Meals| | Large meals can cause cramping and diarrhea for those with IBS. Symptoms may be eased if you eat smaller meals more often or just eat smaller portions. This should help, especially if your meals are low in fat and high in carbohydrates such as pasta, rice, whole-grain breads and cereals, fruits, and vegetables. |
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Digestion |
Digestive Enzymes| | People with spastic colon are often fiber-intolerant and have a tendency to like fats because they produce a feeling of wellbeing. They often respond well - sometimes even dramatically so - to a multiple digestive enzyme formula. |
Hydrochloric Acid (Trial) |
Drug |
 Antibiotics |
Mineral |
Calcium
Magnesium
MSM (Methyl Sulfonyl Methane)
Zinc| | A study involving zinc supplementation in inflammatory bowel disease illustrated the importance of taking adequate supplementation, but not too much. In this study, excess amounts of zinc caused tissue injury and impaired wound healing [Cario et al. 2000]. However, relative zinc deficiencies, especially in the elderly, are common in the United States [Andrews et al. 1999]. |
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Oxygen / Oxidative Therapies |
Ozone / Oxidative Therapy |
Psychological |
Stress Management| | Stress stimulates colonic spasm in people with IBS. Stress reduction (relaxation) training or counseling and support help relieve IBS symptoms in some people. |
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Vitamins |
Vitamin A
Vitamin B12 (Cobalamine)| | Vitamins B12, A, D, E and K along with calcium and a lactose-free diet are often recommended by clinicians treating IBS. |
Vitamin D
Vitamin E
Vitamin K |
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Preventive measures against IBS (Irritable Bowel Syndrome): | | | | | Diet | Dairy Products Avoidance| | Mycobacterium paratuberculosis (Para-T) RNA (a bacteria causing Johne’s disease in cows) was found in 100% of Crohn's disease patients, compared with 0% of controls.
This bacteria becomes cultured in milk, and is not destroyed by pasteurization. Para-T crosses the species barrier to infect and cause disease in humans. Occasionally, the milk-borne bacteria will begin to grow in the human host, and irritable bowel syndrome and Crohn's disease results. The USDA estimates that 30% of America's dairy herds contain cows infected with Para-T. |
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KEY | | Weak or unproven link |  | | Strong or generally accepted link |  | | Proven definite or direct link |  | | Strongly counter-indicative | | | May do some good | | | Likely to help | | | Highly recommended |
GLOSSARY
Abdomen (Abdominal)
That part of the body between the chest and the hips that contains the stomach, intestines, liver, bladder, pancreas and other organs.
Allergy (Allergies)
Hypersensitivity caused by exposure to a particular antigen (allergen), resulting in an increased reactivity to that antigen on subsequent exposure, sometimes with harmful immunologic consequences.
Anaerobic (Anaerobically)
Of, relating to, or being activity in which the body incurs an oxygen debt (for example weight training or resistive exercises) and does not immediately burn off a lot of calories and fat.
Bacteria (Bacterial, Bacterium)
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
Calcium
The body's most abundant mineral. Its primary function is to help build and maintain bones and teeth. The body also needs calcium to carry nerve signals, keep the heart functioning, contract muscles, clot blood and maintain healthy skin. Calcium helps control blood acid-alkaline balance, plays a role in cell division, muscle growth and iron utilization, activates certain enzymes, and helps transport nutrients through cell membranes. Calcium also forms a cellular cement called ground substance that helps hold cells and tissues together.
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Carbohydrates (Carbohydrate)
The sugars and starches in food. Sugars are called simple carbohydrates and found in such foods as fruit and table sugar. Complex carbohydrates are composed of large numbers of sugar molecules joined together, and are found in grains, legumes, and vegetables like potatoes, squash, and corn.
Chronic Fatigue Syndrome (CFS, Chronic Fatigue)
A disorder of unknown cause that lasts for prolonged periods and causes extreme and debilitating exhaustion as well as a wide range of other symptoms such as fever, headache, muscle ache and joint pain, often resembling flu and other viral infections. Also known as Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS), Chronic Epstein-Barr Virus (CEBV), Myalgic Encephalomyelitis (ME), "Yuppy Flu" and other names, it is frequently misdiagnosed as hypochondria, psychosomatic illness, or depression, because routine medical tests do not detect any problems.
Cobalamin (B12, B-12, Cobalamine, Vitamin B12)
Essential for normal growth and functioning of all body cells, especially those of bone marrow (red blood cell formation), gastrointestinal tract and nervous system, it prevents pernicious anemia and plays a crucial part in the reproduction of every cell of the body i.e. synthesis of genetic material (DNA).
Colitis
Colon inflammation, usually involving the mucus membranes. Mucus colitis is a type with cramps, periods of constipation, and copious discharge of mucus with feces. Ulcerative colitis has pain, inflammation, ulceration, fever, and bleeding, all interspersed at various times - a long and serious illness.
Colon (Colonic)
The part of the large intestine that extends to the rectum. The colon takes the contents of the small intestine, moving them to the rectum by contracting.
Constipation (Constipated)
Difficult, incomplete, or infrequent evacuation of dry, hardened feces from the bowels.
Cramp (Cramping, Cramps)
A sudden, involuntary, painful muscular contraction.
Crohn's Disease (Crohn's)
Chronic inflammatory disease of the gastrointestinal tract. The most common symptoms are abdominal pain, often in the lower right area, and diarrhea. Rectal bleeding, weight loss, and fever may also occur. Bleeding may be serious and persistent, leading to anemia.
Diarrhea
Excessive discharge of contents of bowel.
Dietary Fiber (Insoluble Fiber, Insoluble Fibers, Soluble Fiber, Soluble Fibers)
There are two types of dietary fiber - soluble and insoluble. Insoluble fiber acts like a sponge; it absorbs water and moves solid waste out of the intestines. It is found mainly in whole grains and on the outside of seeds, fruits, and legumes. Soluble fiber is found in fruits, vegetables, seeds, brown rice, barley, oats and oat bran. It forms a gel when mixed with liquid producing a softer stool. It also prevents and reduces the absorption of certain substances from the intestines into the bloodstream.
Distention (Distended)
An excess expansion of a tissue or organ, either from inflammation, injury or gas.
Enteric (Enteric-coated)
Pertaining to the small intestines. Enteric-coated: A coating that prevents a tablet or capsule from being digested until it reaches the small intestine.
Enzymes (Enzyme)
Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.
Fibromyalgia (FMS)
Originally named fibrositis, it is a mysteriously debilitating syndrome that attacks women more often than men. It is not physically damaging to the body in any way, but is characterized by the constant presence of widespread pain that often moves about the body. Fibromyalgia can be so severe that it is often incapacitating.
Glutamine
A "conditionally essential" amino acid, glutamine is considered to be a brain fuel. Glutamine has been used therapeutically for alcoholism, mild depression and to reduce the craving for sweets. Glutamine is very important in the functioning of the metabolism and muscle maintenance. Glutamine supplementation can help prevent muscle and other tissue breakdown by providing the body with nitrogen and fuel.
Herbs (Herb, Herbal)
Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with one teaspoon herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Tinctures may be used singly or in combination as noted. The high doses of single herbs suggested may be best taken as dried extracts (in capsules), although tinctures (60 drops four times per day) and teas (4 to 6 cups per day) may also be used.
Hormones (Hormone)
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Hydrochloric Acid (HCl)
An inorganic acidic compound, excreted by the stomach, that aids in digestion.
Irritable Bowel Syndrome (IBS)
A condition that causes upset intestines for a long period of time. It is very unpleasant to the sufferer but tends to be harmless and usually does not lead to more serious complaints. The symptoms vary from person to person and from day to day. In order to be diagnosed with IBS, a person must have at least three of the following symptoms: pain in the lower abdomen; bloating; constipation; diarrhea or alternating diarrhea and constipation; nausea; loss of appetite; tummy rumbling; flatulence; mucous in stools; indigestion; constant tiredness; frequent urination; low back pain; painful intercourse for women.
Laxative (Laxatives)
A substance (food, herb, chemical) that stimulates evacuation of the bowels. Examples include cascara sagrada, senna, castor oil, aloe vera, bisacodyl, phenolphthalein and many others.
Magnesium
An essential mineral. The chief function of magnesium is to activate certain enzymes, especially those related to carbohydrate metabolism. Another role is to maintain the electrical potential across nerve and muscle membranes. It is essential for proper heartbeat and nerve transmission. Magnesium controls many cellular functions. It is involved in protein formation, DNA production and function and in the storage and release of energy in ATP. Magnesium is closely related to calcium and phosphorus in body function. The average adult body contains approximately one ounce of magnesium. It is the fifth mineral in abundance within the body--behind calcium, phosphorus, potassium and sodium. Although about 70 percent of the body's magnesium is contained in the teeth and bones, its most important functions are carried out by the remainder which is present in the cells of the soft tissues and in the fluid surrounding those cells.
Menstruation (Menses, Menstrual, Menstrual Cycle, Menstrual Cycles, Menstrual Flow, Menstrual Phase, Monthly Cycle)
The periodic discharge of blood, tissue fluid and mucus from the endometrium (lining of the uterus) that usually lasts from 3 - 5 days. It is caused by a sudden reduction in estrogens and progesterone.
Mucus (Mucous)
The viscous, slippery substance that consists chiefly of mucin, water, cells, and inorganic salts and is secreted as a protective lubricant coating by cells and glands of the mucous membranes.
Mumps
An acute infectious disease, caused by a paramyxovirus, and most common in children. Although it usually infects the parotid glands, and is often only a mild condition, it can spread to the testes or ovaries and cause serious problems, particularly when contracted by unresistant adults. A mild child's infection that is not properly monitored holds the potential for pancreatic or meningeal complications.
Nausea
Symptoms resulting from an inclination to vomit.
Over-The-Counter (OTC, Over The Counter)
A drug or medication that can legally be bought without a doctor's prescription being required.
RNA
A ribonucleic acid found in plant and animal cells; a complex protein chemical. Important in the coding of genetic information with DNA carrying information from the nucleus of the cell into the cytoplasm.
Small Intestine (Small Bowel)
The small intestine lies between the stomach and the large intestine. It is about 6 meters (20 feet) long and its primary function is to digest (break down) food and absorb nutrients (vitamins, minerals, proteins, carbohydrates, and fats). The small intestine makes up more than 70% of the length and 90% of the surface area of the gastrointestinal (GI) tract.
Spasm
Involuntary contraction of one or more muscle groups.
Ulcerative Colitis (Colitis Ulcerosa)
Ulceration of the colon and rectum, usually long-term and characterized by rectal bleeding or blood in the stool, frequent urgent diarrhea/bowel movements each day, abdominal pain.
USDA
United States Department of Agriculture
Zinc
An essential trace mineral. The functions of zinc are enzymatic. There are over 70 metalloenzymes known to require zinc for their functions. The main biochemicals in which zinc has been found to be necessary include: enzymes and enzymatic function, protein synthesis and carbohydrate metabolism. Zinc is a constituent of insulin and male reproductive fluid. Zinc is necessary for the proper metabolism of alcohol, to get rid of the lactic acid that builds up in working muscles and to transfer it to the lungs. Zinc is involved in the health of the immune system, assists vitamin A utilization and is involved in the formation of bone and teeth.
Last updated: Sep 19, 2009
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