Topic Overview
What is irritable bowel syndrome (IBS)?
Irritable bowel
syndrome (IBS) is a disorder of the intestines. It causes belly pain, cramping
or bloating, and diarrhea or constipation. Irritable bowel syndrome is a
long-term problem, but there are things you can do to reduce your symptoms.
Your symptoms may be worse or better from day to day, but your
IBS will not get worse over time. IBS does not cause more serious diseases,
such as
inflammatory bowel disease or cancer.
What causes IBS?
It is not clear what causes irritable bowel syndrome, and the cause may be different for different people. Some ideas for what causes IBS include problems with the way signals are sent between the brain and the digestive tract, problems digesting certain foods, and stress or anxiety. People with IBS may have unusually sensitive intestines or problems with the way the muscles of the intestines move.
For some people with IBS, certain
foods, stress, hormonal changes, and some antibiotics may trigger pain and
other symptoms.
What are the symptoms?
The main symptoms of
irritable bowel syndrome are belly pain with constipation or diarrhea. Other
common symptoms are bloating, mucus in the stools, or a feeling that you have
not completely emptied your bowels.
Many people with IBS go back
and forth between having constipation and having diarrhea. For most people, one
of these happens more often than the other.
IBS is quite common.
Most people's symptoms are so mild that they never see a doctor for treatment.
But some people may have troublesome symptoms, especially stomach cramps,
bloating, and diarrhea.
How is IBS diagnosed?
Most of the time, doctors
can diagnose irritable bowel syndrome from the symptoms. Your doctor will ask
you about your symptoms and past health and will do a physical exam.
In some cases, you may need other tests, such as stool analysis or blood tests. These tests can help your doctor rule out other
problems that might be causing your symptoms.
How is it treated?
Irritable bowel syndrome is a
long-term condition, but there are things you can do to manage your symptoms.
Treatment usually includes making changes in your diet and lifestyle, such as
avoiding foods that trigger your symptoms, getting regular exercise, and
managing your stress.
There are also medicines that may help with
your symptoms. If diet and lifestyle changes do not help enough on their own,
your doctor may prescribe medicines for pain, diarrhea, or constipation.
Frequently Asked Questions
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Learning about IBS:
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Being diagnosed:
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Getting treatment:
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Ongoing concerns:
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Living with IBS:
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Cause
The exact cause of
irritable bowel syndrome (IBS) is not known. But
health experts believe faulty communication between the brain and the
intestinal tract causes the symptoms of IBS.
A complex
combination of elements, including psychological stress, hormones, the
immune system, and chemicals called neurotransmitters,
appears to interfere with messages between the brain and the bowel. The
miscommunication causes abnormal muscle contractions or spasms, which often
cause cramping pain. The spasms may either speed the passage of stool, causing
diarrhea, or slow it down, causing constipation or bloating.
People who have IBS seem to have unusually sensitive intestines. It is
not known why their intestines are more likely to react strongly to the
elements that contribute to IBS. People who have IBS may start having symptoms
because of one or more factors, including:
- Eating (though no particular foods have been associated with
IBS).
- Stress. Stress may affect the movements of the intestines and
also may affect the way a person feels pain. (Stress may also have the same
effect on people who do not have IBS.)
- Trapped gas that causes bloating.
- Hormonal changes, such as during the menstrual cycle.
- Some medicines, such as antibiotics.
- Genetics. IBS may be more likely to occur in people who have a
family history of the disorder.
Symptoms
An expert panel has outlined a list of
symptoms common in
irritable bowel syndrome (IBS). Doctors often use this
list of symptoms, known as the Rome III criteria, to distinguish IBS from other
intestinal problems. But people who don't have all of these symptoms may
still have IBS.
You meet the Rome III criteria for IBS if your
symptoms began at least 6 months ago, you have had abdominal pain or discomfort
at least 3 days each month in the last 3 months, and at least two of the
following statements are true:1
- The pain is relieved by having a bowel movement.
- The pain is linked to a change in how often you have a bowel
movement.
- The pain is linked to a change in the appearance or consistency
of your stool.
The presence of any of the following symptoms supports a
diagnosis of IBS.
Bowel movement patterns
When you have IBS, your
pattern of bowel movements may be different over time. Two or more of the
following may happen:
- Bowel movements may occur either more often (diarrhea) or less
often (constipation) than usual, such as having more than 3 bowel movements a
day or less than 3 a week.
- Bowel movements may differ in size or consistency (may be hard
and small, pencil-thin, or loose and watery).
- The way stools pass changes. You may strain, feel an urgent
need to have a bowel movement, or feel that you haven't completely passed a
stool.
- You may have bloating or a feeling of gas in the
intestines.
Other intestinal symptoms
Some people may have
lower abdominal pain with constipation that is sometimes followed by diarrhea.
Other people have pain and mild constipation but no diarrhea.
Symptoms that are sometimes present include intestinal gas and passage of
mucus in stools.
Nongastrointestinal symptoms
You may sometimes
have other symptoms that don't affect the intestines, such as:
- Anxiety or depression.
- Fatigue.
- Headache.
- Unpleasant taste in the mouth.
- Backache.
- Sleeping problems (insomnia) not caused by symptoms of
IBS.
- Sexual problems, such as pain during sex or reduced sexual
desire.
- Heart palpitations (feeling like the heart skips a beat or is
fluttering).
- Urinary symptoms (frequent or urgent need to urinate, trouble
starting the urine stream, trouble emptying the bladder).
Symptoms often occur after a meal, during stressful
times, or during menstruation.
There are many
other conditions with symptoms similar to IBS.
What Happens
Symptoms of
irritable bowel syndrome (IBS) may persist for a long
time, but IBS does not cause cancer or shorten life expectancy.
The pattern of IBS varies from one person to the next and from one bout
to the next. Some people have symptoms off and on for many years. You may go
months or years without having any symptoms. However, most people have
recurrent episodes of symptoms. It is rare for a person to have symptoms
constantly.
As people get older, their symptoms of IBS tend to
get better. And over time about 3 out of 10 people will stop having any
symptoms at all.2
Although IBS does not
cause more serious conditions, such as cancer or
inflammatory bowel disease, a person who has IBS may
also have one of these illnesses.
What Increases Your Risk
Between 7% and 10% of people in the world have irritable bowel syndrome.3 But most people with IBS don't see a doctor about their symptoms.
IBS tends to be more
common in:
- People in their late 20s.
- Women.
- People who have panic disorder or other psychological
conditions.
- People who have a family history of IBS.
- People who have a history of physical or sexual abuse or other
psychological trauma. Several studies have found a link between a past history
of abuse and gastrointestinal disorders.4
- People with other conditions such as
depression,
migraine headaches, and
fibromyalgia (which causes widespread muscle and
soft-tissue pain and tenderness).
When To Call a Doctor
Call your doctor or other
health professional if:
- You have been diagnosed with
irritable bowel syndrome (IBS) and your symptoms
become worse, begin to disrupt your activities, or do not respond as usual to
your home treatment.
- You are becoming more tired than usual.
- Your symptoms wake you from sleep.
- You have unexplained weight loss.
- You have decreased appetite.
- You have abdominal pain that is not associated with changes in
bowel function or that is not relieved when you pass gas or a stool.
- You have abdominal pain that is now in one area (localized) more
than any other area.
- You see blood in your stool.
Watchful Waiting
Watchful waiting is not appropriate if you have
any "alarm symptoms," which could mean a serious problem. Alarm symptoms
include:
- Fever.
- Unexplained weight loss.
- Blood in your stools.
-
Anemia
, which is a decrease in the amount of
oxygen-carrying substance (hemoglobin) found in red blood cells.
- Family history of colon cancer or
inflammatory bowel disease, which causes chronic
inflammation of the intestines.
If none of the symptoms listed above is present, try to
rule out other causes of abdominal problems, such as eating a new food; eating
sugar-rich foods, especially milk products; eating foods containing sorbitol or
other artificial sweeteners; nervousness; or stomach flu. Try home treatment
for 1 or 2 weeks. If your symptoms don't get better or if they get worse, call
your health professional.
An occasional case of upset stomach,
diarrhea, or constipation is common, especially during stressful times.
Symptoms of stomach pain, nausea, vomiting, and diarrhea that come on quickly
and that go away on their own are more likely to be caused by stomach flu or
food poisoning, especially if other people around you are also sick.
Who To See
The following health professionals can diagnose and
treat irritable bowel syndrome (IBS).
If more tests are needed or your symptoms do not respond
to initial therapy, it may be helpful to see a doctor who specializes in
treating digestive system problems (gastroenterologist). If stress may be playing a role
in IBS, it may be helpful to see a
psychiatrist or
psychologist.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Exams and Tests
Irritable bowel syndrome
(IBS) can be diagnosed based on symptoms. In most cases, only
minimal tests are needed. A health professional diagnoses IBS when a person has
the typical symptoms of the disorder and, if needed, tests have ruled out other
possible causes.
The amount of testing that may be done depends on
several factors: your age, how your symptoms come on and how severe they are,
and how you respond to the initial treatment. For example:
- For a 20-year-old woman who has all the typical symptoms of IBS,
a routine blood test may be the only test needed. Irritable bowel syndrome is
more common in young women, and so if symptoms are typical of IBS, extensive
testing is probably not needed.
- For a 55-year-old man whose symptoms started recently, more
extensive testing is probably needed. People over age 50 are less likely than
younger people to develop IBS symptoms for the first time, so it is more likely
that symptoms may be caused by another problem.
- If you get better after some initial treatment for symptoms that
the health professional suspects are caused by IBS, no further tests are
needed.
Depending on your symptoms, results of the initial tests,
or your response to treatment, other tests may be done.
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Irritable Bowel Syndrome: Should I Have Tests for IBS Symptoms?
Tests may include:
Thyroid function tests and imaging tests, such as colonoscopy, are occasionally done.
Treatment Overview
Irritable bowel syndrome
(IBS) is a long-term (chronic) but manageable condition.
Treatment will depend on the types of symptoms you have and their severity, as
well as how they affect your daily life, and will likely involve changes to
your lifestyle. It is important that you work closely with your doctor to create a treatment plan that will meet your needs. Learn all
you can about your condition so you can effectively communicate concerns and
questions to your doctor.
Initial treatment
No single type of treatment for
irritable bowel syndrome works best for everyone. You
and your doctor will need to work together to determine what may
be triggering your symptoms. It will be necessary for you to adapt your
lifestyle to best deal with your symptoms and still carry on with your daily
activities. Let your doctor know if parts of your treatment are
not helping your symptoms.
For some people who have IBS, certain
foods may trigger symptoms. The following suggestions may help prevent or
relieve some IBS symptoms:
- Avoid caffeine and alcohol.
- Limit your intake of fatty foods.
- If diarrhea is your main symptom, limit dairy products, fruit,
and artificial sweeteners such as sorbitol or xylitol.
- Increasing fiber in your diet may help relieve
constipation.
- Avoiding foods such as beans, cabbage, or uncooked cauliflower
or broccoli can help relieve bloating or gas.
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Irritable Bowel Syndrome: Controlling Symptoms With Diet
Getting regular, vigorous exercise (such as swimming,
jogging, or brisk walking) may help reduce tension and make your bowels more
regular.
Medicines may be used along with lifestyle changes to
manage symptoms of IBS. Medicines for IBS may include anticholinergics for
cramping, medicines for diarrhea or constipation, antidepressants, or antianxiety drugs.
If stress triggers your symptoms, some form of psychological therapy or
stress management may help you deal more positively with stress and help
prevent or reduce stress-related IBS episodes.
Ongoing treatment
Treatment for
irritable bowel syndrome (IBS) usually involves
long-term management of your symptoms. It is important that you have a good
working relationship with your doctor to monitor your symptoms and
identify changes in your diet and lifestyle that can help relieve the symptoms.
Keeping a journal of your symptoms can help you identify triggers that make
symptoms worse.
Be especially aware of significant changes in
symptoms, such as the appearance of blood in your stools, increased pain,
severe fever, or unexplained weight loss. If any of these occur, your doctor may want to conduct additional tests to determine whether there is
another cause for your symptoms.
In treating chronic IBS, be sure to maintain the changes to lifestyle and diet that relieve
symptoms. Quitting smoking, avoiding caffeine and foods that make symptoms
worse, and getting regular exercise should all be permanent parts of your daily
routine.
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Irritable Bowel Syndrome: Controlling Symptoms With Diet
You will likely continue to take medicines as needed to
treat your symptoms.
Because IBS often results from a combination
of physical and stress-related factors, a treatment approach that addresses
both these causes will be most successful. In addition to treating constipation
or diarrhea with medicines and changes to diet and lifestyle, stress
management or other psychological therapy should be a major part of your
treatment plan.
Treatment if the condition gets worse
If your
symptoms get worse, your doctor will likely conduct more tests to
determine whether there is another cause for your symptoms.
Irritable bowel syndrome (IBS) does not lead to more
serious conditions, such as cancer or inflammatory bowel disease, but a person
with IBS may also have one of these illnesses.
Your doctor may also want you to try different medicines, or different
dosages of your current medicines, if your symptoms are not responding to
treatment.
Prevention
You cannot prevent
irritable bowel syndrome (IBS). But proper
self-care may help minimize symptoms and perhaps extend the time between
episodes. This includes quitting smoking, avoiding caffeine and foods that make
symptoms worse, and getting regular exercise.
Home Treatment
For most people who have
irritable bowel syndrome (IBS), home treatment may be
the best way to manage the symptoms. It is also helpful to learn all you can
about IBS so you can effectively communicate concerns and questions to your
doctor.
Although there currently is no cure for IBS,
careful attention to diet and stress management should help keep your symptoms
under control and perhaps even prevent them from coming back.
Diet modification
In many people who have IBS,
eating may trigger symptoms. But for most people, there is not a
particular type of food that triggers symptoms.
Increasing the
amount of fiber in your diet can help control constipation. High-fiber foods
include fresh fruits (raspberries, pears, apples), fresh vegetables (peas,
brussels sprouts), wheat bran, and whole-grain breads and cereals. Beans such
as kidney, pinto, and garbanzo are also high-fiber foods, but they should
probably be avoided if gas is one of your symptoms.
If you have trouble getting enough fiber in your diet, you can take a fiber supplement, such as psyllium (for example, Metamucil). If you take a fiber supplement, start with a small dose and very slowly increase the dose over a month or more. Also, make sure you drink plenty of fluids, enough so that your urine is light yellow or clear like water.
You can take
steps to reduce the possibility that certain foods will cause symptoms, such as
avoiding or limiting gas-producing foods (including beans and cabbage),
sugarless chewing gum and candy, caffeine, and alcohol.
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Irritable Bowel Syndrome: Controlling Symptoms With Diet
Stress management
If stress seems to trigger your
symptoms, the following may help you better manage stress and avoid or ease
some IBS episodes:
- Keep a diary or journal of your symptoms as well as life events
that occur with them. This often helps clarify the connection between symptoms
and stressful occasions. After you have identified certain events or situations
that bring on symptoms, you can develop ways of dealing with these
situations.
- Get regular, vigorous exercise (such as swimming, jogging, or
brisk walking) to help reduce tension.
- A hobby or an outside activity can provide a break from
stressful situations.
- Psychiatrists, psychologists, hypnotists, counselors, social
workers, and biofeedback specialists can provide methods for coping with
stress.
Because there are no structural problems in the
intestines of people who have IBS, some people may think this means that the
symptoms "are all in their head." This is not true. The pain, discomfort, and
bloating are real and have many different causes that can be addressed to help
relieve symptoms.
While the symptoms are quite real, psychological
factors often play a role in the development of IBS. People who have IBS are
more likely than people without the condition to have
depression, panic disorder, or other psychological
conditions.1 Acknowledging these factors may help you
and your doctor successfully manage your condition.
Medications
Medicine may be used along with
lifestyle changes to manage symptoms of
irritable bowel syndrome (IBS).
The goal
of medicine treatment is to relieve your symptoms enough to prevent them from
interfering with your daily activities, because it may not be possible to
eliminate your symptoms. Medicines may be prescribed to treat moderate to
severe pain, diarrhea, or constipation that does not respond to home treatment.
No single medicine has been shown to be effective in relieving IBS over the
long term.
Medication Choices
In most cases, the choice of medicine is based on your
most troublesome symptom. For example, if diarrhea is the most bothersome
symptom, using antidiarrheals or anticholinergics may be helpful.
For diarrhea
Medicines that may be used to
treat severe diarrhea that does not improve with home treatment include:
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Antidiarrheals, including diphenoxylate (such as Lomotil) and
loperamide (such as Imodium), which slow intestinal movements.
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Bile acid binding agents, including cholestyramine (such as Questran), which
prevent bile acids from stimulating the colon, slowing the passage of stools
and relieving diarrhea.
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Alosetron (Lotronex), which is used for some women who
have severe diarrhea and who have not responded to other treatments. This
medicine slows the movement of stools through the bowels.
For constipation
There are many medicines for severe
constipation that does not improve with home treatment. Most of these medicines are available without a prescription and are okay to take once in awhile. Check with your doctor before you use any of these medicines every day for constipation. Medicines for constipation include:
- Lubiprostone (Amitiza), which works by increasing the amount
of fluid in your intestines, making it easier for stool to pass.
- Osmotic laxatives (such as Milk of Magnesia and nonabsorbable
sugars such as lactulose), which work by holding fluids in the intestine and
drawing fluids into the intestine from other tissue and blood vessels. This
extra fluid in the intestines makes the stool softer and easier to pass.
- Polyethylene glycol (such as MiraLax), which helps the stool hold on
to more water, making it softer and easier to pass.
- Stimulant laxatives (such as Senokot), which speed up how fast stool moves through the intestines by
irritating the lining of the intestines.
For pain and cramping
The following medicines
may be used for long-term pain and cramping:
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Anticholinergics (antispasmodics), including dicyclomine
(Bentyl), which help prevent or relieve painful cramping spasms in the
intestines
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Antidepressants, including desipramine (such as Norpramin), which in low doses can help with pain caused by IBS
For anxiety or depression
The following
medicines may be used if your IBS causes you to have anxiety or
depression:
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Antidepressants, including fluoxetine (such as Prozac), which are especially helpful if you have depression and IBS
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Antianxiety agents, including diazepam (such as Valium), which can be used short-term to help with anxiety if it makes your IBS symptoms worse
What To Think About
Few medicines have proven
consistently helpful and all medicines have side effects, so medicine should
be used for specific symptoms that disrupt your normal daily activities.
If you also have another illness, such as depression, that triggers
symptoms of irritable bowel syndrome, medicine for that illness may be
needed.
Alosetron, a medicine that decreases abdominal
sensitivity, has been shown to relieve symptoms in some women who have severe
diarrhea and who have not responded to other treatments. Although this medicine
was previously removed from the market when its use was shown to contribute to
ischemic bowel disease (which occurs when there is not
enough blood flowing to the intestines), the U.S. Food and Drug Administration
(FDA) reapproved alosetron for limited use in IBS. Specific guidelines for the
use of alosetron require health professionals prescribing it to sign a
certificate and patients to sign a consent form.
Other Treatment
A wide range of other
therapies has been used to treat
irritable bowel syndrome (IBS). Treatment methods that
help you better cope with stress can help reduce symptoms.
Other Treatment Choices
Fiber
Increasing the amount of fiber in your diet can help with some symptoms of IBS, especially constipation. You can get more fiber in your diet by eating foods that are high in fiber such as fresh fruits (raspberries, pears, apples), fresh vegetables (peas, spinach, celery), wheat bran, and whole-grain breads and cereals.
If you have trouble getting enough fiber in your diet, try a fiber supplement. Examples include psyllium (such as Metamucil). If you take a fiber supplement, start with a small dose and very slowly increase the dose over a month or more. Also, make sure you drink plenty of fluids, enough so that your urine is light yellow or clear like water.
Psychological treatment
Some kinds of psychological treatment may help with IBS symptoms. These treatments include cognitive-behavioral therapy, psychotherapy, and hypnosis.5
These
treatment methods are usually more effective if they are used along with other
treatment methods, such as diet changes, stress reduction, and sometimes
medicine.
Other psychological treatments that are sometimes used for IBS include relaxation therapy, meditation, and biofeedback.
Complementary treatment
Because IBS is so
different for each person and because no medicines have been proven to work
really well for IBS, many people try alternative or complementary treatments.
Some of these treatments have been studied and some have not. The evidence to
support their use varies as much as the evidence seen when medicines for IBS
are studied.
- Herbal therapies, including
Ayurvedic medicine and
Chinese herbal medicine, may improve the symptoms of
IBS. This has been shown in many studies of herbal therapy for IBS.6
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Acupuncture is used as a treatment for IBS. But the
effectiveness of acupuncture in treating IBS is still unknown.7
- Peppermint oil has also been used to treat IBS. Studies have
shown that peppermint oil works to improve IBS symptoms by preventing cramps and spasms in the intestines.5
- Aloe is commonly used for IBS, especially IBS with
constipation. There is currently no evidence for the use of aloe as an
effective treatment for IBS.
- Ginger has been used to treat nausea and has been studied as
a treatment for nausea caused by seasickness and surgery. It is not known how
well ginger helps in IBS.
- Helpful bacteria, called probiotics, may help with IBS symptoms. Studies show that a supplement with a combination of types (called strains) of bacteria probably helps more than just one type. But more research is needed.5
Antibiotics
Experts are studying whether
antibiotics may relieve symptoms of IBS. One antibiotic in particular, rifaximin (Xifaxan), has been shown to help IBS symptoms, especially bloating and diarrhea.5
What To Think About
Some people have been
successful at handling stressful situations and controlling their symptoms
after trying psychological therapies. These techniques are not harmful and have
no side effects. Some of them can be used before a stressful event to prevent
or reduce symptoms.
Other Places To Get Help
Organizations
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American College of
Gastroenterology
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| P.O. Box 342260 |
| Bethesda, MD 20827-2260 |
| Phone: |
(301) 263-9000 |
| Web Address: |
www.acg.gi.org |
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The American College of Gastroenterology is an
organization of digestive disease specialists. The Web site contains
information about common gastrointestinal problems.
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American Gastroenterological
Association
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| 4930 Del Ray Avenue |
| Bethesda, MD 20814 |
| Phone: |
(301) 654-2055 |
| Fax: |
(301) 654-5920 |
| Web Address: |
www.gastro.org |
| |
|
The American Gastroenterological Association is a
society of doctors who specialize in the digestive system
(gastroenterologists). This Web site can help you find a gastroenterologist in
your area. They also have patient information on many gastrointestinal diseases
and disorders.
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International Foundation for Functional Gastrointestinal
Disorders
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| P.O. Box 170864 |
| Milwaukee, WI 53217-8076 |
| Phone: |
1-888-964-2001
(414) 964-1799 |
| Fax: |
(414) 964-7176 |
| Email: |
iffgd@iffgd.org |
| Web Address: |
www.iffgd.org |
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|
The International Foundation for Functional
Gastrointestinal Disorders (IFFGD) is a nonprofit organization that provides
information and support to adults and children affected by hard-to-diagnose
gastrointestinal (GI) disorders. The Web site has information about GI symptoms
and conditions such as irritable bowel syndrome, indigestion, gastroesophageal
reflux disease (GERD), incontinence, gas, bloating, belching, heartburn,
nausea, and belly pain.
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National Center for Complementary and Alternative
Medicine (NCCAM) Clearinghouse
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| P.O. Box 7923 |
| Gaithersburg, MD 20898 |
| Phone: |
1-888-644-6226
(301) 519-3153 for international calls |
| Fax: |
1-866-464-3616 toll-free |
| TDD: |
1-866-464-3615 toll-free |
| Email: |
info@nccam.nih.gov |
| Web Address: |
www.nccam.nih.gov/health/clearinghouse (or
www.nccaminfo.org/livehelp/ for live help online) |
| |
|
The National Center for Complementary and Alternative Medicine
(NCCAM) at the National Institutes of Health (NIH) explores complementary and
alternative healing practices in the context of rigorous science, trains
complementary and alternative medicine researchers, and gives out authoritative
information. Send all requests for information and questions about NCCAM to the
NCCAM Clearinghouse.
|
|
|
National Digestive Diseases Information Clearinghouse
|
| 2 Information Way |
| Bethesda, MD 20892-3570 |
| Phone: |
1-800-891-5389 |
| Fax: |
(703) 738-4929 |
| TDD: |
1-866-569-1162
toll-free |
| Email: |
nddic@info.niddk.nih.gov |
| Web Address: |
www.digestive.niddk.nih.gov |
| |
|
This clearinghouse is a service of the U.S. National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the
U.S. National Institutes of Health. The clearinghouse answers questions;
develops, reviews, and sends out publications; and coordinates information
resources about digestive diseases. Publications produced by the clearinghouse
are reviewed carefully for scientific accuracy, content, and readability.
|
|
References
Citations
-
Longstreth GF, et al. (2006). Irritable bowel syndrome
section of Functional bowel disorders. In DA Drossman et al., eds.,
Rome III: The Functional Gastrointestinal Disorders, 3rd
ed., pp. 490–509. McLean, VA: Degnon Associates.
-
Talley NJ (2008). Functional gastrointestinal
disorders: Irritable bowel syndrome, dyspepsia, and noncardiac chest pain. In L
Goldman, D Ausiello, eds., Cecil Medicine, 23rd ed., pp.
990–998. Philadelphia: Saunders Elsevier.
-
American College of Gastroenterology (2009). An evidence-based position statement on the management of irritable bowel syndrome. American Journal of Gastroenterology, 104(Suppl 1): S1–S7.
-
Tack J (2006). Irritable bowel syndrome. In MM Wolfe
et al., eds., Therapy of Digestive Disorders, 2nd ed.,
pp. 701–710. Philadelphia: Saunders Elsevier.
-
American College of Gastroenterology (2009). An evidence-based systematic review on the
management of irritable bowel syndrome. American Journal of Gastroenterology, 104(Suppl 1): S8–S35.
-
Liu JP, et al. (2006). Herbal medicines for treatment
of irritable bowel syndrome. Cochrane Database of Systematic Reviews (1). Oxford: Update Software.
-
Lim B, et al. (2006). Acupuncture for treatment of
irritable bowel syndrome. Cochrane Database of Systematic Reviews (4). Oxford: Update Software.
Other Works Consulted
- Chang I, et al. (2005). A dose-ranging,
phase II study of the efficacy and safety of alosetron in men with
diarrhea-predominant IBS. American Journal of Gastroenterology, 100(1): 115–123.
- Ford AC, et al. (2008). Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: Systematic review and meta-analysis. BMJ. Published online November 13, 2008 (doi:10.1136/bmj.a2313).
- Spanier JA, et al., (2003). A systematic review of
alternative therapies in the irritable bowel syndrome. Archives of Internal Medicine, 163: 265–274.
- Talley NJ (2006). Irritable bowel syndrome. In M
Feldman et al., eds., Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 8th ed., vol. 2, pp. 2633–2652.
Philadelphia: Saunders Elsevier.
Credits
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By
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Healthwise Staff |
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Primary Medical Reviewer
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Kathleen Romito, MD - Family Medicine |
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Specialist Medical Reviewer
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Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology |
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Last Revised
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May 17, 2010 |
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Talley NJ (2008). Functional gastrointestinal
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