IRRITABLE BOWEL SYNDROME

What Is Irritable Bowel Syndrome? Irritable bowel syndrome, or IBS, is a common disorder of the intestinal system which affects 10-20% of the general population. It is a chronic disorder that is characterized by abdominal pain associated with altered bowel habits such as increase in frequency of stool or change in consistency of stool (i.e diarrhea or constipation). In the majority of cases, the abdominal pain is relieved by defecation. One may also have mucus in the stool, and may feel bloated. Doctors will often only consider IBS as a diagnosis if these symptoms persist either intermittently or continuously for three months or more. Although IBS is a source of distress and irritation, it does not cause any permanent damage to the intestines and is not known to be associated with any serious diseases such as cancer.

What Causes IBS? No one knows the cause of IBS and numerous attempts to find any intestinal changes related to IBS have been unsuccessful. Previously, it was believed that stress was a major factor in the development of IBS. Currently there is no proof that emotional stress causes IBS; however, it is still thought that stress can worsen IBS symptoms. One theory about IBS is that it is a motility disorder of the colon in which the colon is hypersensitive to mild stimulation. Another theory is that patients with IBS react differently to visceral pain (i.e. pain from the intestines). While research has consistently indicated that patients with IBS have lower pain thresholds, no consensus exists regarding the cause of IBS.

What Are The Signs And Symptoms Of IBS? Along with the abdominal-related signs and symptoms mentioned above, patients may also experience a variety of other symptoms such as non-cardiac chest pain, heartburn, difficulty eating, a sensation of something stuck in the throat, fatigue, and complaints related to dysfunctions of the urinary or gynecological systems. However, IBS does not usually cause blood in the stool, weight loss, fever, or pain which is strong enough to wake you up. If you have any of these latter signs or symptoms, you should call your doctor.

With What Can IBS Be Confused? IBS can be confused with other conditions which can cause abdominal pain and changes in bowel habits. These include lactose intolerance, inflammatory bowel disease, bowel obstruction, infections such as giardiasis, and cancers of the gastrointestinal system such as colorectal cancer. Depression, panic disorders, somatization (in which a variety of physical complaints occur that cannot be fully explained on the basis of a physical disorder) and anxiety can also be confused with IBS. In women, endometriosis must be ruled out. It is thus important to consult a physician in order to establish that you have IBS and not some other disorder.

What Can You Do For IBS? Dietary changes are important to managing IBS. You should avoid dairy products; foods, drinks, or medications with fructose or sorbitol in them; excessive caffeine; and foods associated with the production of gas, such as beans. Fibre supplements are recommended if you are constipated. If these dietary modifications are not helpful, your doctor may prescribe appropriate medications for relief of abdominal cramps and pain, diarrhea or constipation. For relief of cramps (spasms), an antispasmodic agent such as dicyclomine or a mixture of chlordiazepoxide and clidinium may be prescribed. Another commonly employed mixture contains phenobarbital, hyoscyamine, atropine and hyoscine. For diarrhea, drugs such as diphenoxylate or loperamide are useful. If constipation is a problem, then a psyllium-containing medication can be employed. Sometimes intolerance to the sugar lactose can be a factor in the production of cramps or diarrhea, in which case curtailment of lactose in the diet and use of the enzyme lactase should be beneficial. When flatulence is a factor, an antiflatulence compound such as simethicone may also be of help. If ongoing IBS results in depression, an antidepressant such as amitryptiline, desipramine or imipramine may be used. Employment of narcotic drugs for relief of pain should be avoided.