Understanding irritable colon syndrome

What is irritable colon syndrome?

Irritable colon syndrome, also known as irritable bowel syndrome (IBS) is a chronic condition of the digestive system. This condition causes abdominal pain and altered bowel habits.1

People who suffer from irritable colon syndrome often complain of either frequent, watery bowel movements (diarrhoea) or not frequent enough bowel movements (constipation). Sometimes these symptoms may switch between diarrhoea and constipation.1

Irritable colon syndrome usually begins in young adulthood. More often diagnosed in women than in men,2 it is the most commonly diagnosed gastrointestinal condition3 and is second only to the common cold as a cause of absence from work.4

An estimated 10 to 20 percent1 of people in the general population experience symptoms of IBS, although only about 15 percent of affected people seek medical help.5

What are the symptoms of irritable colon syndrome?

People with irritable colon syndrome suffer from the following symptoms:

Abdominal pain and cramps: Abdominal pain typically varies in intensity. Some people notice that emotional stress and eating worsen the symptoms6 and that having a bowel movement relieves the pain. In women, the abdominal pain may be associated with the menstrual cycle.1

Diarrhoea or constipation or both: Altered bowel habits are a second symptom of irritable colon syndrome. This can include diarrhoea, constipation, or alternating diarrhoea and constipation. If diarrhoea is more common, the condition is called diarrhoea-predominant irritable bowel syndrome (ibs-d); if constipation is more common, the condition is called constipation-predominant irritable bowel syndrome (ibs-c).

Bowel movements usually occur during the daytime,7 and most often in the morning or after meals.3 Diarrhoea is often preceded by a sense of urgency and followed by a feeling of incomplete emptying. In 50% of IBS patients, also mucus discharge with diarrhoea may occur.7

Diarrhoea during nighttime is not typical7. The constipation of irritable colon syndrome can be intermittent and last for days. Stools are often hard and pellet-shaped. You may not feel empty after a bowel movement, even when the rectum is empty. This faulty sensation can lead to straining and sitting on the toilet for prolonged periods of time.1

Other symptoms can include: bloating, gas (occasionally with burping or flatulence), feeling full too quickly when eating, and nausea.3

Is there a test for irritable colon syndrome?

Unfortunately, there is no test to diagnose irritable colon syndrome, but your doctor or nurse can figure out if you have it by asking you some questions, and by running tests to make sure you do not have something different.

Since a number of other diseases can cause symptoms similar to irritable colon syndrome, it is important to rule out those diseases by having different tests. Examples of diseases with similar symptoms to irritable colon syndrome include coeliac disease, and inflammatory bowel disease (such as ulcerative colitis, Crohn’s disease and microscopic colitis).8

What are the treatment options for irritable colon syndrome?

Although the condition cannot be cured, treatments are available to alleviate symptoms of irritable colon syndrome (also known as irritable bowel syndrome). The medicines that can help include:8

  • Medicines to ease diarrhoea
  • Medicines to ease constipation
  • Medicines that resolve stomach aches and cramps (In the intestine, antispasmodics relax the smooth muscle cells by blocking calcium channels, thus relieving abdominal cramps and pain)
  • Antidepressants (These are mainly used to treat pain when used in irritable colon syndrome, and given at a much lower dose than would normally be given when treating depression)
  • Antibiotics
  • Probiotics

As stated these measures help alleviate symptoms, but do not cure the condition. The chronic nature of irritable colon syndrome and the challenge of controlling its symptoms can be frustrating for both the people that suffer from it and healthcare providers.

Is there anything else I can do?

Stress and anxiety can worsen irritable bowel syndrome in some people.

The best approach for reducing stress and anxiety depends upon the situation and the severity of symptoms. Some people benefit from psychosocial therapies, such as formal counseling, with or without antidepressant or antianxiety medications. Other treatments, such as hypnosis and cognitive behavioral therapy may also be helpful.9

Please consult your healthcare professional for further information.

  1. Longstreth G. F. et al. Functional Bowel Disorders. Gastroenterol 2006;130:1480-1491
  2. Brandt L. J. et al. An Evidence-Based Systematic Review on the Management of Irritable Bowel Syndrome. AJG 2009;104, Suppl 1;S1-S35
  3. Soares RL. Irritable bowel syndrome: a clinical review. World J Gastroenterol. 2014;20(34):12144-12160
  4. Schuster MM. Diagnostic evaluation of the irritable bowel syndrome. Gastroenterol Clin North Am. 1991;20 (2):269
  5. Smith GD, Steinke DT, Kinnear M, et al. A comparison of irritable bowel syndrome patients managed in primary and secondary care: the Episode IBS study. Br J Gen Pract. 2004;54(504):503-507
  6. Drossman D. A. et al. The Functional Gastrointestinal Disorders and the Rome III Process. Gastroenterol 2006;130:1377-1390
  7. Owyang C. Irritable bowel syndrome. In: Textbook of Gastroenterology, T. Yamada (Ed). 5th ed. Philadelphia: Lippincott Williams and Wilkins; 2009;pp.1536-74
  8. Lacy B. E. et al. Bowel Disorders. Gastroenterol 2016;150:1393-1407
  9. Drossman D. A. et al. The Irritable Bowel Syndrome: Review and a Graduated Multicomponent Treatment Approach. Annals of Internal Medicine 1992;116, Number 12 (Part 1):1009-1016