¡ WHAT IS IRRITABLE BOWEL SYNDROME?

Irritable bowel syndrome (IBS) is a common disorder that may affect up to 30 percent of all Americans at some time during
their lives. The disorder has many names, including nervous colon, spastic colon, spastic bowel, mucous colitis and spastic
colitis. However, it should not be confused with diseases like ulcerative or Crohn's colitis.

IBS is a syndrome, a pattern of symptoms such as pain and bloating that tend to occur together. It is not a "disease" in the
normal sense of the word (i.e., it cannot be caught or transmitted from person to person as a cold can, nor can it be cured by
an operation or medication). It is not life-threatening.
¥WHAT ARE THE SYMPTOMS OF IBS?

People with IBS may experience constipation, diarrhea, or a combination - constipation at some times and diarrhea at other
times.
In addition, IBS may produce cramps, urgency or a gassy, bloated feeling in the abdomen. Mucus, sometimes seen in bowel
movements, is also a symptom of IBS. Rectal bleeding is never caused by IBS, and any rectal bleeding must be properly and
thoroughly evaluated.
¥WHAT CAUSES IBS?

The underlying cause of this disorder is an abnormality in the way the intestinal muscles contract. These muscles, which
form the outer layer of the intestine, work automatically to move food products along the intestine to the rectum and out the
anus. IBS is a disorder of the function of the intestinal muscles. Even when the muscles appear normal under a microscope,
they may not function normally, contracting too forcefully or weakly, too slowly or rapidly, at certain times.
¥WHAT ROLE DOES STRESS PLAY IN IBS?

Emotional stress may contribute to IBS.
The brain and the intestine are closely connected by nerve fibers that control the automatic functioning of the intestinal
muscles, and many people may experience nausea or diarrhea when nervous or anxious. While we may not be able to control
the effect stress has on our intestines, reducing the sources of stress in our lives - high pressure jobs, family tensions, etc.
- may alleviate the symptoms of IBS.
¥HOW CAN I TELL IF THE PROBLEM IS IBS OR SOMETHING ELSE?

A careful medical history and physical examination by a colon and rectal surgeon or other physician are essential to proper
diagnosis.
Tests performed to ensure that your symptoms are not caused by other problems may include q flexible sigmoidoscopic
examination, colonoscopy, a hemmocult test to detect hidden blood in the stool, an x-ray examination of the lower intestines
and psychological evaluation. These tests may rule out other diseases or conditions, - cancer, diverticulitis, inflammation of
the intestines or depression, for example.
¥HOW IS IBS TREATED?

Simply understanding that IBS is not a serious or life-threatening condition may relieve anxiety and stress, which often
contribute to the problem. Mental health counseling and stress reduction (relaxation training) can help relieve the symptoms
of IBS in some individuals.

In others, increasing the amount of non-digestible, bulk-forming foods ("roughage") in the diet may be all that is needed to
relieve symptoms. Adding roughage, such as psyllium seed, to your diet may eliminate or lessen the severity of cramps, result
in softer stools that pass along the intestine more easily, and absorb excess water in the intestine to prevent diarrhea. When
the major complaint is constipation, additional water should be provided in the diet along with bulk agents to soften the stool.

In some cases, dietary roughage alone may not provide adequate relief from cramping and bloating. Your physician may
prescribe medications that act directly on the intestinal muscles to help the contractions return to normal. Some people
obtain greater relief from one medication than another. Therefore, your physician may recommend changing medications to
improve symptomatic relief.

¥ARE THERE ANY FOODS TO BE AVOIDED?

Sometimes, caffeine, milk products or alcohol can make symptoms of IBS worse. Your physician may recommend avoiding
foods that contain significant amounts of caffeine - coffee, tea, chocolate and cola drinks, for example - and alcoholic
beverages, including beer, wine and "mixed" drinks.

Your physician may also recommend that you avoid dairy products, such as cheese and milk, which may cause diarrhea in
some people and constipation in others. Because dairy products are an important source of calcium and other nutrients that
your body needs, be sure to get adequate nutrients in the foods that you substitute.
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