Irritable Bowel Syndrome

Irritable bowel syndrome is a common condition that labels many functional disorders of the lower gastrointestinal tract, especially of large intestine disorders. In general, the functional gastrointestinal disorders can have many symptoms and mimic organic diseases. They do not have an objectively determinable cause and their diagnosis is usually stated by exclusion of organic diseases. Functional problems are often related to psychic problems, exhaustion and neurasthenia. They are not dangerous but they can worsen the life quality.


The exact cause of the irritable bowel syndrome is not known, psychological factors seem to have an important role in the development of the disease. We have to accept the fact that the digestive tract is still not fully-understood system that contains a huge number of nerve cells and nerve fibers. This “digestive nervous system” represents a connection between digestive tract and central nervous system, our feelings, emotions and current psychic state. That is why many mental disorders may manifest as digestive tract disorders. These psychological factors can probably increase negative reactions to certain food, often spicy and irritating.


Irritable bowel syndrome mimics symptoms of many organic diseases of the colon and it is not easy to distinguish it from them. These symptoms may include abdominal pain, bloating, diarrhea, constipation and sometimes even mucus presence in stool.


The main problem is that the symptoms of irritant colon are similar to the intestinal organic diseases, for example Crohn's disease, ulcerative colitis, celiac disease, colon cancer, diverticulosis and infectious intestinal diseases. It is essential to cautiously listen to the patient's complaints and problems and try to distinguish the irritable bowel syndrome from more dangerous gastrointestinal diseases, especially from the feared colon cancer. The doctor should be vigilant especially in below mentioned cases:

  • The symptoms are exhibited by an older person, especially a man. The risk of colon cancer increases with age and more in men.
  • When blood in stool is present. Blood in stool is never caused by the irritable bowel syndrome and patient complaining about this symptom should be further investigated.
  • When the troubles wake the patient from his sleep. As the irritable syndrome depends on the patient's psyche, it usually disappears during sleeping and occurs in vigilant state. When the digestive problems wake the patient and disrupt the sleep, we should be more cautious.
  • When there is a significant weight loss. If the patient suffers from an unexplained weight loss of more than 10% of his previous weight, it is suspicious of an organic disease presence.

There are many examination methods to distinguish the irritable bowel syndrome from serious diseases such as blood tests (blood count, hemoglobin, CRP, etc.), fecal occult blood test, abdominal ultrasound, radiological examination of the bowels (enteroclysis, barium enema), endoscopic examination of the colon (colonoscopy) and many more. Particularly the colonoscopy is a valuable method. It allows to visualize the interior of the intestine and to take biopsy samples out of suspicious lesions.


The irritable bowel syndrome is difficult to treat and lifestyle changes are possibly the most effective way of therapy. Avoiding stress, yoga exercises, meditation, probiotics usage and regular eating with avoiding of spicy and irritating food are advisable. As a support, antidepressants may be prescribed. When diarrhea becomes the most bothering symptom, the doctor may prescribe anti-diarrheal drugs and on the contrary laxatives against constipation.

Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources