Irritable Bowel Syndrome :: Nationwide Children's Hospital

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Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a disorder of the colon (large intestine). The colon is the part of the bowel that connects the small intestine with the anus (Picture 1). The colon absorbs water and salt from the waste products left over after the digestion of food. After most of the water and salt are absorbed, the rest of the waste is passed into the rectum as stool.

Picture 1 - The gastrointestinal system inside the body.
Image of GI system

Movements of the colon are partly controlled by nerves. The nerves make the colon contract in a rhythm to push the stool toward the rectum. In IBS, the movements of the colon do not work in rhythm.

When the lower part of the colon contracts abnormally, there is a spasm. This spasm produces diarrhea or pain. The abnormal spasm may also cause constipation.

How Diet and Stress Affect IBS

Diet and stress are factors that may also trigger symptoms of IBS. Many people with IBS notice symptoms after a meal or when they are under stress. Normal contractions of the colon after a meal can cause cramping pain. Stress may also stimulate spasms of the colon, because the movement of the colon is partly controlled by the nerves. However, the way stress affects the colon is not clearly understood.

Symptoms of IBS

Signs and symptoms of irritable bowel syndrome include:

  • Abdominal pain (usually in the lower abdomen, often on the left side)
  • Constipation or diarrhea
  • Bloating (a feeling of being "gassy")
  • Mucus in the stools

How IBS Is Diagnosed

IBS can be diagnosed after the doctor takes a history and does a physical exam. Tell your doctor if other members of your family have IBS. Before making a diagnosis of IBS, your child's doctor may also do some tests (such as a proctoscopy or colonoscopy) to see if there
are other problems. (Refer to the Helping Hand: Proctoscopy or Sigmoidoscopy, HH-III-23.)

How IBS Is Treated

The amount IBS is treated by diet, exercise, and medicine. It is important to understand that IBS may be a lifelong problem but can be controlled.

Avoiding the following foods and ingredients may decrease IBS symptoms:

-Fructose (Be sure to read the labels.)

-Milk and milk products (if the child is not able to digest milk sugar)

-Caffeine (in tea, coffee, colas, real chocolate and some soft drinks such as Mountain Dew®)

-Nicotine (in tobacco)

-Fruit juices

-Sorbitol® (Be sure to read the labels.)

-Alcohol (including cough syrups)

  • If your child cannot eat foods such as milk, milk products and fruit juices, ask your doctor to refer you to a registered dietitian.
  • The amount of fiber in the diet should be increased to add bulk in the stool. Foods high in fiber include whole wheat bread, fresh fruits and vegetables and high fiber cereals. (Refer to the Helping Hand: Diet: High Fiber, HH-IV-1.)
  • Your doctor may also suggest forms of calcium supplements.
  • Medicine can be prescribed by your doctor to decrease bowel spasms.
  • Regular exercise helps to ease tension and reduce stress.
  • Education to reduce stress through relaxation techniques and biofeedback can also decrease symptoms of IBS.
  • Counseling to learn ways of coping with stress may also be effective in decreasing symptoms.

Follow-Up Appointments

Follow-up appointments with your doctor may be scheduled to help monitor your progress.

If you have any questions, be sure to ask your doctor or nurse, or call _____________________.

Irritable Bowel Syndrome (PDF)

HH-I-181 6/94, Revised 6/99 Copyright 1994-1999, Nationwide Children's Hospital

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