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DEAR MAYO CLINIC: For the past year or so, I feel like I am often either constipated or I have diarrhea, with only a few “normal” days here and there. I have a friend who has IBS, and she suggested I be tested for it as well. But my symptoms are not as severe as hers. Would you suggest I see a doctor about my symptoms?
ANSWER: Irritable bowel syndrome, or IBS, can cause the symptoms you describe, but other medical conditions can trigger them, too. It would be a good idea to see your doctor and talk to him or her about your symptoms. Although no specific test to diagnose IBS exists at this time, your doctor can then decide whether additional tests are needed to rule out other disorders.
IBS is a disorder that affects the intestines. It’s not clear what causes IBS, but several factors seem to play a role in its development. The walls of the intestines are lined with layers of muscle that contract and relax in a coordinated rhythm as they move food — which later becomes waste — from your stomach through your intestinal tract to your rectum. If you have IBS, the contractions may be stronger and last longer than normal. That can lead to abdominal pain or discomfort as food, gas or stool passes through the GI tract. IBS is also associated with bowel irregularity — sometimes diarrhea, sometimes constipation, sometimes both. Common associated symptoms can include gas and bloating.
Both adults and children can get IBS. But the condition often begins in the early twenties, and it tends to affect women slightly more often than men. The exact symptoms of IBS and the severity of those symptoms can vary from one person to another. Although symptoms may come and go, for most people diagnosed with it, IBS is a chronic, lifelong condition. Estimates suggest that about 10 to 15 percent of the population in the United States has IBS.
An evaluation for IBS typically involves a comprehensive assessment of your symptoms and your medical history, along with a thorough physical exam. No other testing usually is necessary beyond that if your symptoms are typical of IBS. Depending on your situation, your doctor may recommend additional tests to rule out other causes for your symptoms, since there are other conditions that can cause pain, diarrhea and constipation. This may happen if your symptoms are severe, if there is a family history of a GI condition, or if you are experiencing other symptoms that are not typical of IBS (for example, bleeding).
If you do have IBS, treatment for the disorder typically focuses on controlling the symptoms. For people with mild to moderate IBS, diet changes can often make a big difference. The specific changes needed depend on whether you are dealing with diarrhea, constipation or both. Some people with IBS find it helpful to work with a dietitian to identify healthy food choices that won’t trigger their symptoms. For more severe forms of IBS, a number of over-the-counter and prescription medications are available to help reduce symptoms.
If you feel like your symptoms are interfering with your daily life, make an appointment with your doctor to review your condition and decide on next steps. If IBS is the diagnosis, it is likely that there are therapies that can relieve your discomfort and help you feel better. — Yuri Saito, M.D., M.P.H., Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minn.