Dr. Jacqueline Gerhart: Irritable Bowel Syndrome

UW Health Family Medicine physician Dr. Jacqueline GerhartMadison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears weekly on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.


Dear Dr. Gerhart: I was told by my doctor that I have IBS, but when I check online for information about IBS, I see it can mean either "irritable bowel syndrome" or "inflammatory bowel syndrome." Are they the same thing?


Dear Reader: Unfortunately in the medical field, we often use acronyms without clearly describing them. Usually, when a general medical doctor uses the term "IBS," he is referring to irritable bowel syndrome. This is not the same as inflammatory bowel syndrome, which is more correctly termed inflammatory bowel disease, or IBD.


Both can cause diarrhea, cramping, bloating, abdominal pain, decreased appetite, nausea and bowel irregularity. Both can have symptoms that come and go, and both can run in families. But let's talk about the differences.


Irritable bowel syndrome, or IBS, is very common, occurring in 10 to 15 percent of the population, and is twice more common in women. Sometimes called "spastic gut," IBS is characterized by changes in bowel movements. There is no specific test for it and it is a diagnosis of exclusion, meaning we first rule out more concerning causes of the symptoms, such as infection, IBD or cancer.


Once other possibilities are ruled out, your type of IBS will be defined based on your symptoms. Namely, you may have constipation-predominant IBS, diarrhea-predominant IBS, or may have alternating-symptom IBS, where you change between constipation and diarrhea.


IBS is often associated with stress and depression. There is no "cure" for irritable bowel, but the symptoms can be controlled by decreasing triggers such as stress, and modifying your diet. Diet modifications include increased fiber, increased hydration and elimination of foods that worsen symptoms.


Low-dose anti-depressant medications and psychotherapy/counseling can also help. For more information on irritable bowel syndrome, check the UW-Madison Integrative Medicine website.


Now let's briefly touch on inflammatory bowel disease. Notice that because it is called a disease, its acronym is IBD, not IBS. The two major types of IBD are Crohn's disease and ulcerative colitis. You may also hear of lymphocytic colitis or microscopic colitis.


IBD is an autoimmune disorder in which your immune system attacks parts of the digestive system. It can often be seen on CT scans, and the diagnosis can be confirmed on a colonoscopy with a biopsy. It occurs less frequently than IBS, with only about 0.4 percent of the population affected.


IBD usually is diagnosed between the ages of 15 and 30 and is much more severe than irritable bowel syndrome. Flare-ups of inflammatory bowel disease often cause severe pain and rectal bleeding, and may require hospitalization. Severe cases may require surgery.


In summary, based on your question, I am guessing you were diagnosed with irritable bowel syndrome. But please contact your doctor to be sure. And in the future, if your doctor uses an acronym or word you don't know, be sure to say, "What is that?"


It's our job to explain your diagnoses and treatments in a clear and understandable way. We want you to be fully aware and in charge of your health care.


This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.

Date Published: 06/26/2013

News tag(s):  jacqueline l gerhart

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