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National Digestive Diseases Information Clearinghouse
Irritable bowel syndrome (IBS) is a dis-order that interferes with the normalfunctions of the large intestine (colon).
It is characterized by a group of symp-
nosed by doctors. It occurs more often in
women than in men, and it usually beginsaround age 20.
IBS causes a great deal of discomfort anddistress, but it does not permanently harmthe intestines and does not lead to intestin-al bleeding or to any serious disease suchas cancer. Most people can control theirsymptoms with diet, stress management,
and medications prescribed by their physi-
cian. But for some people, IBS can be dis-
abling. They may be unable to work, go to
social events, or travel even short distances.
• The lining of the colon (epithelium),
What causes IBS?
cannot be traced to a single organic cause.
seem to have a colon that is more sensitive
things, including certain foods and stress.
result is too much fluid in the stool.
• The colon responds strongly to stimuli
of Health and
can strongly affect the colon. It has many
which has been proven to respond to stress.
nerves that connect it to the brain. Like the
For example, when you are frightened, your
heart and the lungs, the colon is partly con-
heart beats faster, your blood pressuremay go up, or you may gasp. The colonresponds to stress also. It may contract toomuch or too little. It may absorb too much
What does the colon do?
The colon, which is about 5 feet long,connects the small intestine with the
Research has shown that very mild or hid-
den (occult) celiac disease is present in a
that mimic IBS. People with celiac disease
cannot digest gluten, which is present in
wheat, rye, barley, and possibly oats. Foods
containing gluten are toxic to these people,
sents what the colon absorbs each day.
test can determine whether celiac diseaseis present. (For information about celiac
disease, see the Celiac Disease
from the National Institute of Diabetes and
hormones and by electrical activity inthe colon muscle. Contractions move
The following have been associated with a
this passage, water and nutrients areabsorbed into the body. What remains
muscle contractions move down thecolon, pushing the stool ahead of them.
• drinks with caffeine, such as coffee,
relax at the right time to allow the stoolto be expelled. If the muscles of the
• stress, conflict, or emotional upsets
colon, sphincters, and pelvis do not con-tract in a coordinated way, the contents
What are the symptoms
Criteria for IBS Diagnosis
(hard, difficult-to-pass, or infrequent bowel
need to move the bowels); and still othersexperience alternating constipation and
ing, which is gas building up in the intes-
tines and causing the feeling of pressure
fluids are absorbed. When stool remains in
the colon for a long time, too much water isabsorbed from it. Then it becomes hardand difficult to pass. Or spasms push thestool through the colon too fast for the flu-
id to be absorbed, resulting in diarrhea. In
addition, with spasms, gas may get trapped
flexible tube inserted through the anus). If
place, temporarily unable to move forward.
these tests are all negative, the doctor maydiagnose IBS based on your symptoms:
that is, how often you have had abdominal
urge to move their bowels but cannot do so
or pass mucus with their bowel movements.
when the pain starts and stops in relation
Bleeding, fever, weight loss, and persistent
to bowel function, and how your bowel fre-
quency and stool consistency are altered.
may indicate other problems such asinflammation or rarely cancer.
What is the treatment
How is IBS diagnosed?
If you think you have IBS, seeing your doc-
options are available to treat the symptoms.
tor is the first step. IBS is generally diag-
Your doctor will give you the best treat-
ments available for your particular symp-
history that includes a careful description
of symptoms and a physical examination.
No particular test is specific for IBS. How-
ever, diagnostic tests may be performed to
suggest fiber supplements or occasional lax-
The colon has a vast supply of nerves that
atives for constipation, as well as medicines
connect it to the brain. These nerves con-
to decrease diarrhea, tranquilizers to calm
at stressful times. People often experience
pressants may also relieve some symptoms.
cramps or “butterflies” when they are nerv-
Medications available to treat IBS specifi-
ous or upset. But with IBS, the colon can
be overly responsive to even slight conflictor stress. Stress also makes the mind more
tuned to the sensations that arise in the
ceive these sensations as unpleasant.
for women with severe IBS who havenot responded to conventional therapy
Some evidence suggests that IBS is affected
by the immune system, which fights infec-
also affected by stress. For all these rea-
it can have serious side effects, such as
part of treatment for IBS. Stress manage-
• stress reduction (relaxation) training
counter medications such as laxatives andfiber supplements, it is important to follow
your doctor’s instructions. Laxatives can be
habit forming if they are not used carefullyor are used too frequently.
It is also important to note that medica-
Can changes in diet
tions affect people differently and that noone medication or combination of medica-
tions will work for everyone with IBS.
You need to work with your doctor to find
keep a journal noting the foods that seem
to cause distress. Then discuss your find-
ings with your doctor. You may also wantto consult a registered dietitian, who can
How does stress affect IBS?
help you make changes to your diet. Forinstance, if dairy products cause your symp-
toms to flare up, you can try eating less of
tense, troubled, angry, or overwhelmed—
those foods. You might be able to tolerate
stimulates colon spasms in people with IBS.
Is IBS linked to other
sugar found in milk products. Dairy prod-ucts are an important source of calcium
and other nutrients. If you need to avoid
indicates, it is a syndrome—a combination
been shown to lead to any serious, organic
diseases, including cancer. Through theyears, IBS has been called by many names,
among them colitis, mucous colitis, spastic
IBS symptoms, particularly constipation.
colon, or spastic bowel. However, no link
However, it may not help pain or diarrhea.
Whole grain breads and cereals, fruits, and
vegetables are good sources of fiber. High-
Crohn’s disease or ulcerative colitis.
fiber diets keep the colon mildly distended,which may help prevent spasms. Someforms of fiber also keep water in the stool,
Hope Through Research
thereby preventing hard stools that are dif-
ficult to pass. Doctors usually recommend
research into many kinds of digestive dis-
a diet with enough fiber to produce soft,
studying gastrointestinal motility and sen-
diets may cause gas and bloating, but these
sitivity to find possible treatments for IBS.
symptoms often go away within a few weeks
contraction of gastrointestinal muscles as
about diets for people with celiac disease,
please see the Celiac Disease
through the intestines. Understanding the
influence of the nerves, hormones, andinflammation in IBS may lead to new treat-
Drinking six to eight glasses of plain water
ments to better control the symptoms.
a day is important, especially if you havediarrhea. But drinking carbonated bever-ages, such as sodas, may result in gas and
For More Information
International Foundation for Functional
Phone: 1–888–964–2001 or 414–964–1799
often or eating smaller portions should help
meals are low in fat and high in carbohy-
drates, such as pasta, rice, whole-grainbreads and cereals (unless you have celiacdisease), fruits, and vegetables.
National Digestive Diseases
Points to Remember
• IBS is a disorder that interferes with
2 Information WayBethesda, MD 20892–3570
The National Digestive Diseases Information
Clearinghouse (NDDIC) is a service of theNational Institute of Diabetes and Digestive
is part of the National Institutes of Health
digestive diseases to people with digestivedisorders and to their families, health care
professionals, and the public. NDDIC answers
inquiries, develops and distributes publications,
and works closely with professional and patient
coordinate resources about digestive diseases.
Publications produced by the clearinghouse are
carefully reviewed by both NIDDK scientistsand outside experts. This fact sheet was
reviewed by Michael Camilleri, M.D., Mayo
related to Crohn’s disease or ulcera-tive colitis.
This publication is not copyrighted. Theclearinghouse encourages users of this factsheet to duplicate and distribute as many
The U.S. Government does not endorse or favor
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Trade, proprietary, or company names appearing
in this document are used only because they are
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