Irritable bowel syndrome (IBS) is extremely common, in fact 20 to 40% of all visits to gastroenterologists are due to IBS symptoms.

IBS is a disorder that affects the large intestine (colon) and it occurs in people of all ages, even children. As many as 10 to 20 percent of the adult population have symptoms of IBS.

Although the symptoms of IBS can be extremely troubling, it does not damage the intestines.

Symptoms
Symptoms are unpredictable and vary from person to person. The severity can range from mildly bothersome to severely disabling. Symptoms may subside for a few months and then return, or they may be persistent and worsen over time.

In general a person with IBS has abdominal pain, cramping, bloating, constipation, and diarrhea. Some people will have constipation while others will have diarrhea. In some cases the constipation will alternate with diarrhea. The abdominal discomfort or pain are usually relieved with a bowel movement.

Other symptoms of IBS may include heartburn, early feeling of fullness, nausea, abdominal fullness, bloating, intermittent upper abdominal pain, feelings of urgency (sudden urge to find a restroom), and a feeling of incomplete bowel emptying.

Bleeding, fever, weight loss, and persistent severe pain are not symptoms of IBS and may indicate other more serious problems.

Cause
The exact etiology of IBS is not clear, but a common theory is sensitivity to certain foods and stress. IBS is not caused by stress, however, symptoms can be exacerbated or triggered by stress.

Diagnosis
There is no specific test for IBS, however, it is important to be evaluated by your health care provider.

Make the most of your visit by completing and taking a symptom diary. This information will greatly help your health care provider diagnose and manage your condition.

In most cases, tests will be needed to rule out other more serious diseases. These tests may include blood tests, stool samples, x-rays, and a sigmoidoscopy or colonoscopy.

Irritable bowel syndrome linked with allergies
People with allergies appear to be more likely to have irritable bowel syndrome (IBS) than do those without allergies. The researchers noted that "identifying the allergic triggers, both inhaled and ingested, as well as appropriate treatment of the allergies, can markedly improve the patient's quality of life by controlling the symptoms." Annals of Allergy, Asthma and Immunology, January 2008.

Sugar-free gum or candy can be cause of chronic diarrhea, bloating & abdominal cramps
Sorbitol-sweetened sugar-free gum or candy, in large enough amounts, can be the source of chronic diarrhea and functional bowel problems as well as substantial unintended weight loss. Sorbitol is one of the most commonly used artificial sweeteners in chewing gum and candy as well as liquid medications. It is poorly absorbed in the intestines and it becomes an osmotic laxative at higher doses. In a recent case report published in the Brittish Medical Journal, patients who chewed 16 to 20 sticks of sorbitol-sweetened gum daily lost about 20% of their usual body weight.
BMJ, January 2008

• Daily intake of sorbitol as low as 5 g (the equivalent of four sticks of sugar-free gum) can cause gas, bloating, and abdominal cramps. MedPage Today January 2008

• Irritable Bowel Syndrome from the International Foundation for Functional Gastrointestinal Disorders
• Irritable Bowel Syndrome from the National Digestive Diseases Information Clearinghouse (NDDIC), a service of the National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Health

Written by N Thompson, RN, MSN, ARNP and M Thompson, MD, Internal Medicine, Last updated February 2008