Irritable bowel syndrome

Synonyms in a broader sense

IBS, irritable bowel syndrome, Colon irritable, irritable colon, "nervous bowel"

English: irritable bowel syndrome (IBS

Definition of irritable bowel syndrome

The Irritable bowel syndrome calls Discomfort of the gastrointestinal tract for example pain, feeling of fullness, Flatulence or diarrhea and constipation alternately.

Read more about the topic here Bloated stomach after eating

Irritable bowel syndrome is a medical term from the Gastroenterology, which describes a functional disorder of the gastrointestinal tract. In this case, “functional” means that a person affected is suffering from chronic complaints such as stomach pain or changes in bowel habits (which as a rule do not occur at night or only in a weakened form) without these being explained by recognizable changes or diseases or inflammations in the digestive organs. For this reason, it usually takes a long time before irritable bowel syndrome can be diagnosed, as all other diseases that can be reconciled with the symptoms must be ruled out beforehand.

The Irritable bowel symptoms can significantly reduce the general well-being of a patient, but are not burdened with an increased risk of other diseases and do not show a limited life expectancy.

Here you will also find general information on the topic bowel movement.

Occurrence in the population

About 20% of the total population and half of all patients with gastrointestinal complaints suffer from one Irritable bowel syndrome. The symptoms often begin in the 3rd decade of life and the frequency peak is between the ages of 30 and 40. Women are affected twice as often as men. In addition to dyspepsia, it is the most common gastrointestinal disorder.
It is difficult to make statements about the exact frequency of irritable bowel syndrome, as most of those affected do not seek medical help.

Clinical picture

The clinical picture can consist of 4 different facets, which can occur in combination with one another.

  • cramp-like pain in the lower abdomenthat improves through defecation and through stress can be made worse. They do not necessarily appear permanently, but can fade away from time to time and reappear again
  • 'Flatulence" and "Bloating", which express themselves as a feeling of tension and pressure in the lower abdomen
  • accompanying constipation or diarrhea, possibly alternating, which can lead to a discharge of mucus. Mushy stools often appear during the pain episodes.

Causes of Irritable Bowel Syndrome

The exact causes of irritable bowel syndrome are still the subject of research at the present time.
In the vast majority of cases, there is no organic trigger. Instead, it is assumed that the smallest injuries to the intestinal mucosa promote inflammatory processes. This results in the release of various messenger substances and hormones that influence the specific nervous system of the intestine.

You might also be interested in this topic: Leaky Gut Syndrome

In the majority of patients with irritable bowel syndrome, an overactivity of the so-called mast cells was found. These are immune cells that release the messenger substances histamine and heparin. They are not only active in the defense against disease-causing substances, but also in the context of allergic reactions. It is believed that they contribute to the symptoms typical of irritable bowel syndrome.

Another cause is an unbalanced microbiome in the gut. There is an imbalance between bacteria that aid digestion in the intestines and those that do less. (See also: Bacteria in the intestine)

There are psychological factors that favor the occurrence of irritable bowel syndrome. These include depression, anxiety disorders and stress. The messenger substances released in this context not only work in the brain, but also influence the so-called enteric nervous system of the intestine. (You can find more information on the subject here Abdominal pain from psyche)

Irritable bowel syndrome can appear after an allergic reaction to certain foods (food allergy) or their intolerance or an intestinal infection caused by bacteria.

Read more on the topic: Causes of Irritable Bowel Syndrome

Overview of the causes

It will three Possible causes for irritable bowel syndrome discussed:

  • a disorder of motility
  • an altered intestinal sensation of stimulation
  • psychosocial factors

Motility disorders

  • The proper movement of the Large intestine is disturbed. This happens through influences such as meals, emotions or stretching and can lead to excessive contraction (->constipation) as well as too slight a contraction (->diarrhea) to lead.

Altered intestinal sensation of stimulation

  • Patient with Irritable bowel syndrome feel pain faster than healthy people when the intestine is filled.

Psychosocial factors

  • More than half of the patients with irritable bowel syndrome suffer from unusual psychosocial conditions Stressors. Often they also have depressions or suffer from Anxiety. Such psychological factors can influence the perception of pain.

Some researchers are discussing the possibility of an imbalance of messenger substances in the gastrointestinal tract and inflammatory changes in the mucous membrane are also suspected of causing such complaints.


There is no single, typical symptom of irritable bowel syndrome. Instead, in most cases there is a similar complex of symptoms that is harmless.

People with irritable bowel syndrome often have symptoms such as Flatulence, Convulsions and irregular digestion. The stomach feels tense and full. As a result of the accumulation of air, pain can arise in different regions of the abdomen. Cramps, too Spasms and abdominal pain is also seen in connection with going to the toilet.
In addition, the stool changes in terms of frequency, texture and the urge to defecate. Admixed mucus is not uncommon. Listening to the intestinal region with the stethoscope reveals lively intestinal noises.

Basically, different types of irritable bowel syndrome can be distinguished. It depends on which symptom is dominant. One can differentiate between constipation and diarrhea type irritable bowel syndrome.


Medical history irritable bowel syndrome

Since patients with irritable bowel syndrome are ill, but actually physically healthy, the diagnosis is often difficult for the doctor. The procedure is referred to as so-called "exclusion diagnostics", because the final diagnosis of "irritable bowel syndrome" comes from the fact that all other diseases and inflammations that are present in the digestive tract and could lead to corresponding symptoms must be excluded.

The beginning of this odyssey is always a detailed survey of the medical history (anamnese), where the doctor can often collect valuable information about the type and duration of the complaints. Some symptoms, as well as late seeking medical attention, can be characteristic of irritable bowel syndrome. It is very helpful if the person concerned brings a diary with them when they visit the doctor, in which they have made notes about the frequency, intensity, type and duration of the pain.

The first conversation, after which the doctor usually already has the suspicion that irritable bowel syndrome is present, is followed by a thorough physical examination. Depending on the findings the doctor made during the anamnesis, different examinations can be useful in different ways. For example, the doctor will not perform the same tests on every person with suspected irritable bowel syndrome.
First of all, the abdomen is often scanned and listened to, or the rectum is scanned (rectal examination). This is usually followed by a laboratory blood test, which usually includes at least a blood count and inflammation parameters (such as CRP); liver and kidney values ​​can also be requested to rule out diseases in these organs. The stool will also be checked for blood, bacteria, or parasites.

In addition, depending on the suspicion of specific other diseases, there are further measures for making a diagnosis. An ultrasound of the abdomen can be done, for example to rule out gallstones. In order to rule out diseases such as chronic inflammatory bowel disease (especially Crohn's disease and ulcerative colitis) or intestinal tumors, an intestinal or gastroscopy can be performed, which may be supplemented by taking a tissue sample (biopsy). If necessary, an X-ray examination or computed tomography (CT) can also be useful. Since food intolerance such as lactose intolerance can also be responsible for corresponding symptoms, food intolerance tests occasionally also play a role in the diagnosis. Last but not least, the diagnosis should, under certain circumstances, also include a psychosomatic examination in order to determine the presence of anxiety disorders and depression, which can be both causal and caused by the illness and play an important role in the patient's quality of life.

Finally, the so-called Rome criteria are important for the definitive diagnosis of irritable bowel syndrome, which assume that no biochemical or structural changes in the digestive tract can explain the symptoms. These criteria are met if the patient has experienced abdominal pain or discomfort within the last 12 months that was associated with at least two of the following three characteristics:

(1) The symptoms improve after a bowel movement
(2) the frequency of bowel movements has changed since the symptoms began
(3) The appearance or consistency of the stool has changed since the symptoms began.

Symptoms must have occurred for at least three days per month in the past three months. Additional criteria that support the diagnosis, but do not prove it, are flatulence, abnormal frequency of stool (more than three times a day or less than three times a week), abnormal stool consistency, slimy stool, or difficult defecation (incomplete evacuation or heavy pressing).


Treatment for irritable bowel syndrome is primarily aimed at relieving symptoms, as the cause is in many cases unknown. As a result of complaints, the quality of life can be impaired.

Since the symptoms are aggravated in connection with various factors, one focus should be on introspection. Little sleep, stressful situations and food intolerance can intensify the disease and, when people become aware, avoid them. In this context, learning different relaxation techniques can help. This includes, for example, progressive muscle relaxation Jacobson.
If a psychological trigger for irritable bowel syndrome can be identified, there is the possibility of psychotherapeutic treatment.

A balanced diet with lots of vitamins and fiber, as well as adequate fluid intake, provide a useful basis for alleviating symptoms.

In the case of constipation, a high-fiber diet, sufficient exercise and a daily fluid intake of 1.5-2 liters are recommended. Furthermore, probiotics from living microorganisms promote the development of an intact intestinal flora.
They are contained in various foods, for example in probiotic yogurts such as Actimel® or Yakult®. These are not conventional bacterial cultures, but rather those that survive in spite of the acidic stomach environment. Only the regular consumption of probiotic products has a positive influence on the intestinal flora.

In addition to symptomatic treatment with medication, homeopathic remedies are also used in the treatment of irritable bowel syndrome. The ginseng root, for example, and Schüssler salts help relieve gastrointestinal discomfort.

For the treatment of irritable bowel syndrome there has been a completely new approach to therapy for some time. The stool transplant is already used for the treatment of inflammatory bowel diseases and is now also intended to help treat irritable bowel syndrome.
A stool transplant is the transfer of stool or the bacteria contained in stool from a healthy donor into a patient's bowel. The aim of stool transplantation is to restore the irreparably damaged intestinal flora of the patient and thus to create or at least promote a physiological, i.e. healthy microbiome.
Since the cause of irritable bowel syndrome is largely unexplained to this day and the term irritable bowel syndrome actually seems to be a collective term for various diseases, a great deal of research is still required on the subject. There are virtually no studies, case collections or experiences of treating irritable bowel syndrome with a stool transplantation worth mentioning.

Read more on the topic: Treatment of irritable bowel syndrome

Irritable bowel syndrome medication

Different drugs are used depending on the prevailing symptom.

Laxatives include linseed and pectin, such as Macrogol. They belong to the group of swelling substances that make the stool softer. Lactulose is a non-recyclable sugar that binds water to itself and in this way results in softer stools.

If diarrhea is the predominant symptom, comes Loperamide for short-term use in question. It has an inhibiting effect on intestinal muscle activity. Since toxins can accumulate in the intestines, it should be taken for a maximum of two days. Furthermore, soluble fiber in the form of herbal supplements such as Psyllium, such as Probiotics relieve the symptom of diarrhea.

Read more on the topic: Kijimea®

In the treatment of painful cramps, herbal ingredients help, among other things, in Caraway seed-, fennel-, anise- and Camomile tea are included. A hot water bottle can also calm the cramped intestinal muscles. Only when such measures do not have any effect are various pain relieving drugs used.
However, your intake should be limited for a short time.

The muscle relaxant helps against flatulence and cramps Antispasmodic Mebeverin and that Parasympatholytic agent Butylscopolamine. So-called serotonin reuptake inhibitors are used in treatment if, in addition to the painful symptoms, there is a mental illness in the form of depression.

Herbal ingredients in caraway, fennel, aniseed and chamomile tea also help in the treatment of flatulence. As a non-prescription drug, the puffing agents simethicon and dimethicon are available in pharmacies.

Guidelines for irritable bowel syndrome

Specific guidelines for irritable bowel syndrome have been developed to assist in decision-making on health-related matters.
They serve as a helpful guide in treatment. The S3 guideline on irritable bowel syndrome is currently being revised. According to the 2009 guideline, the disease is diagnosed based on three main criteria:

  1. the complaint interval is more than three months and is associated with the intestine
  2. the person concerned feels restricted in his quality of life and
  3. other diseases can be excluded with a high degree of certainty. Women are affected more often on average.

The doctor-patient relationship comes into play Treatment of irritable bowel syndrome a fundamental position too. It serves, among other things, the thorough and sensitive uncovering of the pathophysiological disease mechanism, which can be based on a complex system of different causes.

In addition to symptomatic treatment with medication, diet plays an important role. However, no general recommendations can be made, as each clinical picture shows different, strongly pronounced symptoms.


The Irritable bowel syndrome Subjectively causes severe complaints, but does not cause any tangible physical damage even with a chronic course.


One can Irritable bowel syndrome unfortunately not immediately preventive, at least not based on current knowledge. Not only with regard to the development of irritable bowel syndrome, but also other common diseases (such as arteriosclerosis, Obesity or Type 2 diabetes mellitus) To prevent it, however, it makes sense to focus on a healthy and balanced diet nutrition to pay attention. These include, above all, foods rich in fiber, as little fat as possible and an adequate supply of fluids, which should primarily consist of water or diluted juices. In addition, sports and various also have an effect Relaxation training positive.


The Irritable bowel syndrome is a very common disease, which is still largely a mystery to medicine. Although the symptoms are like diarrhea, constipation, Stomach cramps or Flatulence undeniably occur and are sometimes so severe in those affected that they significantly reduce their quality of life, no pathological tissue / organ changes or inflammations in the digestive tract can be detected. The diagnosis of irritable bowel syndrome is correspondingly difficult and lengthy, since any other possible diseases with organic reasons must be ruled out in advance.
All of this also results in a very limited possibility of Treatment of irritable bowel syndromewhich consequently is not characterized by the elimination of causes and thus the striving for a complete cure, but is only intended to alleviate the suffering of the patient. As a positive point, however, it should be noted that the symptoms of those affected often diminish or even disappear completely over time and that no form of irritable bowel syndrome is associated with a reduced life expectancy or an increased risk of secondary diseases such as cancer.

Treatment of irritable bowel syndrome in homeopathy

Further information on the topic of treating irritable bowel syndrome with homeopathy is also available under our topic:

  • Homeopathy for irritable bowel syndrome