Unpredictable IBS

Symptoms of spastic colon often fluctuate along with the ups and downs of life stress


The colon is best heard from once a day, and otherwise should be out of mind. But for those who suffer with a spastic colon condition, this organ unfortunately is often top of mind.

Doctors call it functional bowel syndrome, but spastic colon or irritable colon are more descriptive terms.

It’s also known as IBS, short for irritable bowel syndrome.

Whatever the name, the characteristic irregularity of bowel movements and associated colon distress brings misery to many.

The symptoms of spastic colon include constipation, diarrhea, belly cramps, gaseousness and bloating, mucous in the stool and passage of rabbit-like bits of stool.

All of these symptoms may exist, but one or a few are usually prominent.

Irregularity is the common feature.

Most people with spastic colon complain of both constipation and loose stool, one following the other in a poorly predictable fashion.

Some experience only constipation, and some have only looseness and increased frequency of movement.

Distention, bloating and cramps may be as distressing as the irregularity.

The symptoms of spastic colon typically persist for months, years or even a lifetime.

It’s the persistence of symptoms — without deterioration in general health — that distinguishes this disorder from other colon ailments.

Weight loss, fever, bleeding, steady worsening of symptoms and ill health aren’t due to a spastic colon condition.

Forces of nature

The cause of a spastic or irritable colon is a disturbance in bowel motility.

The colon (or lower bowel) normally contracts slowly and smoothly, forcing stool toward the rectum.

With spastic colon, the motility rhythm is disturbed and colon contractions are overactive in some areas and diminished in others.

The final symptoms depend on the balance of the contractile forces.

Most experts feel there’s an association between emotional stress and the presence of a colon motility disorder.

Easygoing people who cope well to stress are less likely to suffer from a spastic colon than those who are tense, compulsive and prone to worry.

An overly simplistic explanation is that stress causes the nervous system to send jumbled signals to the colon.

There’s no test or X-ray that allows a physician to diagnose a spastic colon condition.

A doctor performs tests only to make sure that other, more serious ailments that can cause similar symptoms don’t exist.

Tests are less likely to be ordered if symptoms are chronic, typical and not progressive.

Colon cancer, diverticulitis (tics), colon infection and colon inflammation are diseases that can produce symptoms similar to those caused by a spastic colon.

The prognosis with a diagnosis of spastic colon is excellent.

The person suffers, but general health remains good.

The symptoms may be relentless and the colon may try to rule the person’s life, but most often the troubles are tolerable.

Symptoms often wax and wane in concert with the ups and downs of life stresses.

In its very mildest form (might we all have a bit of it?) there’s loose stool with stress and constipation with travel.

Treatment is drug free

The only good news about spastic colon is that a person needn’t go broke buying medications.

In fact, medications are best avoided.

Treatment starts with an evaluation by a physician and education about the nature of the problem.

Regular well-balanced meals, high in bulk and low in sugar, are helpful.

Avoidance of foods such as milk products and spices proves worthwhile for some.

Exercise, along with moderation in use of alcohol and caffeine, are helpful parts of a treatment plan that’s directed at changing lifestyle.

The most effective, and most difficult, way to alleviate symptoms is to control stress and worry.

Maybe there’s more good news — functional bowel syndrome isn’t more common in older persons than in those who are younger.

But in an older adult, a physician may too readily attribute symptoms to functional bowel syndrome and dismiss them as harmless when they actually may be caused by another more serious disease.

If you suffer symptoms of spastic colon, take comfort in the knowledge that a whole lot of others have the same problem.

Make sure a physician advises you that the troubles aren’t caused by something more serious, and then follow your doctor’s advice on how to control your symptoms.

Dr. Michael Spilane, now retired, spent more than four decades practicing and teaching geriatric medicine in St. Paul. Send comments or questions to [email protected].