IBS is a condition that affects the large intestine and is characterized by alternating periods of diarrhea and constipation, abdominal cramps, and straining. It is sometimes called a spastic colon. It is not a disease and there is no cure for IBS, but it can be managed throughout life. IBS has a high incidence in women under 40 years of age, if there is a family history, and those with anxiety and stress. The same is true for children, but may include a history of gastroenteritis or food poisoning. The cause is not well defined. Normally, the muscles in your intestine contract and relax in rhythm, but in IBS the contractions can be stronger and longer, resulting in diarrhea, or weaker and slower, resulting in constipation. Poor communication between the brain and the intestines can cause a change in reaction time while digesting. Possible causes include anxiety, stress, hormones, laxative abuse, food or drug allergies, and lactose intolerance. In addition, diet appears to be an important factor, such as fiber, raw fruit, coffee, alcohol, spicy or highly seasoned foods, and cold foods.
Additional symptoms include abdominal pain, stools that are very thin and pencil-like, heartburn, mucus in the stool, bloating, gas, fatigue, and weakness. Tests include checking stool for blood, parasites, or bacteria, blood work, lower GI test, where a liquid barium is swallowed, x-rays, and sigmoidoscopy.
Complications of IBS include inflammation of the hemorrhoids and malnutrition. In children, seek medical attention if growth is poor, rectal bleeding, abdominal pain, difficulty swallowing, or vomiting or diarrhea at night.
Immediate treatment includes stress management and lifestyle change. Diet changes that are based on the patient’s symptoms. A food log will help identify foods that cause symptoms. List what you ate and any symptoms that appeared after the meal. Slowly add foods to your diet to allow you to adjust. If you have cramps or diarrhea, try following a low-fat, high-carbohydrate diet. Avoid high gas content foods such as cabbage, broccoli, cauliflower and raw fruit. Fatty foods, chocolate, alcohol, caffeine and carbonated drinks. Foods containing lactose, such as milk and cheese, as well as certain cereals, should be avoided. For children, avoid foods and drinks with sugar. Also, don’t let your child eat large meals. Increasing the volume of the diet with supplements and fluid intake helps control symptoms. Medications include high-fiber supplements to control constipation, such as psyllium (Metamucil), methylcellulose (Citrucel), milk of magnesia (MOM), and polyethylene glycol (Miralax). Hyoscyamine (Levsin) and dicyclomine (Bentyl) help stop spasms. Loperamide (Immodium) helps stop diarrhea. Other medications that can be used are laxatives and medications to treat nausea. For anxiety and stress, mild tranquilizers and/or an antidepressant may be prescribed. Aloestron (Lotronex) and Lubiprostone (Amitiza) are new drugs on the market and currently targeted treatments for women. Seek immediate medical attention if you experience rectal bleeding, ongoing abdominal pain, and weight loss.
