Irritable Bowel Syndrome (IBS):
What is irritable bowel syndrome?
Irritable Bowel Syndrome (IBS) is a chronic disorder and is most commonly characterized by abdominal pain, cramping, bloating, constipation, and diarrhea. There is no obvious cause for IBS. Persons with IBS typically experience a great deal of discomfort and distress; however IBS does not commonly lead to any serious diseases, such as cancer. This disorder most commonly affects persons between the ages of 20 and 30 and is twice as common in women as in men. Approximately 20 percent of the adult populations is affected IBS, making it one of the most common digestive disorders.
Symptoms of IBS:
The most common symptoms of IBS include abdominal pain and occasional diarrhea, often alternating with constipation, rapid transit of food with frequent bowel motions, a sense of fullness (bloating), abdominal tenderness and swelling, an awareness of the bowel action and often headache and anxiety.
Abdominal pain is usually felt in one of the four corners of the abdomen, especially the lower left corner. It is sometimes brought on by eating, and is often relieved by having a bowel movement. The stools are often ribbon-like or pellet-like and may contain mucus. Oftentimes, after a person has eaten, there is extreme urgency to empty the bowels. Other symptoms may include:
- Burping
- Bad breath
- Excessive gas production
- Headache
- Tiredness
- Nausea
- A sense of incomplete emptying after going to the toilet
Causes of IBS:
Researchers have yet to discover any specific cause for IBS. One theory is that people who suffer from IBS have a colon that is particularly sensitive to particular foods and to stress. The immune system, which fights infection, may also be involved. A person with IBS may not have normal motility or movement of their colon, which can be spasmodic or can even stop working temporarily. The lining of the colon called the epithelium, which is affected by the immune and nervous systems, regulates the flow of fluids in and out of the colon. In IBS, the epithelium appears to work properly. However, when the contents inside the colon move too quickly, the colon looses its ability to absorb fluids. The result is too much fluid in the stool. A person’s colon may respond strongly to stimuli such as certain foods or stress that may not bother most people.
Recent research has reported that serotonin is linked with normal gastrointestinal (GI) functioning. Serotonin is a neurotransmitter that delivers messages from one part of your body to another. Ninety-five percent of the serotonin in your body is located in the GI tract, and the other 5 percent is found in the brain. Cells that line the inside of the bowel work as transporters and carry the serotonin out of the GI tract. People with IBS, however, have diminished receptor activity, causing abnormal levels of serotonin to be present within the GI tract, and as a result, people with IBS experience problems with bowel movements, motility, and sensations.
Researchers have also found very mild celiac disease in some people with symptoms similar to IBS. People with celiac disease cannot digest gluten, a substance found in wheat, rye, and barley. People with celiac disease cannot eat these foods without becoming very sick because their immune system responds by damaging the small intestine. A blood test can determine whether celiac disease may be present.
The following have been associated with a worsening of IBS symptoms
- large meals
- bloating from gas in the colon
- medicines
- wheat, rye, barley, chocolate, milk products, or alcohol
- drinks with caffeine, such as coffee, tea, or colas
- stress, conflict, or emotional upsets
- Researchers have found that women with IBS may have more symptoms during their menstrual periods, suggesting that reproductive hormones can worsen IBS problems
Diagnosis:
A physician may diagnose a patient with IBS after full investigation has failed to reveal any underlying cause and the symptoms are strongly suggestive of irritable bowel syndrome. A physician may perform a full medical investigation, including a rectal examination, a barium meal X-ray, and sometimes a gynecological examination, to confirm the diagnosis. Oftentimes the colon is seen to be in a state of unusual activity, contracting and relaxing in an abnormally rapid manner. Researchers have now created guidelines for the diagnosis. The affected person should, for at least 12 weeks in the last 12 months, have suffered abdominal discomfort or pain for which no other cause is found. The 12 weeks need not be continuous but may be a total. The person should also show at least two of the following three features:
- Pain is relieved by defecation (opening the bowels)
- Pain is associated with a change in the frequency of bowel movement, either an increase or a decrease
- There is a change in the form of the stool - it is watery, loose or pellet-like.
Treatment options:
No cure has been found for IBS, but many options are available to treat the symptoms. It is often recommended that patients strictly control their diet and the amount of stress to which they are subjected. Medications are an important part of relieving symptoms. A physician may suggest fiber supplements or laxatives for constipation, or medicines to decrease diarrhea. An antispasmodic is commonly prescribed, which helps to control colon muscle spasms and reduce abdominal pain. Antidepressants may relieve some psychological symptoms, such as depression and anxiety. Both antispasmodics and antidepressants can, however, worsen constipation, so some doctors will also prescribe medications that relax muscles in the bladder and intestines, such as Donnapine and Librax. These medications contain a mild sedative, which can be habit forming, so they need to be used under the guidance of a physician.
Medications affect people differently, and no one medication or combination of medications will work for everyone with IBS. Patients will need to work with their doctor to find the best combination of medicine, diet, counseling, and support to control the symptoms of IBS.
Related information:
| University of Missouri Health Care | This information is not intended to replace the advice of a doctor. |
