Definition: A condition of abnormally increased spontaneous movement (motility) of the small and large intestine, generally exacerbated by emotional stress.

Causes, incidence, and risk factors: Irritable bowel syndrome is characterized by a combination of abdominal pain and altered bowel function. The cause is a disturbance in the muscle movement (motility) in the large intestine; however, there is no abnormality in intestinal structure. The condition occurs more frequently in women and usually begins in those between 20 and 30 years old. Predisposing factors may be a low residue diet, emotional stress, bowel consciousness, and use of laxatives. The incidence is 5 out of 1000 people.

Prevention: For people prone to irritable bowel syndrome, symptoms are not always preventable. See Treatment for measures to reduce symptoms.

Symptoms:

diarrhea alternating with constipation for 6 months or more

diarrhea

abdominal pain following meals relieved by bowel movement

intermittent abdominal tenderness

abdominal fullness, gaseous, bloating abdominal distention

nausea

vomiting

loss of appetite

emotional distress

depression

Signs and tests: characteristic history. Tests usually reveal no abnormalities.

Treatment: The objective of treatment is to relieve symptoms. Changes in diet may help alleviate symptoms in some patients. No diet is applicable to all patients. Increasing dietary fiber and eliminating gastrointestinal stimulants such as caffeine containing beverages may be beneficial. Other possible treatment may include: anxiety reducing measures, such as regular exercise. anticholinergic medications before meals. Counseling in cases of severe anxiety or depression.

Expectations (prognosis): Irritable bowel syndrome may be a life-long chronic condition, but symptoms can often be improved or relieved through treatment.

Complications: discomfort, dehydration, malnutrition, and depression.

Last updated May 25, 1999

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