Question

I have had stomach problems for over 30 years. I can't eat acidic foods, roughage, or dairy products without having severe intestinal cramps, followed by very mucous stools. I have had tests done, but they always come back negative. Could it be Irritable Bowel Syndrome?

Answer

Irritable Bowel Syndrome (IBS) is a very common disorder. Many persons have typical symptoms of the condition at some point in their lives. However, some have these symptoms on a very frequent basis. The symptoms include abdominal cramps (often in the lower left side of the abdomen), which often occurs after eating and which typically improve after a bowel movement. The stool may be loose or hard and diarrhea and/or constipation may occur. Often these two occur at different times and may alternate. Mucus in the stool is a common finding.

These symptoms are not very specific, as other gastrointestinal (GI) problems may have similar effects. Thus, before diagnosing IBS, other disorders, such as colitis, must be ruled out. Often endoscopic exams (putting a 'telescope' into the large intestine) are done, in addition to various blood tests.

Certain symptoms, such as weight loss, bleeding, fever, and severe pain that wakes the patient from sleep are not consistent with IBS, and another diagnosis should be sought. Your description of your symptoms and the length of your problem are certainly consistent with IBS. It sounds as though various tests have failed to diagnose another disease.

Treating IBS can be very difficult. We do not know what causes IBS, and thus the therapy cannot be properly targeted. It is known that IBS is a complex interplay between a hypersensitive intestinal tract, the brain's ability to sense the extreme sensitivity, and abnormal contractions in the muscle of the intestines. Various drugs such as antispasmodics, fiber supplements, medications for diarrhea and constipation, and even anti-anxiety drugs are used in various combinations in patients to achieve symptom relief. Newer, more specific, medications have recently been introduced, so that the picture is improving. Close follow-up with your doctor is imperative to evaluate your response to any medication and to decide if another one, or a combination, may be more effective. IBS is a chronic disorder, but not a progressive one, and should be managed with the expectation that treatment must continue for some time.

Links

• IBS - Recent Advances
• A Psychologist has Irritable Bowel Syndrome - Part 1: Understanding the Problem