Irritable Bowel Syndrome (IBS)

Irritable Bowel Syndrome (IBS), previously referred to as spastic or nervous colon or spastic bowel, is a functional gastrointestinal disorder. This means that the bowel displays symptoms even though it is healthy and normal.

In other words, the intestines do not show any inflammation or other abnormalities, for example, during endoscopy. In addition to abdominal pain, the syndrome causes gastrointestinal issues. The symptoms may be similar to, for example, inflammatory bowel diseases or coeliac disease. If you have persistent stomach or bowel symptoms, we recommend seeing your doctor to find out the cause. It is important to rule out the possibility of illness.

What causes IBS?

There are a number of causes of IBS and they vary from person to person. Some people's stomachs are more sensitive than others. Irritation of the intestine may occur as a result of:

  • stress,
  • certain food items,
  • irregular meal patterns,
  • eating in a hurry, and
  • excessive food intake.

Stomach flu and bacteria as a reason for stomach problems

Gastric diseases, such as norovirus, as well as germs picked up when travelling, such as campylobacter, salmonella and protozoa, can also cause irritation in the intestine. For some people, the bowel calms down after the virus or bacterial infection has passed, while others discover that they now have a recurring case of IBS.

Symptoms of IBS

Symptoms of IBS include abdominal pain, diarrhoea and constipation. The symptoms may fluctuate between constipation and diarrhea. For some, the same symptom will recur over and over again, whereas for others, the symptoms will vary. Abdominal pain often eases after defecation. Many people with IBS experience bloating in the evening. The symptoms may also include a sudden need to defecate, a feeling that the bowel is not emptying properly, and mucus in the stool. Abdominal symptoms may be accompanied by urinary problems, headache, heartburn and non-cardiac chest pain. The symptoms may go away once in a while and then come back.

If the diarrhoea or constipation is severe, there is blood in the stool, you experience weight loss or fever, or you need to get up to defecate even during the night, the cause may be something more serious than IBS. In that case, we recommend seeking medical attention.

Diagnosing IBS

The doctor discusses the issue with the patient and, based on the discussion, may arrange laboratory tests, such as blood tests and stool samples. These may already indicate whether the symptoms are caused by something more serious than IBS. Blood tests can show signs of, for example, coeliac disease or inflammatory bowel diseases, and suspected lactose intolerance may be confirmed by a blood sample. If necessary, the doctor will also arrange a colonoscopy and a gastroscopy.

If no organic disease is found, the most likely answer is IBS. While IBS is not dangerous, it can be very unpleasant and uncomfortable.

Treatment of IBS

Regular routines and meals are the most important tool in treating IBS. Patients are advised to try to avoid stress as it often aggravates the symptoms. Exercise and adequate fibre intake are important, especially for those suffering from constipation. While it may seem like the symptoms are caused by certain foods, actual hypersensitivity to nutrients is rare. The FODMAP diet may help reduce bloating, flatulence and, as a result, abdominal pain. People on the FODMAP diet avoid carbohydrates that are poorly absorbed in the small intestine and ferment in the colon.

If the basic tests have been carried out and the doctor has diagnosed IBS, you can also use antidiarrhoeal and constipation medication as instructed by your doctor or pharmacist. Fibre products can help balance the functions of the bowel and can be safely used for the rest of your life, if necessary. There are also prescription medications for severe abdominal pain.

Prevalence of IBS

Studies show that 5–25% of westerners suffer from IBS at some point in their lives or from time to time. The syndrome is twice as common in women as in men.

The expert interviewed for the article is Satu Väkeväinen, D.Med.Sc, gastroenterologist. Learn more about Satu’s expertise and book an appointment

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Specialists and locations

Markku Aarnio
Gastrokirurgian erikoislääkäri, LT, Dosentti
Samuli Aho
Gastroenterologisen kirurgian erikoislääkäri
Jussi-Pekka Haikio
LL,Sisät.- ja gastroenterologian erikoislääkäri
Satu Haikio
Gastroenterologian ja sisätautien erikoislääkäri