Irritable bowel syndrome


  • Health
  • Sunday, 05 Oct 2003

IRRITABLE bowel syndrome (IBS) is also known by many other names, such as nervous colon, spastic gut and irritable colon.  

The terms describe a series of symptoms that affects the gut such as abdominal pain and altered bowel habits that has no discernible cause.  

 

What happens in IBS? 

Approximately 50% of people with IBS report symptoms beginning before they were aged 35 years. You could experience the following symptoms: 

·       Altered bowel habits 

This includes constipation and diarrhoea. Alternating habits are common, although usually, one feature predominates.  

· Abdominal pain 

This varies widely. Pain is frequently diffuse. There can also be episodes of sharp pain superimposed on a more constant dull ache.  

· Abdominal distention 

Increased incidence of bloating and gas is common.  

· Other symptoms 

There have been associations with other symptoms such as dyspepsia, heartburn, nausea and stress.  

 

What causes IBS? 

No one knows for sure, but the current theories centre on three areas: disturbances in the motility of the gut, enhanced sensitivity to normal motility and organ pain and psychological factors.  

 

What are the implications? 

IBS is a chronic relapsing condition. It does not increase mortality or the risk of inflammatory bowel disease or cancer. 

The principal problem relates to physical pain and discomfort due to gut symptoms and the lifestyle modifications secondary to altered bowel habits.  

 

Who’s likely to suffer from IBS? 

The incidence is markedly different among countries.  

In Western countries, women are two to three times more likely to develop IBS than men, although men are more affected in the East.  

 

 

Once in medical care 

The doctor will take a full history and do a full physical examination. Most importantly, the doctor will carry out the necessary tests to make sure that nothing else is going on in the body before even thinking about making a diagnosis of IBS.  

Blood tests are carried out to screen for anaemia, inflammation, infection and other conditions that could be associated with the symptoms. Stools are examined rule out gut pathogens and parasites.  

This is followed by imaging studies to screen for tumours, inflammation, obstruction, and other gut related diseases. 

Treatment aims to alleviate the symptoms. Doctors will often have to reassure their patients that IBS does not have an organic pathology and a normal life expectancy is to be expected. However, IBS is a chronic condition, with periods where the symptoms are worse.  

Some doctors recommend psychological support, especially if symptoms are deemed to have psychological roots.  

There has been much research carried out on new novel therapies, and these will emerge in time.  

Many of these are in phase II and phase III trials and could significantly make the treatment of IBS much easier, both for doctors and their patients.  

 

Risk modifications 

Fibre supplementation may improve symptoms of constipation and diarrhoea. Avoid caffeine to limit anxiety and may reduce symptom exacerbation. In addition, avoiding legumes may decrease abdominal bloating. 

 

Take home message 

IBS does not affect life expectancy. However, a doctor must be consulted so that other conditions are ruled out. It’s extremely dangerous for individuals to assume that their symptoms are due to IBS without medical consultation.  

If you know that certain foods or situations worsen symptoms of IBS, then avoidance is best. Go for regular check-ups. If symptoms change or worsen, get your doctor’s advice. 

 

The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care.  

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