Regional Gastrointestinal Consultants

Irritable Bowel Syndrome IBS

Irritable Bowel Syndrome IBS

Irritable Bowel Syndrome (IBS)


Irritable bowel syndrome (IBS) is one of the most common disorders of the digestive system and affects about 10% to 15% of the general population. IBS can affect any part of the gastrointestinal tract, which is one reason for the variety of symptoms that patients may experience. Irritable bowel syndrome (also called spastic colon, irritable colon, or nervous stomach) is a condition in which the colon muscle contracts more readily than in people without IBS

IBS is generally classified as a functional disorder because it impairs the functioning of the body’s normal activities, such as the movement of the intestines, the sensitivity of the nerves of the intestines, or the way in which the brain controls some of these functions. However, although the normal functioning is impaired, there are no structural abnormalities that can be found with an endoscope (a flexible viewing tube), x-rays, biopsies, or blood tests. Thus, IBS is identified by the characteristics of the symptoms and, when done, normal results of tests.

The cause of IBS is not clear. In many people with IBS, the digestive tract is especially sensitive to many stimuli. People may experience discomfort caused by intestinal gas or contractions that other people do not find distressing. Although the changes in bowel movements that occur with IBS might seem to be related to abnormal intestinal contractions, not all people with IBS have abnormal contractions, and in many of those who do, the abnormal contractions do not always coincide with symptoms. In some people, symptoms of IBS begin after an episode of gastroenteritis.

Emotional factors (for example, stress, anxiety, depression, and fear), diet, drugs (including laxatives), hormones, or minor irritants may trigger or worsen a flare-up (a bout or attack) of IBS. For some people, high-calorie meals or a high-fat diet may be a trigger (precipitating factor). For other people, wheat, dairy products, beans, chocolate, coffee, tea, some artificial sweeteners, certain vegetables (such as asparagus or broccoli), or stone fruits (such as apricots) seem to aggravate the symptoms. These foods contain carbohydrates that are poorly absorbed by the small intestine. The carbohydrates become fermented by bacteria in the intestine, which causes gas, bloating, and cramping. Because many food products contain several ingredients, it may be difficult to identify the specific trigger. Other people find that eating too quickly or eating after too long a period without food stimulates a flare-up. However, the relationship is inconsistent. People do not always get symptoms after a usual trigger, and symptoms often appear without any obvious trigger. It is not clear how all the triggers relate to the cause of IBS.


Several symptoms that occur together characterize irritable bowel syndrome (IBS). This may confuse you at first. Plus, symptoms will likely change over time. The changes may seem random. But there is a pattern to symptoms of IBS. Common symptoms of IBC include abdominal pain and cramps, excess gas, bloating, and a change in bowel habits such as harder, looser, or more urgent stools than normal. Often people with IBS have alternating constipation and diarrhea. Symptoms vary but often include lower abdominal pain, bloating, gas, and constipation or diarrhea.

Symptoms include abdominal pain related to or relieved by having a bowel movement (defecation), change in stool frequency (such as constipation or diarrhea) or consistency (loose or lumpy and hard), abdominal expansion (distention), mucus in the stool, and the sensation of incomplete emptying after defecation. The pain may come in bouts of continuous dull aching or cramps, usually over the lower abdomen. However, symptoms may increase or decrease in severity and change over time. Common indications of IBS are least 3 days per month in the last 3 months along with 2 or more of the following:

  • Pain that is relieved by having a bowel movement
  • Start of each flare-up is associated with a change in stool frequency (constipation or diarrhea)
  • A change in the consistency of stool

Other digestive tract disorders (such as appendicitis, gallbladder disease, ulcers, and cancer) may develop in a person with IBS, particularly after age 40. Thus, if a person’s symptoms change significantly, if new symptoms develop, or if symptoms are unusual for IBS, further testing may be needed.


Most people with IBS appear healthy. Doctors base the diagnosis on the characteristics of the person’s symptoms. Doctors also use standardized symptom-based criteria for diagnosing IBS called the Rome criteria. They may also do tests to diagnose common illnesses that can cause similar symptoms, particularly when people are over 40 or have warning signs such as fever, weight loss, rectal bleeding, vomiting.

A physical examination generally does not reveal anything unusual except sometimes tenderness over the large intestine. Doctors do a digital rectal examination, in which a gloved finger is inserted in the person’s rectum.

Doctors usually do some tests—for example, blood tests, a stool examination, and a sigmoidoscopy (see Endoscopy)—to differentiate IBS from Crohn disease, ulcerative colitis, cancer (mainly in people over age 40), collagenous colitis, lymphocytic colitis, celiac disease, and the many other diseases and infections that can cause abdominal pain and changes in bowel habits. These test results are usually normal in people with IBS, although the stool may be watery, and the sigmoidoscopy procedure may cause an unusual amount of spasms and pain. Doctors usually do more tests, such as ultrasonography of the abdomen, x-rays of the intestines, or a colonoscopy (see Endoscopy), in older people and in people who have symptoms that are unusual for IBS, such as fever, bloody stools, weight loss, and vomiting. Doctors may do a test to rule out lactose intolerance or bacterial overgrowth and also ask questions to rule out laxative abuse.

Because IBS symptoms can be triggered by stress and emotional conflicts, doctors ask questions to help identify stress, anxiety, or mood disorders. Treatment differs from person to person. If particular foods or types of stress appear to bring on the problem, they should be avoided if possible. Some of the treatment solutions may include eating habits changes and diet management.


We recommend that people experiencing gastrointestinal symptoms do not attempt self-treatment. With many medications being available over the counter, and numerous do-it-yourself online unqualified remedy recommendation, it is natural to consider treating yourself but we highly recommend against this.

If you are experiencing gastrointestinal symptoms you may have a more significant issue than you would expect from the sometimes muted or infrequent symptom you may be experiencing. It is important to keep in mind that is you are having gastrointestinal symptoms or concerns it is best see a doctor to have those symptoms diagnosed and any conditions treated. Also, it is worth noting, that if health conditions do exist, the earlier they are diagnosed and treated, the greater the probability will be to successfully eliminate or manage a present condition, in fact successful outcomes will increase significantly with early detection.

If you have gastrointestinal concerns or are experiencing any gastrointestinal symptoms, please contact us promptly to schedule a consultation with a physician.


The information on this website is to provide general information. In no way, does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a best in class physician regarding ANY and ALL symptoms or signs as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today at (215) 321-4700 to schedule a consultation.