Irritable bowel syndrome (IBS) is a common ailment that involves flares of abdominal pain, bloating, gas, and constipation or diarrhea. Most people who have IBS only experience minor, infrequent symptoms. Severe IBS, however, is a chronic problem in which symptoms can be bad enough to significantly impair a person's ability to enjoy a normal life. There is not a reliable cure for severe IBS, but a doctor can prescribe medications to relieve symptoms and suggest lifestyle changes that may help a person learn to better manage his or her condition.

It is not always clear what causes severe IBS to develop. It is most commonly seen in adolescents and young adults, and more often afflicts females than males. Problems are thought to be related to neurological disorders that affect muscle contractions in the intestines. Abnormal contractions can cause waste to pass through the long intestine quicker or more slowly than it should, which irritates the lining and causes IBS symptoms. Stressful conditions, alcohol, dairy products, and spicy foods are common triggers of mild or moderate IBS, but people who suffer from severe problems tend to experience symptoms regardless of what they eat or what their emotional states might be.

The most common symptoms of severe IBS include stomach cramps, tenderness in the abdomen, and bloating. Some people have excessive gas and diarrhea episodes several times a day. Frequent diarrhea can lead to dehydration, fatigue, and other health problems. Constipation may also occur that lasts for several days and causes loss of appetite and nausea. Painful hemorrhoids inside or outside of the rectum can develop that make it uncomfortable to sit and walk.

A person who experiences gastrointestinal problems for more than a few days should visit a doctor. The physician can ask about symptoms and try to rule out other possible causes, such as lactose intolerance or inflammatory disorders such as Crohn's disease and ulcerative colitis. In order to confirm a diagnosis, a patient may need to undergo a colonoscopy so the doctor can look for damage to the large intestine.

A number of different treatment options are available to help people manage severe IBS. Antispasmodics are drugs that calm nerve signals in the bowels that trigger muscle contractions. A patient may also be given anti-diarrhea drugs; laxatives; or topical ointments to ease hemorrhoid pain. Doctors also help patients identify and avoid foods that seem to make symptoms worse. Counseling is suggested for many people to help them maintain positive attitudes and learn how to better manage stress in their lives.