The exact cause of IBS is not really known, but there are several factors that may contribute to the condition. The muscles of the walls of the intestine may contract either stronger and longer than normal, or they may be weak in contraction and inefficient in moving the food through the digestive tract to the rectum for elimination of waste. There may be an abnormality of the GI nervous system as well. This may result in increased sensitivity to gas and bloating. Signals from the brain to the intestines may not be coordinated properly, which can result in a heightened response to the normal changes that occur during digestion. This overreaction of the nervous system can result in pain, diarrhea or constipation that occurs in IBS.
Triggers for IBS differ from person to person. Food is a common trigger, but not all people with IBS react negatively to the same foods. Some common triggers include:
- Chocolate
- Spices
- Fats
- Fruit
- Beans
- Cabbage and/or broccoli
- Milk and milk products (foods with lactose)
- Wheat, rye and barley (sensitivity to foods such as in celiac disease)
- Cauliflower
- Alcohol and carbonated beverages
- Hormonal changes
- Stress
- Bacterial overgrowth in the bowel
- Other conditions of the digestive tract, such as gastroenteritis
Assigning a diagnosis of IBS can involve a long process of ruling out other conditions. This is because there are usually no physical signs that can be measured in a blood test, or any type of lab value. A complete physical and history is conducted by the physician to rule out other disorders. The following criteria are measured to diagnose IBS:
-Abdominal pain and discomfort lasting at least 3 days a month in the last 3 months, associated with 2 or more of the following:
- Change in frequency of stool
- Change of consistency of stool
- Improvement with pattern of elimination of stool
Other criteria for diagnosis focuses on whether the pain is relieved after elimination of stool, presence of incomplete bowel movements, and mucus in the stool. Overall, the more symptoms which present, the higher the likelihood of an IBS diagnosis.
If you or your loved one experiences any of the following symptoms, it may indicate a more serious condition and the physician should be notified right away:
- New onset of IBS symptoms in a person over age 50
- Rectal bleeding
- Weight loss
- Fever
- Recurrent vomiting or nausea
- Persistent diarrhea (particularly if it wakes you up at night)
- Abdominal pain that is NOT relieved by a bowel movement
- Anemia
Your physician may order various tests to rule out other conditions such as infection, or other problems with the digestive tract including:
- Sigmoidoscopy-to examine the sigmoid colon with a lighted scope
- Colonoscopy-for those over 50, to rule out any other serious conditions
- X-ray or CT scan to rule out any other causes of symptoms such as abdominal pain
- Laboratory tests-lactose intolerance test
- Breath tests to check for bacterial overgrowth in the intestines (commonly done for people with diabetes, or after bowel surgery or other conditions which slow down the motility of the digestive tract)
- Blood tests-for celiac disease (wheat, barley and rye sensitivity)
- Stool tests-for parasites (particularly for those with chronic diarrhea)
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