Irritable Bowel Syndrome
• What Is Irritable Bowel Syndrome?
Guide To IBS
|What Is Irritable Bowel Syndrome?
Irritable bowel syndrome (IBS) is where a person suffers intermittent bouts of abdominal pain, combined with either constipation or diarrhea (image). These symptoms occur in the absence of any other disease or cause being diagnosed. Doctors and gastroenterologists (specialists in bowel and digestive disorders) differ on the exact definition of IBS, despite efforts to standardize diagnostic criteria. It is a syndrome which means that a collection of symptoms occur together in a typical pattern. It affects at least 15 percent of the American population although the exact figure is unknown because most people never seek medical care for it. IBS has had several names in the past including mucous colitis, spastic colitis and nervous stomach. As the suffix -col implies of the colon and -itis implies inflammation - and IBS does not cause inflammation nor is not limited to the colon - these terms are no longer used. IBS is not the same as inflammatory bowel disease (IBD) which does cause inflammation. Symptoms of IBS usually start in early adulthood; and it is quite rare for them to start after the age of 50. IBS tends to affect more women than men. Whether this is because of physiological differences between the sexes or simply because women are better at reporting bowel disorders to their doctors, is not clear. Interestingly enough, in less developed countries more men report cases of IBS than women. This may have something to do with cultural biases in using local medical healthcare systems. People can generally manage IBS with dietary changes, medications and stress management. However, for some it can be a debilitating condition disrupting their personal life and work.
Although IBS symptoms can be quite uncomfortable and distressing, IBS does not appear to harm the intestines or predispose a person to more serious illnesses, nor does it shorten a person's life expectancy. It can however cause embarrassment, harm relationships, cut short vacations and spoil an evening out. In addition, surveys show that women who suffer IBS are nearly 55 percent more likely to have abdominal surgery than healthy women, in particular ovarian surgery and hysterectomy. Why this should be, is still not clear. What is known however is the cost of IBS to those who suffer in terms of medical expenses. According to one study the direct medical costs annually exceed $8 billion and patients with IBS incur 74 percent more direct healthcare costs than non-IBS sufferers.
Scientists have yet to discover a specific cause for IBS. It occurs when exaggerated muscular contractions in the intestines take place. There are two types of intestine contractions: segmenting contractions which keep waste products from expelling too quickly and propulsive contractions which propel the food forward. When segmenting contractions become too excessive, constipation occurs. When propulsive contractions become too excessive, diarrhea can result. Possible causes for excessive contractions include:
• Sensitivity or reaction to certain foods/drinks such as dairy products, caffeine and wheat.
Research into possible IBS causes is ongoing, in particular on the influence of hormones, nerves and inflammation.
• Abdominal pain with cramps, for at least 12 weeks in a year. Those weeks do not have to be consecutive.
Although some people experience symptoms every day, the majority can have days, weeks or even months without problems.
There is no specific test for IBS. Instead a doctor will make an IBS diagnosis based on a physical examination and the nature of the symptoms reported. For this reason it is important to keep an IBS food diary for at least 2 to 4 weeks before a doctor's appointment. When making an assessment the doctor will consider other potential causes such as lactose intolerance, bacterial infections, uterine fibroids, diverticular disease and colon cancer. Tests will need to be performed to rule out other problems, which may include sending a stool sample to labs, blood tests, ultrasound scan and X-Rays. A doctor typically performs a sigmoidoscopy or colonoscopy which allows them to look inside the colon. If the tests all return negative, then a diagnosis of IBS may be considered. Those who only report some symptoms are often diagnosed with functional bowel disorder, although doctors use the term interchangeably with IBS.
As IBS has so many different causes, there is no one treatment for all. For some, just knowing that the symptoms are not the result of a serious condition can reduce stress and alleviate the problem. However, for the majority of people, IBS treatment will involve both dietary changes and medications. Generally dietary changes involve decreasing intake of fat and increasing fiber. A doctor may also recommend taking fiber supplements as well as laxative supplements for constipation or antidiarrheal's for treating diarrhea. If neither of these remedies works, stronger medications may be prescribed. Anticholinergics (antispasmodics) such as Donnatal and Bentyl can alleviate muscle spasms and pain, even though they have not been proven for specifically treating IBS. Lotronex has been approved by the FDA for treatment in women with severe IBS who have not responded to conventional therapy. However it is fraught with complications and needs to be monitored very closely.
As the causes of IBS are not clear, there are no known ways to prevent the condition. However, there are certain prevention strategies which can reduce the effects and frequency of flare-ups. The most important thing to do is identify your personal triggers. Keeping an IBS food diary will help you do this. Note any medications or drugs you are taking. Antidepressants, cough medicines containing sorbitol and antibiotics taken for extensive periods may be troublesome. If you suspect a food intolerance such as lactose, have this tested.
As IBS is a chronic and often unpredictable condition, it can be challenging to live with. As presently there is no cure, it is important to learn ways to manage the symptoms when they occur. What works for one person may not work for another, so some trial and error work is necessary. However, there are some general guidelines and tips to managing IBS:
• Do get a diagnosis; otherwise you may spend time stressing and worrying about the cause.
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