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"Irritable bowel syndrome (IBS) is a mixture of abdominal symptoms for which there&amp;#039;s no apparent cause. The symptoms are defined by the &amp;#039;Rome critera&amp;#039;, a diagnostic tool doctors use to diagnose IBS and include abdominal pain with either diarrhoea, constipation or a combination of the two.  It&amp;#039;s the most common condition seen by gastroenterologists, more common in women than men. Some estimates suggest that as many as one in five adults in the UK have IBS at any one time. The bowel and IBS  Your bowel, or gut, extends from your stomach to your anus. It is made up of the small intestine and the large intestine. Their job is to process food from the stomach. Other names for IBS  Irritable colon. Spastic colon. Mucous colitis.   These names are misleading because IBS is not limited to the colon and should be thought of as a multi-system disorder rather than confined only to the bowel itself. The small intestine absorbs nutrients from food and passes undigested food into the large intestine. In the large intestine, or colon, this waste product is processed into faeces. The normal bowel moves food along the intestines through muscular contractions known as peristalsis  The control of peristalsis is complex. The best way to regard IBS is as a loss of coordination of these muscular contractions. In addition, there&amp;#039;s evidence that people with irritable bowel syndrome have increased sensitivity within the gut to external stimuli, such as stress and is referred to as &amp;#039;increased visceral sensitivity&amp;#039;. This means IBS is often the outcome of a complex interaction between psychological and physical factors. A disorder of the digestive system can affect the gut anywhere from the mouth to the anus, which accounts for the diversity of symptoms seen in IBS.  What causes irritable bowel syndrome? How common is IBS?  IBS is more common in women. In the UK about 13 per cent of women and 5 per cent of men have IBS.  We don&amp;#039;t know what causes IBS.  About half of people with IBS date the start of their symptoms to a major life event \u2013 such as change of house or job, or bereavement. This suggests that there may be a psychological trigger for IBS. About 10 to 20 per cent of people will date the start of their symptoms to an acute gastroenteritis \u2013 an infection in the bowel that causes vomiting and diarrhoea. In the remainder of cases, the trigger factor remains unidentified.   Abnormalities in peristalsis can often be seen in close relatives of people with IBS, although without symptoms. This suggests a trigger sets off the condition in susceptible people. Nerve-signalling chemicals, particularly serotonin, appear to have an important role. A theory put forward is known as the brain-gut axis theory. In the bowel, serotonin is a &amp;#039;neurotransmitter&amp;#039; and is also seen in the brain. Ninety-five per cent of the bodies serotonin is in the gut.  It is thought that abnormal signals or impulses are transmitted between the gut and brain, which result in abnormal responses.  Medicines known as SSRIs or selective serotonin reuptake inhibitors, normally used in depression, can influence the symptoms that some sufferers have.  Another theory is small intestinal bacterial overgrowth (SIBO) theory.  The basis of this is abnormal population of the small bowel with inappropriate bacteria.  Treatment with antibiotic therapy and possibly probiotics (inert bacterial therapy to replace bacteria) has provided improvement in some people with IBS.  What are the symptoms of IBS? IBS and cancer Although IBS can be a distressing condition, it never causes bowel cancer or bowel damage.  IBS symptoms can start at any age, but they are most common in late teenage years or early adulthood. The most common symptoms are:  constipation abdominal pain diarrhoea a combination of constipation and diarrhoea bloating which that usually subsides overnight and returns the following day.  IBS symptoms normally occur during day time. Night time bowel symptoms are rare. Other symptoms  Heartburn and indigestion. Wind and bloating. Headaches. In women, abdominal pain pain during sex, known as dysparunia. Passing urine more often. Fatigue and tiredness. Sleep disturbance. Loss of appetite.  Nausea. Depressive symptoms in about a third of patients. Anxiety and stress-related symptoms, which may interact with gut symptoms.  When should I see a doctor? Because irritable bowel syndrome can mimic so many other intestinal disorders you should always seek advice from your doctor.   You should always see your doctor if you identify any of the following symptoms.  Difficulty in swallowing when food gets stuck.  Indigestion-type pain that wakes you up at night or persistent indigestion. Abdominal bloating that does not get better overnight. Significant and unexplained weight loss. Bleeding from the back passage. Chronic, painless diarrhoea.  In women, ovarian cancer can present with similar symptoms to IBS. How is irritable bowel syndrome diagnosed?  There is no single blood test, X-ray or scan that will diagnose IBS. The diagnosis is often made on the basis that typical symptoms are present, particularly in younger people who have had at least six months of change in bowel habit, abdominal pain and bloating.  Symptoms, such as pain relieved by opening your bowels and those made worse by eating and passing mucus from the rectum, will help to confirm that you are suffering from IBS. Blood tests may be taken to exclude other conditions such as coeliac disease, which can mimic IBS, and occasionally further investigations are performed. If you have symptoms of IBS and over the age of 50 years, more investigations are performed to ensure the diagnosis is correct \u2013 especially if there&amp;#039;s:  unexplained weight loss abdominal or rectal masses (unexplained lumps felt by your doctor in the tummy or back passage) rectal bleeding anaemia a family history of bowel or ovarian cancer  being aged over 60 with a change in bowel habit lasting over 6 weeks.   These may include:  gastroscopy \u2013 examination of the oesophagus, stomach and small intestine with a camera on the end of a long thin tube (endoscope) ultrasound  barium studies \u2013 a salt that shows up in X-rays of the stomach and intestines CT colonography (CTC) \u2013 an X-ray test that is used to detect bowel cancer when not fit for colonoscopy. colonoscopy \u2013 examination of the large intestine with an endoscope.  Is there anything I can do to prevent IBS?  Since the cause of IBS is unknown, it&amp;#039;s not possible to reliably prevent symptoms. The following strategies can help your digestive system and so may improve the condition.  FODMAP stands for:  F \u2013 Fermentable O \u2013 Oligosaccharides (kinds of sugars) in foods such as cereals, bread, biscuits, cakes, pasta  D \u2013 Disaccharides (lactose), for example, dairy foods  M \u2013 Monosaccharides (fructose) in fruit juice, honey, peas, jams, snack bars  A \u2013 and P \u2013 Polyols (sugar alcohols) found in fruits with stones and some vegetables, such as onions and leeks. Also found in artificial sweeteners and sugar-free gum.   Drink lots of water, preferably two litres a day. Avoid food or beverages that make the symptoms worse. Coffee and milk are frequent offenders. It may be helpful to keep a diary in which you note down the foods that seem to upset your stomach. Avoid strong spices and foods that give you wind. Brassicas, such as brussel sprouts, are a good example of vegetables that can cause wind. Avoid large meals, but eat regularly. Limit your alcohol intake.  A specific IBS diet may help your symptoms. A low FODMAP diet from Australia has helped some people with this condition and very specific diet types can be used depending on whether you have diarrhoea or constipation.   In the past, a high fibre diet was recommended, but this can cause worsening of symptoms in some sufferers.   The choice of diet should be discussed with a dietician or health care professional with an interest in irritable bowel syndrome.   What else can improve IBS?   Physical activity and exercise can improve digestion and reduce stress. Heat treatment with hot packs, hot-water bottles or electric blankets may relieve stomach pain. Try to reduce the amount of stress in your life. You might like to experiment with some of the different relaxation techniques, such as meditation. Cognitive behavioural therapy \u2013 a therapist helps you to alter your perception of IBS, any emotional issues you might have and change your behaviour to them. Hypnotherapy \u2013 hypnosis can help some sufferers with IBS. Try to keep things in perspective: excessive worrying about digestive problems could lead to social and psychological problems.  Which medicines are used? There is no single treatment to tackle all symptoms of IBS. Medicines should only be considered when lifestyle changes have failed to help symptoms and should be limited to when symptoms are particularly bad. Medicines can relieve specific symptoms of IBS, depending on which is giving you most trouble. But by controlling some symptoms, a medicine may make others worse.    Medicines called antispasmodics can relieve stomach cramps. Examples are Spasmonal, Colofac, Buscopan and peppermint oil.  If constipation is a major problem, bulk laxatives (Fybogel, Regulan, Isogel, Celevac) are usually tried first. More powerful types known as stimulant laxatives (Senokot, Dulcolax) are not usually recommended for IBS because they can cause cramping. Fybogel mebeverine contains ispaghula husk and mebeverine. Ispaghula husk helps with constipation while mebeverine acts as an antispasmodic to relieve stomach cramps. Medicines can treat gas and stomach rumbling in cases where these are a major problem. Examples are charcoal tablets and simethicone, an anti-foaming agent which disperses trapped gas in the stomach and intestine. Products that contain simethicone are Wind-eze, Windsetlers and Rennie deflatine. Antidiarrhoeals, such as loperamide (Imodium), can ease diarrhoea. Imodium plus also contains simethicone to ease cramps and bloating. Tricyclic antidepressants are sometimes used to relieve pain in people who have not responded to other treatments. SSRIs or selective serotonin reuptake inhibitors can be used as an alternative to the tricyclic antidepressants in people that have constipation predominant symptoms. Colestyramine (Questran) can help the small proportion of people with IBS whose diarrhoea is due to impaired handling of bile salts within the gut.  Long-term outlook IBS usually occurs periodically throughout life. The symptoms can:   improve get worse disappear for years.   Irritable bowel syndrome is not a life-threatening condition and cannot result in cancer or serious intestinal disease. An understanding of the syndrome and lifestyle changes is often all that is required for mild symptoms. In more severe symptoms, treatment with medicines, such as those mentioned above, will normally ease symptoms. Other people also read: Abdominal pain: What causes lower abdominal or pelvic pain? Diarrhoea: What causes diarrhoea? Constipation: What are the symptoms of constipation?  Based on a text by Dr Dan Rutherford, GP  Last updated 13.03.2014 "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.netdoctor.co.uk/conditions/digestive-health/a4906/irritable-bowel-syndrome-ibs/>