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Irritable bowel syndrome (IBS), also known as functional bowel syndrome, spastic bowel, spastic colon, or irritable colon, affects 10 to 15 percent of the American population. The condition is defined as "abdominal pain and discomfort with altered bowel habits in the absence of any other mechanical, inflammatory, or biochemical explanation for these symptoms." (Am Fam Physician 2005;72:2501-6)

Stated more simply, IBS patients have a problem with their intestines that is caused by abnormal movement of the muscles in the wall of the gut. If the muscles squeeze too much, abdominal pain and diarrhea are the result. Too little muscular activity causes bloating and constipation. In addition to diarrhea, constipation, bloating, and cramping, sufferers complain of flatulence (gas), fecal urgency (the sensation of needing to have a bowel movement), and tenesmus (painful spasm of the muscles around the anus accompanied by the urgent desire to empty the bowel).

Symptoms of IBS can be worsened by stress, such as social events or travel. Often, just a change in daily routine or altering one's diet can aggravate the problem. Women with IBS may notice a worsening of symptoms during their menstrual periods. Some people report that certain foods make their symptoms worse. IBS may be more troublesome at certain times of the day.

Unfortunately, the symptoms of IBS can overlap those of other intestinal conditions, such as ulcers, colitis or Crohn's disease. Certain illnesses, such as diabetes, can cause bowel problems that mimic IBS. So, anyone with symptoms lasting more than two to three weeks should consult their doctor.

For years, the mainstays of therapy for IBS have included dietary management, stress reduction and, for severe cases, medications. Though no specific food causes IBS, there are many foods that can aggravate symptoms: High fat intake or the consumption of caffeine can increase cramping and diarrhea; milk or milk products can cause bloating, pain, and diarrhea, particularly for those people who are also lactose intolerant; gas-producing foods like beans lead to bloating and flatulence; sudden increases of fiber in the diet can worsen symptoms, too. For those individuals who associate certain foods with a worsening in their condition should, of course, avoid those foods.

Slowly increasing the water-soluble fiber in one's diet is helpful for most IBS sufferers, whether they complain of constipation or diarrhea. Psyllium (Metamucil, Perdiem, or Fiberall, for example)

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