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Irritable bowel syndrome is a common intestinal problem.  We are unsure why it occurs.  It may signal intestinal hypersensitivity to pain or nerves–or a change in bowel bacteria.  A “textbook case” involves a 20-year-old woman with symptoms as below.

• Bloating and gas
• Constipation
• Diarrhea, especially after eating or after morning awakening
• Feeling that after a bowel movement, you are not completely
  emptied
• Stomach pain and cramping that may go away after a bowel
  movement.

What makes it worse?  Changes may make it worse: schedule changes, traveling, stress, change in diet, the beginning of a menstrual period.

Irritable bowel is a “diagnosis of exclusion.”  That means that we, physicians, rule out more concerning diagnoses like inflammatory bowel (like ulcerative colitis) and cancer.

Treatment is avoiding triggers (keep a journal so you know which foods aggravate your bowels), eating a healthy diet, and finding ways to cope with symptoms.

Fiber is a great treatment option.  Soluble fiber helps make stools soft, formed, and more controllable.  Foods high in soluble fiber are apples (WITH peels) and beans.  Psyllium is an over the counter fiber supplement.  Fiber is available many forms.  OOOOOOOh. . . the choices. . . .Pick your favorite!  Powder.  Tablet.  Capsule.  Wafer.  Increase dietary fiber slowly—so your gut can get used to it.

What can your doctor do?  A good history and physical may help diagnose this (and rule out the other bad stuff).  A colonoscopy may be needed to see the bowel walls and take biopsies.  Prescription medication may decrease colon spasms.  Heating pads and hot baths can also help with symptoms.

What else can you do?  Learn ways to cope with stress, avoid laxative use as they may make your condition harder to control over time, drink plenty of water, eat a small,
frequent meals of healthy food, and avoid dietary triggers.

irritable bowel will look normal on colonoscopy