Funky malfunctions
Part of what makes IBS so hard to deal with is that it’s a “functional disorder.” When the intestines of an IBS sufferer are examined, doctors don’t find biological, biochemical, or structural problems. Things look normal. But despite this appearance of good health, the gut doesn’t function correctly.

A normally functioning intestine moves food along with regular, gentle, rhythmic contractions. These contractions are triggered by a variety of stimuli. In an IBS sufferer, the colon is too sensitive and overreacts to these stimuli. As a result, the colon contractions are out of order, either too slow, too fast, or too violent, which leads to wide-ranging and often unpredictable symptoms. If the contractions are too slow or prolonged, or the colon holds tension, constipation and cramps can result; too fast, and you’ve got violent diarrhea with cramping. Or the contractions can be mistimed, trapping gas in the gut, which causes pain and bloating.

To make matters worse, it’s not always clear which stimulus causes any given attack of IBS. In many cases, specific foods can be a trigger. Some common triggers include fatty foods, alcohol, and dairy products. Many female sufferers report that symptoms worsen before or during their menstrual cycle, suggesting that hormonal fluctuations may act as a trigger as well.

Stress is also believed to be a trigger, but experts agree that one shouldn’t assume that IBS is “all in your head.” Current diagnostic standards characterize IBS at a “brain-gut dysfunction,” meaning that IBS is a result of a malfunction of the connection between the brain and the intestines. The nerves become stimulated too easily, which leads to a miscommunication between the brain and the gut. The bottom line: IBS is a physiological problem that needs to be viewed as a medical issue, not a psychological problem.