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JAMA Patient Page
March 3, 2015

Irritable Bowel Syndrome

JAMA. 2015;313(9):982. doi:10.1001/jama.2015.0958

Irritable bowel syndrome (IBS) is a common cause of stomach pain, cramping, and changed bowel habits.

What Causes IBS?

Irritable bowel syndrome can disrupt normal routines. But it is not life-threatening. Nor is it related to a higher risk of cancer. It has many causes. For example, your bowels might contract abnormally. You might have changes in the bacteria in your bowels. Or you might be sensitive to stress or certain foods. Sometimes these conditions can be triggered by severe infections. Other causes are possible. A Clinical Review in the March 3, 2015, issue of JAMA provides more information on IBS.

What Are the Symptoms?

  • Stomach pain or cramping

  • Changes in bowel habits (diarrhea, constipation, or both)

  • Stomach bloating or distention

  • Intense urges to move your bowels. These urges may not be related to having a bowel movement.

Symptoms are often related to eating. Having a bowel movement often improves IBS pain. Symptoms of IBS can change. Your doctor might suspect another disorder if your symptoms started after age 50 years or if you have a family history of other bowel disorders. Your doctor also might suspect another disorder if you have

  • Unexplained weight loss

  • Diarrhea at night or blood in your stool

  • Unexplained iron deficiency

What Makes the Symptoms Worse?

  • Certain foods. Examples include those that contain lactose, fructose, or some other carbohydrates. Other examples are foods that contain gluten (found in wheat).

  • Stress or anxiety

  • Certain over-the-counter and prescription drugs

  • Menstrual periods

  • Severe infections affecting the stomach or bowels. Examples include “traveler’s diarrhea” or “food poisoning”

What Can Be Done?

Doctors can diagnose IBS based on typical symptoms and a few simple tests. But doctors don’t have reliable tests to determine the precise cause of IBS. No single treatment works for everyone. So finding the right treatment can take time and patience.

Treatments include

  • Diet change. You might, for example, stop eating gluten or certain carbohydrates. Ask your doctor or dietitian.

  • Exercise

  • Dietary fiber or fiber supplements (if you are constipated)

  • Over-the-counter and prescription drugs

  • Reducing stress or changing behaviors

  • Treatments that affect the bacteria in your bowels. Your doctor might suggest probiotics. These provide helpful bacteria. Your doctor also might also suggest certain antibiotics. These change the type of bacteria already in your bowels.

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For More Information

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA’s website at jama.com. Many are available in English and Spanish.

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
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Article Information

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Sources: International Foundation for Functional Gastrointestinal Disorders, IBS Self-help and Support Group, American College of Gastroenterology, American Gastroenterological Association

Topic: Gastroenterology