What is Irritable Bowel Syndrome?

Are you experiencing alternating diarrhea and constipation these past few days and have been confined to home by abdominal pain? If yes, better visit your doctor for you might have an irritable bowel syndrome. What is irritable bowel syndrome?

Irritable bowel syndrome (IBS) is a functional bowel disorder and not a disease. That means that the bowel is not functioning in a normal condition and is not caused by identifiable infection or biochemical cause. It is a syndrome which consists of group of symptoms. IBS is characterized by chronic abdominal pain, bloating, and alternation of constipation and diarrhea. In some cases, the condition is relieved by defecation.

IBS is sometimes referred to the following medical terms: irritable colon, colitis, mucous colitis, spastic bowel, nervous stomach, and spastic colon. IBS may probably recur in later life but the good news is, the symptoms of IBS will not get worse after the first year. Learning to manage the symptoms of IBS is the key to having a comfortable life. There is no need to worry if you have an IBS since it does not cause permanent damage to the bowel or cause cancer. Furthermore, it does not need surgery to treat it.

Incidence

Statistics reveal that in the western world, irritable bowel syndrome is very common. If affects as much as 20% of the population and accounts for 10% of all doctor visits and 50% of all visits to the gastroenterologists. Two thirds of patients with IBS are female and IBS ranked second in the reasons why many people take “sick leave”.

Classification

IBS can be classified as diarrhea predominant, constipation predominant, or IBS with alternating stool pattern. In some patients, IBS may occur after an infectious illness which may include one or two of the following: vomiting, fever, diarrhea or positive stool culture. This post infective IBS is often referred to as “post-infectious IBS”.

Causes

The main cause of irritable bowel syndrome is not fully known but there are proposals that reveal the possible cause of IBS. Some resources revealed that there is a “derailing of the brain-gut axis” which results to IBS. There are also some sources that say that there is an abnormality in the immune system of the person or there are some abnormalities in the gut flora. There are some cases where people develop IBS after episodes of gastroenteritis. Stress and food allergies are also some studied reasons why there is IBS.

Symptoms

The hallmark of irritable bowel syndrome is abdominal pain which is relieved by bowel movement. However, the following symptoms may also be observed:

Diarrhea
Constipation
Change in bowel habits
Flatulence
Bloating
Feeling of incomplete evacuation of stool (tenesmus)

Some sufferers of IBS may experience gastroesophageal reflux and psychiatric symptoms such as depression and anxiety. There are studies that reveal that as much as 60% of those with IBS have psychological disorder, typically anxiety or depression.
The symptoms of IBS may worsen during stressful situations or during menses but these situations does not lead to IBS per se.

Diagnosis

There is actually no specific diagnostic procedure that can lead to the diagnosis of IBS, However, diagnostic tests should still be done in order to rule out diseases that produce IBS-like symptoms such as celiac disease, parasitic infections like giardiasis, fructose malabsorption, and inflammatory bowel diseases. Ruling out of the conditions above are important before a diagnosis of irritable bowel syndrome is made. In patients who ages 50 years old and above, it is recommended that they should undergo a screening colonoscopy.

Management

Below are some of the management of irritable bowel syndrome.

1. Diet

There are some people with IBS that have food intolerances. Dietary modification can be attempted to decrease the incidence of IBS symptoms. A lactose free diet and a diet restricting fructose and fructan have shown to successfully decrease symptoms of IBS.

2. Fiber

It has been found that soluble fiber supplementation is very effective in general INS population. Fiber acts as a bulking agent which allows for a more consistent stool for those experiencing diarrhea and allows a softer and passable stool for those experiencing constipation.
For those with constipation predominant IBS, 20 grams of fiber a day can help reduce overall symptoms but not with the pain.

3. Medication

Laxatives, anti-diarrheals, and pain relievers are found to help patient deal with symptoms of irritable bowel syndrome. Laxatives work well with those experiencing constipation-predominant IBs while anti diarrheals works well with diarrhea-predominant IBS.
Antispasmodics such as hyoscymine or dicycloine can help patients with abdominal cramps.
Since psychiatric symptoms have been found to exist with other symptoms of IBS, there are drugs that can be given to patients exhibiting these symptoms and one of which is tricyclic antidepressants.

Probiotics are also beneficial in treating IBS. Studies reveal that taking 10 billion to 100 billion beneficial bacteria per day can produce beneficial results. Some of the most effective probiotics are Lactobacillus plantarum and Bifidobacteria infantis.

4. Psychotherapy

Psychological therapy has been found to be effective in some patients with IBS. Cognitibe behavioral therapy and hypnosis were among those with beneficial effects. Cognitive behavioral therapy provides sufferers with coping strategies that can help them deal with the stressful symptoms of IBS and help them suppress behaviors that increase symptoms of IBS. On the other hand, hypnosis can help improve mental well being of IBS sufferers.