UNIVERSITY STUDENT HEALTH SERVICES • Fact Sheet IRRITABLE BOWEL SYNDROME
WHAT IS IT?
Irritable bowel syndrome (IBS) is a common condition of the intestines. For unknown reasons, the
intestines are overly sensitive to a variety of stimuli, such as food (the type or quantity), hormonal
changes (like the menstrual cycle), certain medications, stress, etc. Theories regarding possible causes
of this abnormality include changes in the nerves within the intestines, the central nervous system, and/or
the immune system.
IBS is also known as “irritable colon”, “spastic colon”, or “nervous colon”. IBS is not a “colitis” because it
does not involve inflammation of the colon. In fact, IBS is considered a “functional “ disorder because
there is no sign of disease when the colon is examined.
“Irritable bowel syndrome” is the most appropriate term to describe the condition because it refers to
gastrointestinal irritability related to the exaggeration of normal bowel patterns. While IBS can cause
much discomfort and distress, it does not result in permanent harm to the intestines and does not lead to
serious illnesses, such as cancer. Symptoms do not worsen over time, but symptoms do tend to recur.
HOW COMMON IS IT?
IBS is one of the most common gastrointestinal conditions, occurring in up to 15-20% of the population.
Symptoms usually appear during the late teens or early 20’s. IBS is also 2-3 times more common in
women than in men.
WHAT ARE THE SYMPTOMS?
Symptoms vary from person to person but can include:
™ Intermittent abdominal pain and fullness, including cramping that may go away after a bowel
movement.
™ Altered bowel habits (constipation, diarrhea, or alternating constipation and diarrhea).
™ Mucus in the stool.
™ Bloating and gas.
™ Feeling a strong urge to have a bowel movement.
™ Feeling like the need to have a bowel movement after already having one.
HOW IS IT DIAGNOSED?
No specific testing is diagnostic for IBS. The condition is often diagnosed based on a person’s pattern of
symptoms. Your health care provider may recommend testing (such as blood tests, stool tests, or a
colonoscopy) to rule out other, more serious causes of your symptoms.
HOW IS IT TREATED?
There is no specific treatment for IBS. The best way to treat IBS is to eat a healthy diet, avoid triggers
that cause symptoms, and learn to manage or decrease stress in your life. Relief of IBS symptoms is
often a slow process. Patience is extremely important. The goal is to discover long-term solutions that
work for your particular set of symptoms.
Diet
■ Eat more fiber (refer to the table on the next page).
There are 2 types of fiber:
™ Soluble fiber helps both diarrhea and constipation. It is digested by bacteria in the colon. Many foods
contain soluble fiber such as apples, beans, and citrus fruits. Psyllium, a natural vegetable fiber, is
also a soluble fiber. Metamucil is a psyllium supplement. Other soluble fiber supplements include
polycarbophil (Fibercon) and methylcellulose (Citrucel).
™ Insoluble fiber helps constipation by moving material through your intestines and adding bulk to your
stool. Insoluble fiber is found in whole grain breads, wheat bran, many vegetables, and the peels of
various fruits, such as apples and pears.
■ A high fiber diet keeps the colon mildly distended, possibly alleviating spasms. A fiber supplement can
be taken in addition to increasing high fiber foods. Begin these supplements once a day with a large
glass of liquid. If you do not notice improvement in 3-4 days, increase to twice a day. Make gradual
dietary changes. High fiber intake may cause gas and bloating initially, but these symptoms usually
resolve as your body adjusts to the change in diet.
■ Food does not cause IBS but may trigger or worsen symptoms. Keep a food diary to determine which
foods cause problems, and cut out foods that consistently cause distress. If cramping is an issue, avoid
fat and caffeine as they can cause your intestines to contract. If gas is a problem, avoid foods that may
increase intestinal gas (i.e. beans, cabbage, onions, broccoli, chocolate, alcohol, and milk products). Up
to 40% of those with IBS also have lactose intolerance.
■ Eat smaller meals more frequently, or just eat smaller portions. Large meals can cause cramping and
diarrhea.
■ Drink plenty of water. Avoid caffeine or decrease your intake of caffeine-containing products to see if
that makes a difference in your symptoms. Decaffeinated coffee may still cause symptoms due to its high
acidity. Carbonation can also increase gas and abdominal discomfort.
Stress
■ Learn new ways to cope with stress, such as relaxation techniques, meditation, yoga, etc.
■ Exercise regularly. Begin an aerobic form of exercise, and stick to it at least 3 times a week.
■ Consult your health care provider for other ideas about dealing with stress. Consider talking to a
counselor regarding problems you may be having.
Bowel Habits
■ Be sensitive to your body’s needs. Promptly answer the “urge” to have a bowel movement.
■ Avoid straining to have a bowel movement.
Medications
■ Prescription medications are available for IBS symptoms that do not respond to changes in diet and
lifestyle. Antispasmodic medications (such as Levsin or Bentyl) may be helpful if the main symptom is
pain. Lotronex is a medication that has been approved for treatment of IBS in women with severe
diarrhea who are not responding to conventional therapies. Restrictions of its use have been placed by
the FDA due to the possibility of serious side effects. Amitiza is another medication reserved for women
with severe constipation who are not responding to other treatments.
■ Avoid excessive use of laxatives as prolonged use can lead to electrolyte imbalances.
■ Imodium may be helpful if diarrhea is a frequent problem.
■ An antidepressant may be prescribed if your symptoms are severe and you are feeling depressed.
WARNING SIGNS
■ IBS is NOT associated with weight loss, bleeding with bowel movements, or fever.
■ Notify your health care provider if any of these symptoms occur or if you have a significant change in
bowel patterns.
RECOMMENDED WEBSITES
■ www.acg.gi.org
■ www.aboutibs.org
Bran, Whole Grains, Cereals
Raw Fruit (including skin and pulp)
Cooked or Dried Fruit
Raw Vegetables
Cooked Vegetables
HIGH FIBER FOODS
Bran cereals, bran muffins, brown rice, granola, whole grain
breads, whole grain cereals (Fiber One, Raisin Bran, Shredded
Wheat), unbuttered popcorn
Apples, berries, figs, grapes, melons, nectarines, oranges,
peaches, pears, plums
Applesauce, apricots, prunes, raisins
Carrots, cauliflower, celery, green pepper, lettuce, spinach
Asparagus, beans, broccoli, brussel sprouts, cauliflower, corn,
potatoes, rhubarb, spinach, squash, string beans, turnips
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Published by:
Wellness Resource Center & University Student Health Services
Virginia Commonwealth University / Division of Student Affairs and Enrollment Services
828-WELL
Revised 7/09