Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
What are the symptoms of irritable bowel syndrome (IBS)?
The primary purpose of the gastrointestinal tract is to digest (break down)
and absorb (take into the blood stream) food. In order to fulfill this purpose,
food must be ground, mixed, and transported through the intestines, where it is
digested and absorbed. In addition, undigested and unabsorbed portions of the
food must be eliminated from the body.
In functional diseases of the gastrointestinal tract, the grinding, mixing,
digestion, and absorption functions are disturbed to only a minor degree. These
functions are essentially maintained, perhaps because of a built-in
over-capacity of the gastrointestinal tract to perform these functions. The most
commonly affected function in these diseases is transportation. In the stomach
and small intestine, the symptoms of slowed transportation are
nausea,
vomiting,
abdominal bloating (the sensation of abdominal fullness), and abdominal
distention (enlargement). The symptom of rapid transportation usually is
diarrhea. The interpretation
of symptoms, however, may be more complicated than this. For example, let's say
that a person has abnormally rapid emptying of the stomach. The sensing of this
rapid emptying by the intestinal sensory nerves normally brings about a motor
nerve response to slow down the emptying of the stomach and transportation through the
small intestine. Thus, rapid emptying of the stomach may give rise to symptoms
of slowed transportation.
In the colon, abnormally slow or rapid transportation results in
constipation or
diarrhea, respectively. In addition, there may be increased amounts of mucus
coating the stool or a sense of incomplete evacuation after a bowel movement.
As discussed previously, normal sensations may be abnormally processed and
perceived. Such an abnormality could result in abdominal bloating and pain.
Abnormally processed sensations from the gastrointestinal organs also may lead
to motor responses that cause symptoms of slow or rapid transportation.
Slow transportation of food through the small intestine may be
complicated, for example, by bacterial overgrowth. In bacterial overgrowth,
gas-producing bacteria that are normally restricted to the colon move up into
the small intestine. There, they are exposed to greater amounts of undigested
food than in the colon, which they turn into gas. This formation of gas can
aggravate bloating and/or abdominal distention and result in increased amounts
of flatus (passing gas, or
flatulence) and diarrhea.
The gastrointestinal tract has only a few ways of responding to diseases.
Therefore, the symptoms often are similar regardless of whether the diseases are
functional or non-functional. Thus, the symptoms of both functional and
non-functional gastrointestinal diseases are nausea, vomiting, bloating,
abdominal distention, diarrhea, constipation, and pain. For this reason, when
functional disease is being considered as a cause of symptoms, it is important
that the presence of non-functional diseases be excluded (ruled out). In fact,
the exclusion of non-functional diseases usually is more important in evaluating
patients who are suspected of having functional disease. This is so, in large
part, because the tests for diagnosing functional disease are complex, not
readily available, and often not very reliable. In contrast, the tests for
diagnosing non-functional diseases are widely available and sensitive (able to
diagnose most cases).
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
Gas or "intestinal gas" means different things to different people. Everyone has gas and eliminates it by belching or farting (passing it through the rectum).
Constipation is defined medically as fewer than three stools per week and severe constipation as less than one stool per week. Constipation usually is caused by the slow movement of stool through the colon. There are many causes of constipation including medications, poor bowel habits, low fiber diets, abuse of laxatives, hormonal disorders, and diseases primarily of other parts of the body that also affect the colon.
Fibromyalgia, formerly
known as fibrositis, causes chronic pain, stiffness, and
tenderness of muscles, tendons, and joints without detectable inflammation. Fibromyalgia patients have an unusually low pain threshold. Symptoms of fibromyalgia include fatigue, abnormal sleep, mental/emotional disturbances, abdominal pain, migraine and tension headaches, and irritable bladder. Treatment of fibromyalgia involves patient education, medication, exercise, and stress reduction.
In lactose intolerance, the digestive system cannot digest lactose (the main sugar in milk). Symptoms of lactose intolerance include diarrhea, flatulence, abdominal pain, abdominal bloating, abdominal distention, and nausea. There are several tests to diagnose lactose intolerance. Treatment is generally made with dietary changes, supplements, and adaptation to small amounts of milk.
Small intestinal bacterial overgrowth (SIBO) refers to a condition in which abnormally large numbers of bacteria (at least 100,000 bacteria per ml of fluid) are present in the small intestine and the types of bacteria in the small intestine resemble more the bacteria of the colon than the small intestine. There are many conditions associated with small intestinal bacterial overgrowth, to include: diabetes, scleroderma, Crohn's disease, and others. There is a striking similarity between the symptoms of irritable bowel syndrome and SIBO. It has been theorized that SIBO may be responsible for the symptoms of at least some patients with irritable bowel syndrome. Symptoms of SIBO include: excess gas, abdominal bloating, diarrhea, and abdominal pain.
Dyspepsia (indigestion) is a functional disease in which the gastrointestinal organs, primarily the stomach and first part of the small intestine, function abnormally. It is a chronic disease in which the symptoms fluctuate infrequency and intensity. Symptoms of dyspepsia include upper abdominal pain, belching, nausea, vomiting, abdominal bloating, early satiety, and abdominal distention (swelling). These symptoms are most often provoked by eating.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
Irritable bowel syndrome (IBS) is a functional disease that can affect the quality of those who suffer from this condition. Individuals with IBS can make lifestyle changes that may modify or control the number and severity of episodes. Certain foods, medications, and hormone levels may trigger IBS episodes. Learn how to prevent the number and severity of IBS episodes of diarrhea and constipation.
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