By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

IRRITABLE BOWEL SYNDROME NOT A RISK FACTOR FOR COLON CANCER

Question: I have had irritable bowel syndrome (IBS) for two years. It seems to have started after I had a case of the stomach flu. I had a colonoscopy done and the doctor found only a few benign polyps, which he removed. I was told I didn’t have to have another colonoscopy for five years. Still I’m worried that my IBS will eventually turn into cancer. Do you have any suggestions for diet or medications that might help my IBS? 

Answer: About 20 percent of the population has irritable bowel syndrome(IBS). It can occur at any age and is more common in women than men. IBS affects the colon, or large intestine, which is the last five feet of the intestinal tract. That’s the region where water is absorbed from the waste products of digestion and the stool is made firm.

IBS is what doctors call a “functional disorder.” This means that there’s nothing wrong with the actual health of the body part; it’s just not operating, or functioning, correctly. These functional problems are distinguished from organic disorders, where a body part or organ is actually diseased. For example, cancer and many types of heart disease are organic disorders.

The primary symptoms of IBS are cramping and diarrhea after eating. And while these cramps -- often accompanied by gas -- can be very painful, IBS does not damage the colon or lead to other diseases. Many things can trigger IBS symptoms. Certain foods are frequent culprits. These include chocolate, milk and dairy products, caffeine, beans, carbonated beverages, alcohol and high-fat foods. In many people stress can also lead to intestinal symptoms.

The diagnosis of IBS is one of exclusion. First, your doctor made a tentative diagnosis based on the signs and symptoms that you have. Then he excluded all the possible organic causes of your disease before concluding you have IBS. The colonoscopy you had was part of this exclusion process. Also, it’s a wonderful preventive measure. That’s because polyps you had removed during that colonoscopy may have prevented a future colon cancer.

At this point, I’d stop worrying. IBS does not cause long-term harm to the intestines and does not lead to other diseases such as colon cancer, or Crohn’s disease. Just make sure that you have that next colonoscopy in five years.

In the meantime, treatment for your IBS should be individualized to correct the primary problems that you are having. Avoiding offending foods is a place to start. I’d recommend trying an elimination diet. That means selectively eliminating certain foods from your diet and then seeing how your IBS reacts. A good place to start would be to eliminate dairy products. You mentioned in another part of your letter than “beans and cabbage” tear you up. It sounds like those are triggers that should be avoided.

Using laxatives if you are constipated or anti-diarrheal medications if you have diarrhea can make you feel better. Some people with IBS benefit from taking antidepressants.

I’d recommend that you work closely with your doctor to help find what works to minimize your symptoms. There are some newer prescription medications on the market for IBS, but they work best when you first eliminate as many IBS triggers as possible.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.