Irritable Bowel Syndrome (IBS)

What is IBS?

Irritable bowel syndrome is a disorder primarily of the large bowel. It is a common condition that causes abdominal pain, bloating, abdominal distension, gas, diarrhea or constipation. The exact cause and disease process in irritable bowel syndrome is unknown. It is believed that the problem may lie with faster or slower than normal bowel motility. IBS may also be referred to as spastic colon. In most cases the symptoms improve when the disease is controlled by management of lifestyle and stress.

What are the symptoms of IBS?

Symptoms of IBS can vary substantially from person to person. The common symptoms include :

  • Abdominal cramps and pain usually relieved with passage of stools
  • Diarrhea or constipation
  • Change in the consistency of the stools
  • Gas (flatulence)
  • Abdominal distension
  • Bloating – feeling of fullness in the stomach

There may be associated symptoms such as anxiety, fatigue and headaches. IBS is a chronic bowel disorder. Although a person has symptom-free periods, the symptoms often return in acute episodes.

What are the causes of IBS?

The cause of IBS is not clearly known. It is neither contagious nor hereditary. Women are affected to a greater extent.

IBS may be caused by abnormal contraction of the abdominal muscles or due to an increased awareness of the movements of the intestine or a combination of the two. These periodic contractions are involuntary and are required for the movement of food through the intestine. The contractions might be stronger and longer, which will lead to the food passing very quickly leading to gas and diarrhea.

Slower contractions can also occur which might lead to constipation. Abnormal contractions can be due to improper functioning of the muscles or due to improper signals from the nervous system that control these contractions.

The trigger for these can be food, stress or even hormonal changes. Food such as milk, alcohol may lead to the IBS symptoms to worsen in some people. Stress is another major cause, which can aggravate symptoms of the IBS. Hormones can lead to worsening of the symptoms as many women find exacerbation of IBS during their menstrual periods.

How is IBS treated?

Since the causes of IBS are not known yet, the treatment usually deals with relieving the symptoms. Mild symptoms are can easily be controlled by controlling stress and managing the diet.

In moderate to severe cases some treatment may be administered. Fiber supplements such as psyllium or methylcellulose will help control constipation. Anti-diarrheal medicines such as loperamide can help control diarrhea. Food that can lead to gas such as carbonated beverages, salads, raw fruits or vegetables such as broccoli cauliflower are best avoided.

In some cases, anticholinergic medicines may be prescribed. These act on the nervous system and can help in reducing the painful cramps. Tricyclic antidepressants also seem effective in controlling the symptoms.

In IBS with constipation where other treatments have failed, lubiprostone can be prescribed. This is a chloride channel activator, which will increase the secretion of fluids into the intestine thereby allowing smooth passage of stools in constipation predominant IBS. Alosetron may be prescribed in severe cases of diarrhea when all other treatments fail.

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