Definition and Overview

Irritable bowel syndrome (IBS) is a very common chronic disorder of the large intestine or colon that has to be continuously managed throughout life. IBS does not get worse over time, and it is not related to serious diseases of the intestines such as colon cancer or inflammatory bowel disease. A patient suffering from IBS will simply have to deal with the symptoms, which are not always the same and usually just come and go. There may be long periods of flare-ups, during which the patient may experience severe symptoms, but there may be long periods of not feeling any symptoms at all.

IBS is currently one of the most common intestinal disorders in the world. It affects as many as 7 out of 10 people, with most patients being female. Not all sufferers of IBS seek treatment and use home remedies to relieve their symptoms.

Causes

The causes of irritable bowel syndrome are yet to be identified, as each case may be triggered by different factors. So far, findings show that the problem may be due to abnormally sensitive intestines or intestinal muscles that move differently than normal; some studies show that this may be an effect of a communication problem between the brain and the digestive tract.

What triggers this problem, however, is unclear, although genetics and a disrupted immune system accidentally attacking the healthy tissue in the digestive tract while fighting off some bacterial or viral infection may be to blame.

Key Symptoms

The symptoms of irritable bowel syndrome are mainly triggered by the inflammation of the gastrointestinal tract. IBS is characterized by three main symptoms, namely:

Minor symptoms include:

  • Mucus in the stool
  • Bloating
  • Weight loss
  • Extreme and unexplained exhaustion
  • Nausea
  • Fever

Who to See and Types of Treatments Available

If you experience frequent diarrhea and constipation, usually going back and forth from one to another, and you feel pain in the belly, you may consult a general practitioner or family doctor and ask for a physical exam. After asking you about your symptoms, doctors may conduct a blood test, a complete blood count or CBC, and a stool analysis, mainly to check whether there are other problems causing the symptoms. Once other causes are ruled out, you may be diagnosed with IBS. To check if inflammation is present, your doctor may also conduct a test to determine your sedimentation rate.

These may not all be necessary in all cases of IBS. In some patients, testing may not be necessary as doctors can usually diagnose irritable bowel syndrome based on its symptoms. However, the amount of testing a person may get will be impacted by certain factors, such as:

  • Severity of symptoms
  • Age
  • Response to initial treatment

Age plays a role in determining the number of tests a patient needs because the higher the age, the more susceptible an IBS sufferer to developing colon cancer. If a patient is over 50, colon cancer has to be ruled out first. In such cases, a colonoscopy may be conducted.

Irritable bowel syndrome is not curable but can be managed to make the symptoms less pronounced. The treatment is mainly focused on relieving and preventing the symptoms. The common home treatment plans for IBS include:

  • Avoiding triggering factors – Since IBS flare-ups are usually caused by certain triggers, these factors should be avoided during long-term home treatment. These triggers include certain medications and antibiotics, certain foods, and stress.

  • Exercise – Exercise can improve the overall quality of life and can make a patient feel healthier by improving the quality of sleep and maintaining a steady energy level. A comparative study showed that adding about 20 to 60 minutes of vigorous physical activity 3 to 5 days a week helps reduce symptoms.

  • Diet changes – In most cases of irritable bowel syndrome, symptoms are triggered by specific types of food. Thus, careful attention to one’s diet can help prevent flare-ups and keep symptoms from coming back. Aside from avoiding food triggers, it is also important that a person with IBS consume an increased amount of fiber to help prevent constipation. Foods with high fiber content include fresh fruits and vegetables, whole-grain foods, and beans. Drinking plenty of fluids also help. A light yellow or clear urine is a good sign that your body is getting enough liquids.

  • Stress Management – Stress management is a common part of treatment for IBS sufferers, which shows that many cases of this condition is linked with the patients’ stress levels. To avoid IBS episodes, patients are advised to keep a journal of their symptoms and specific events in life to find some connections between them. Focusing on a hobby may also help relieve stress and improve the overall emotional well-being despite chronic IBS. Finding a psychiatrist, psychologist, counselor, or a support group may also be beneficial.

  • Nutritional supplements – Fiber supplements such as psyllium and wheat dextrin can help patients get the adequate amount of fiber they need. When taking fiber supplements, however, remember to take small doses first then gradually increase the dose.

If symptoms are more severe or occur more frequently, medical intervention may be needed to make life more manageable for patients. The primary course of treatment is taking medications to help with the symptoms. Commonly prescribed medications for the management of chronic IBS are:

  • Aminosalicylates
  • Corticosteroids – These work by reducing the inflammation in the gastrointestinal tract.
  • Immunosuppressants – These work by hampering the harmful activities of the immune system to keep it from attacking healthy tissues.

In about 20% of patients suffering from IBS, the symptoms are so severe that medications provide little relief. In these cases, the best course of treatment is the surgical removal of the specific part of the digestive system that is prone to severe inflammation.

When Should You See A Gastroenterologist?

It is important to see a gastroenterologist if your symptoms are so bad that they begin to:

  • Keep you from performing your normal activities
  • Cause severe exhaustion
  • Wake you up from sleep
  • Cause severe weight loss

Immediate medical attention should also be sought if the abdominal pain is severe and localized and if symptoms no longer seem to respond to treatment.

References:

  • Camilleri, M. “Peripheral Mechanisms in Irritable Bowel Syndrome.” (2012). New England Journal of Medicine.
  • Pimental M., Lembo A., Chey W., et al. “Rifaximin Therapy for Patients with Irritable Bowel Syndrome without Constipation.” (2011). New England Journal of Medicine.1
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