It is not known what causes IBS. A diagnosis of IBS may be confirmed by a history of the symptoms described above and by ruling out gastrointestinal diseases for which there are specific clinical signs. There is no cure for IBS, but there are treatments and helpful guidelines for diet, exercise, stress reduction and other effective disease-management techniques.

How diet and stress can affect IBS

It is thought that diet and emotional stress are likely triggers of IBS symptoms. For everybody, eating causes contractions of the colon. Normally this may lead to the urge to have a bowel movement, after 30 to 60 minutes. In a person with IBS, however, this can happen much more quickly and be accompanied by cramps and diarrhea.

Symptoms of IBS may also be caused by stress. Although the process by which stress can affect the colon is not fully understood, this does not mean that IBS is the result of a personality or mood disorder. Training and counseling for stress reduction help provide relief for some people.

How IBS is diagnosed

A blood test, x-ray or even colonoscopy (a visual examination of the colon), will not confirm the presence of irritable bowel syndrome. These tests are normal in the patient with IBS, yet the colon doesn't function normally.

While laboratory and other diagnostic tests cannot positively confirm IBS, they are often needed to rule out other diseases as a cause of the patient's symptoms.

A sound diagnosis of IBS may be made by an evaluation of symptoms according to the following criteria:

• 3 months or more of continuous or episodic abdominal pain that is relieved with bowel movement or associated with a change in bowel movement.
• 2 or more of the following, recurring for a period of at least 3 months:
  - Change in the frequency of bowel movement
  - Change in the stool, either too hard/lumpy or too soft/watery
  - Change in the way the stool passes, such as straining or feeling of urgency or of incomplete passing of stool
  - Passing mucus with stool Bloating, or feeling of gassiness

It's important for anyone dealing with IBS to realize that bowel function and regularity vary from person to person. 'Normal" can mean anything from three bowel movements per day to three per week. A normal stool is one that is formed but not hard, and is passed without cramps or pain.

What can be done to help?

Because of the wide range of symptom patterns in IBS, there is no one, standard way of treating it. Fiber supplements and (only) occasional laxatives may be recommended to treat the constipation. There are prescription drugs that may be used to control colon muscle spasms. Other drugs can be employed to slow the passage of digestive products through the system. Tranquilizers are sometimes used for patients with IBS as are antidepressants, for those who have depression as well.

Following a doctor's instructions regarding medication is, of course, always important, especially so with the use of laxatives, which can become habit-forming and dangerous, affecting both gastrointestinal and overall health.

A good diet for IBS

Many people with irritable bowel syndrome have found a way of eating that lessens their symptoms. A good way to do this is to keep a journal of those foods which seem to lead to episodes of IBS. Then you can discuss the specifics of diet with your doctor and a dietary specialist, who can help with recommendations for changing your diet.

Dairy products can cause IBS symptoms to flare up in many people with the illness; it may be recommended that you restrict these foods in your diet, or try to eat more yogurt than other dairy foods. (Yogurt contains an enzyme which helps the digestive system break down dairy foods.) If you are advised to limit dairy, make sure you understand how to substitute good sources of dietary calcium in its place.

Fiber in the diet is often an issue in IBS, but here again, there's a wide range of responses to the different kinds available in food. While whole-grain breads and cereals, beans, fruit, and vegetables are all good sources of fiber, you may have problems handling one or more of these in your particular diet. Some nutritionists recommend oat bran or rice bran as fiber sources for those who are allergic to wheat. Talk about this with your doctor and dietician.

One aspect of diet that may be true for most people with IBS is the need to avoid larger meals, and portions, when symptoms flare up. This should help, especially when you keep meals low in fat content.

Will IBS lead to other diseases?

There has been no connection shown between irritable bowel syndrome and any other serious diseases. No link to, or risk of developing, inflammatory bowel diseases such as Crohn's disease or ulcerative colitis has been established. Patients with severe IBS need to work with their healthcare teams so that the pain and diarrhea that accompany episodes of illness do not cause them to withdraw from life.