01 May Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is a very common functional disorder, with a point prevalence of 15% of the population. It is a functional gastrointestinal pain disorder and is characterized by various symptoms including abdominal pain, but there are no structural defects.
The symptoms include abdominal pain and diarrhea/constipation and can range from mild to severe, but can be waxing and waning. However, troubling symptoms/signs of fever, low red blood cell levels, rectal bleeding, and unexplained weight loss are not related to IBS and may indicate a serious underlying medical condition.
If you experience rectal bleeding or unexplained weight loss, you should consult a specialist.
IBS is an idiopathic condition, which means that it is not known what causes it. There may be a problem with the functioning of the enteric nervous system resulting in increased bowel “irritation” or sensitivity causing the muscles in the bowel wall to contract and relax n an uncoordinated fashion.
There are some factors that predispose to IBS, including female gender (twice as common as compared to men), bacterial overgrowth in gut, food intolerance, as well as several other environmental and genetic factors. High-stress levels may worsen IBS symptoms as well.
There is no single test to confirm the diagnosis of IBS. It is based on a careful history and physical examination. It is a diagnosis of exclusion, which means that other more serious conditions need to be ruled out first. The symptoms of IBS occur at least three days a month for three months, and the associated abdominal discomfort improves after a bowel movement or passage of gas.
Given that it is a functional disorder, the treatment is conservative and includes stress relief, regular exercise, improved sleep habits, behavioral therapy, physical therapy, biofeedback, relaxation or pain management techniques, diet modification, etc.
Best dietary changes for IBS may be adding high fiber (as it helps with constipation, but can alternatively worsen diarrhea). Low-fat diet is generally a good idea if you have IBS. Elimination diet can be attempted to see which food type is the worst offender, such as coffee, chocolate, nuts, insoluble fiber, etc. Drinking plenty of water, exercise regularly and decrease your caffeine intake are advisable to promote regularity and improve IBS symptoms overall.
There is no single medication works for everyone. Antispasmodics may help control symptoms in moderate to severe IBS. Some patients may benefit from antidepressants in low doses.
IBS is a chronic condition and patience is the key when dealing with it. Treatment largely depends on trial and error, and each patient tends to respond differently, and even then relief is slow. It may take six months or longer for symptoms to improve. If left untreated, the condition may worsen or even get better. Albeit symptomatic, these treatments do improve the quality of life of these patients.