There's A Pain In My Gut: Irritable Bowel Syndrome

"My stomach hurts all the time."

"Whenever I eat anything, it seems almost immediately that I have to go to the bathroom, and then have diarrhea."

"I'm always getting stomach cramps."

"The slightest thing happens in my life and there goes my stomach."

These, and similar kinds of concerns, are some of the most common problems that patients report to their family doctor (AKA primary care physician, PCP). Irritable Bowel Syndrome (IBS) is estimated to affect up to 17% of the U. S. population. Between 13 and 50% of new patient referrals to Gastroenterologists (physicians with a specialty in the digestive tract and gut) apparently have IBS. The key fact here is that a thorough medical examination is necessary to rule out other possible disorders which range from mild food allergies all the way to cancer.

Current medical practice standards suggest a diagnosis of IBS when a patient presents with:

• Abdominal pain or cramping or severe tenderness
  
• Altered bowel habits (diarrhea/constipation)
  
• Symptoms have lasted at least three months
  
• No irritable bowel disease, intestinal parasites,lactose intolerance, malabsorption syndrome or other GI disease.

The gut is one of the most stress responsive organs of the body. This is because in response to stress, we often find:

• Increased blood flow to the gut
  
• Increased pressure in the rectal area
  
• Increased contractions of the large intestine

Like many medical conditions, IBS symptoms are stress responsive:

• Daily hassles are associated with IBS symptoms
• Onset of IBS is often associated with major life stressors: separation or divorce, court appearance, death of a relative

There are many theories of what causes IBS, and a number of medical treatments can be helpful. Consultation with a primary care physician or gastroenterologist is necessary to rule out other serious medical conditions and to identify potentially helpful treatments. Psychological treatments that have been found helpful for IBS include relaxation training, cognitive-behavior therapy (CBT) and hypnosis.