FAQs
FREQUENTLY ASKED QUESTIONS

From: holmes@mrx.webo.dg.com (Chris Holmes)
Archive-name: medicine/irritable-bowel-syndrome-faq
Posting-frequency: every two weeks
Last-modified: 1994/12/02
Version: 1.1.1


Irritable Bowel Syndrome
Frequently Asked Questions

Version 1.1.1 - 12/2/94
Author: Laura J. Zurawski (juniper@uiuc.edu)

INTRODUCTION

This FAQ deals primarily with questions and problems associated with 
Irritable Bowel Syndrome (IBS).  The newsgroup alt.support.crohns-
colitis, on which this FAQ can be found, may look like it only deals 
with Crohn's Disease and Ulcerative Colitis, but frequenters of the 
groups also discuss IBS, thus, the need for an IBS FAQ.

For a more detailed description of alt.support.crohns-colitis, Crohn's 
Disease, and Ulcerative Colitis, please refer to the "Inflammatory Bowel 
Disease Frequently Asked Questions" FAQ, which is posted to 
alt.support.crohns-colitis once a month.

COPYRIGHT AND DISCLAIMER

See end of FAQ for complete use and distribution information, and all 
applicable disclaimers.  This FAQ is by no means meant to be a 
replacement for proper medical treatment from a qualified caregiver.  
You should always check with your doctor if you have any concerns about 
your condition, or before attempting any new treatment program.

OTHER RESOURCES OF INFORMATION

- alt.support.crohns-colitis Information Resources FAQ, posted monthly
  on this newsgroup

- WWW page for bowel disorders: http://qurlyjoe.bu.edu/cduchome.html
  (sorry for the error in last month's post)
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QUESTIONS COVERED IN THIS FAQ

1.1: What is Irritable Bowel Syndrome?
1.2: Who gets IBS?
1.2.1: What factors contribute to the onset of IBS?
1.3: What effect does IBS have on one's lifestyle?

2.1: What are the symptoms of IBS?
2.1.1: How severe are these symptoms?

3.1: How exactly does IBS affect the colon?
3.2: Is IBS life-threatening?
3.2.1: Will IBS lead to cancer?
3.2.2: Will IBS lead to IBD (Crohn's, ulcerative colitis)?
3.3: Will my IBS eventually go away, or is it for the rest of my life?

4.1: How do I know for sure if I have IBS?
4.1.1: What medical tests are regularly given for diagnosing IBS?
4.1.2: Is IBS really a "cop-out" diagnosis?  Should I just accept it?

5.1: What are the standard treatments for IBS?
5.1.1: What is fiber therapy?
5.1.2: What sort of dietary modifications are required?
5.1.3: What conventional prescription medications are used to treat IBS?
5.1.4: Are there any natural or herbal remedies for treating IBS?
5.2: How can stress affect IBS?
5.2.1: How can keeping a record of my symptoms and triggers be helpful?
5.3: With all these different treatments, how do I know which will
	 work for me?

6.1: How does IBS differ from Crohn's disease or ulcerative colitis?

7.1: How does IBS differ from gluten enteropathy/celiac disease?
------------------------------------------------------------------------

1.1: What is Irritable Bowel Syndrome?

Irritable Bowel Syndrome, also known as "Spastic Colon", "Irritable 
Colon", and "Mucous Colitis", is a surprisingly common affliction in 
this day and age.  It is one of the most common complaints treated by 
gastroenterologists.  It is characterized by a wide range of symptoms, 
including but not limited to frequent diarrhea and/or constipation and 
abdominal pain.

1.2: Who gets IBS?

IBS usually surfaces in the early to mid-twenties of adulthood.  It 
affects about twice as many women as it does men in the United States.

1.2.1: What factors contribute to the onset of IBS?

Some factors contributing to its onset are stress level, diet, lack of 
exercise, or genetics.

1.3: What effect does IBS have on one's lifestyle?

Symptoms and effects can range anywhere from barely noticeable to 
frequently debilitating.  Namely, it hits some people harder than 
others.  Each person's IBS is different, which is why it is so often 
difficult to diagnose and treat properly.

--
2.1: What are the symptoms of IBS?

Everyone's set of individual symptoms is different, which is why it is 
often so difficult to diagnose it in a patient.  A person with IBS may 
experience one, several, or all of the following symptoms: 

- frequent diarrhea

- frequent constipation

- excessive intestinal gas (flatulence)

- abdominal pain, usually below the navel, and can be sharp and sudden,
  or dull and achy

- "marked urgency", i.e. an overpowering and immediate urge to have to   
   use the bathroom

- presence of mucous in the stool (but no blood)

- increased sensitivities to certain foods (common offenders are 
  dairy, wheat, raw vegetables, high-fiber foods, fried foods, very
  spicy foods, but can be anything depending on the person)

- possible weight loss, fatigue, lack of energy associated with above 
  symptoms

- nausea

2.1.1: How severe are these symptoms?

It depends on the individual, and the time in that individual's life.  A 
person can have IBS yet his or her symptoms will only surface at 
particular times and be "dormant" at other times, or a person may have 
to deal with his or her symptoms every day.  Often, IBS will have it's 
"good" periods (when symptoms are not as severe) and "bad" periods (when 
symptoms are at their worst).

--
3.1: How exactly does IBS affect the colon?

IBS is characterized as a "motility disorder".  Namely, the normal 
contracting motions of the colon are in some way altered -- either the 
colon moves too slowly (resulting in constipation), or too quickly 
(resulting in diarrhea), or it can go in to spasm in certain areas, 
causing abdominal pain, trapped gas, and similar maladies.

3.2: Is IBS life-threatening?

No.  Since the problem is in the motility of the colon, and not caused 
by an inflammation or infectious agent, there is minimal risk of IBS 
becoming life-threatening.

3.2.1: Will IBS lead to cancer?

No.  

3.2.2: Will IBS lead to IBD (Crohn's, ulcerative colitis)?

It is possible to develop IBS in association with an IBD, but generally  
not the other way around.  Most people who are diagnosed with IBS and 
eventually realize they have UC or Crohn's are certain that they had had 
the UC or Crohn's all along, but were simply misdiagnosed with IBS 
previously.  

3.3: Will my IBS eventually go away, or is it here for the rest of my life?

Some people have reported that their IBS symptoms went away completely 
after a certain amount of time or a major change in their lifestyle or 
treatment program.  Other cases have reported having to deal with IBS 
for life.  Again, it depends on the individual.

--
4.1: How do I know for sure if I have IBS?

The ONLY way to be absolutely certain you have IBS is through a doctor's 
diagnosis.  A doctor (a *good* doctor, at least) will rule out any 
possibility of Inflammatory Bowel Disease (IBD) before even considering 
an IBS diagnosis.  Also, it is good to rule out intestinal parasites and 
other afflictions of the lower digestive tract (polyps, diverticulitis, 
obstruction, etc.) and be completely sure that there is nothing else 
wrong with the colon before giving a diagnosis of IBS. 

4.1.1: What medical tests are regularly given for diagnosing IBS?

Tests given are almost always for the express purpose of ruling out 
other afflictions.  There is no test for IBS itself.
Common medical tests a gastroenterologist may prescribe include: 

- Lower G.I. x-ray (a.k.a. the barium enema)

- Small bowel series x-ray

- Stool parasite culture

- Flexible sigmoidoscopy and/or colonoscopy

- Nutrient absorption tests (these usually require blood or stool
  sample)


4.1.2: Is IBS really a "cop-out" diagnosis?  Should I just accept it?
 
Only if NO evidence of existing disease, parasite, nutrient absorption 
problem, or severe food allergy can be found should a doctor finally 
diagnose IBS.  If you suspect that you have not had a thorough enough 
examination for other afflictions before the doctor tells you that you 
have IBS, you should seek a second opinion.

Many times a person may think that he or she is being "slighted" by 
being given a diagnosis of IBS.  Unfortunately, to some doctors, IBS is not 
considered a "true" disease, but rather an unimportant minor condition 
(when in reality it is hardly all that "minor" to those who have to deal 
with it), and therefore may not be given the medical attention it  
deserves.  Don't despair; there ARE competent doctors out there who are 
very good at dealing with IBS cases.  A good doctor won't just tell you 
that you have IBS and give up on you.  He or she should be willing to go 
over your questions and concerns, and outline and monitor a program of 
treatment for your individual case of IBS.

--
5.1: What are the standard treatments for IBS?

Since each person's IBS is unique, therefore there really 
is no *one* good general treatment for IBS.  Different things work for 
different people, and unfortunately the only way to know exactly what 
works for you is by trial-and-error. 
 

5.1.1: What is fiber therapy?

Fiber therapy involves incorporating more dietary fiber (also called 
bulk or roughage) into the diet.  The premise behind this treatment is 
to add bulk to the stool, which aids in both constipation and diarrhea.

Fiber can be added to the diet through the eating of more fiber-rich 
foods, or by taking fiber supplements (common brands are Metamucil, 
Citrucel, and FiberCon).

5.1.2: What sort of dietary modifications are required?

In some cases, IBS symptoms may be triggered by certain foods. To 
determine what triggers one's symptoms, often one will have to start 
with a very basic, bland diet and gradually add one new food a day and 
record any symptoms associated with that food.  Any food found to be a 
trigger for symptoms should then be eliminated from the diet.

5.1.3: What conventional prescription medications are used to treat IBS?

Conventional medications used in the treatment of IBS include (but are 
not limited to):

	- Anti-spasmodic drugs like Bentyl and Levsin

	- Anti-depressant drugs like Elavil 

	- Over-the-counter antacids/anti-gas medications

	- Over-the-counter IBS medications ("Equalactin")


5.1.4: Are there any natural or herbal remedies for treating IBS?

It has been shown that peppermint and other herbs that calm the 
digestive system can sometimes be helpful in providing relief for 
certain symptoms.  Some people also claim to benefit from other
forms of natural or "alternative" medicine such as acupuncture, 
biofeedback, nutritional and/or vitamin therapy, massage therapy,
and various others.  **Note, though, that herbal and other forms of 
alternative medicine are not accepted by the medical profession as 
legitimate yet, and should only be used under the supervision of a 
qualified practitioner.**


5.2: How can stress affect IBS?

Many people attest to the fact that stress affects their IBS symptoms.  
The effects of stress on IBS symptoms vary from person to person, but it 
has been suggested that stress management is often beneficial to IBS 
patients.

5.2.1: How can keeping a record of my symptoms and triggers be helpful?

This will help you to be more aware of what foods or activities are 
detrimental or helpful to your condition.  By identifying a pattern of 
foods or activities that cause your symptoms to flare up, you will know 
what to avoid in the future to keep your symptoms more effectively under 
control.


5.3: With all these different treatments, how do I know which will
	 work for me?

The only way to know for sure which treatment will work best for you is 
to consult your doctor and discuss which method of treatment would be 
best for you.  Sometimes, one has to try several different treatments 
before finding the one that will work the best.  The important thing is 
not to get discouraged -- there is something that is right for you.

--
6.1: How does IBS differ from Crohn's disease or ulcerative colitis?

IBS differs from IBD's like UC and Crohn's in that there is usually NO 
trace of blood in the stool, whether the problem be diarrhea or 
constipation or both, and there is no trace of damage to the intestine 
that shows up an any medical tests.  Those are a few of the keys to 
recognizing IBS that doctors may use.  Also, unlike IBD, IBS is a 
strictly functional disorder, meaning that there is no part of the colon 
that is "diseased"  or inflamed, as is the case with UC and Crohn's.

--
7.1: How does IBS differ from celiac disease?

People with celiac disease experience marked intestinal symptoms such as 
diarrhea and gas upon the consumption of foods that contain gluten, such 
as products made from wheat, oats, rye, and barley.  Upon the 
elimination of gluten-containing foods, the symptoms disappear.
Some people with IBS may experience an aggravation of symptoms with the 
consumption of similar wheat-related products, but it is not these foods 
that actually cause the symptoms.

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NOTICE: This document is the sole work and property of the author.  It 
may not be redistributed or sold for profit in ANY WAY without consent 
of the author. Permission is granted for the copying of this document 
ONLY for one's own personal use or redistribution to others on a 
strictly informational and NON-profit basis, provided that: A.)the 
document is not edited or modified in any way, B.)the author is not held 
responsible or liable for its content (see disclaimer below), and 
C.)this notice and the disclaimer below remain attached in their 
entirety.

DISCLAIMER: this FAQ is provided by the author as a supplement to the 
newsgroup alt.support.crohns-colitis, and is meant as supplemental 
material only.  In no way is this document meant to be a substitute for 
professional medical care or attention by a qualified practitioner, nor 
should it be implied as such.  ALWAYS check with your doctor if you have 
any questions or concerns about your condition, or before starting a new 
program of treatment.  The author is strictly a fellow IBS patient 
speaking from her own experience and research, and is _not_ a doctor.  The 
author is not responsible or liable, directly or indirectly, for ANY 
form of damages whatsoever resulting from the use (or misuse) of information 
contained in or implied by this document.

--
ACKNOWLEDGMENTS: This FAQ was written using the information the author 
has acquired from a great many sources during the eight years which she 
has lived with IBS.  These sources are mainly licensed 
gastroenterologists, especially Eric J. Yegelwel, Arlington Heights, 
Illinois.  The author wishes to thank Dr. Yegelwel for his help and 
support over the years.

The author would also like to acknowledge the following people for their 
suggestions, contributions, and references for this FAQ:

Susan Blanc
Jeanne Zurawski
Elliott B. Hammett
Christopher Holmes
Michael Bloom
Bill Robertson
the readers of alt.support.crohns-colitis
------------------------------------------------------------------------
Please send all comments, suggestions, corrections, or ideas for
improvement of this FAQ to: juniper@uiuc.edu
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   Christopher G. Holmes   |     Data General Corporation, Westboro, MA
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Last reviewed: By John M. Grohol, Psy.D. on 15 Sep 2002