Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) represents a recurrent gastrointestinal disorder characterized by pain in the abdominal area, food intolerance, bloating, alternating constipation and diarrhea, which represent a negative consequence of alterations in muscle contractions in the bowel. However, the manifestation of these symptoms does not cause visible damage in the digestive tract. Even though researchers have not yet discovered the exact cause, they believe that several environmental factors including diet, stress, routine changes and infection are main triggers of irritable bowel syndrome, which does not lead to severe complications that might endanger people’s life, but is undoubtedly a major inconvenience that impedes them to engage in normal everyday activities.  Those between the ages of 20 and 30, especially women face a higher risk of developing this chronic condition. Doctors generally use blood tests in order to establish an accurate diagnosis and a treatment that relies mostly on medications and counseling when dealing with irritable bowel syndrome. In the past, they used several other names for this condition including nervous colon, spastic bowel and mucous colitis.


Types of Irritable Bowel Syndrome (IBS)

Depending on changes in bowel movements, specialists divide irritable bowel syndrome in three different categories with the purpose to help doctors determine the most adequate medications for specific symptoms of each patient. Not all medicines work for every type of IBS, in fact, they could worsen the problem.

  • IBS with constipation, also known as IBS-C, occurs when the person experiences alternation of constipation and normal stools as well as cramps and aches after eating.
  • IBS with diarrhea or IBS-D happens when the person experiences diarrhea after eating a meal or in the mornings and cannot control the need of going to the toilet urgently. Moreover, incontinence may become an issue.
  • IBS with alternating constipation and diarrhea also called IBS-M practically combines the symptoms of the other IBS types mentioned above.

Causes of Irritable Bowel Syndrome (IBS)

The precise cause of irritable bowel syndrome remains unknown but experts associate this condition with high sensitivity of the stomach and digestions problems. When eating, the food passes through the digestive system by contracting the muscles, more specifically squeezing and relaxing them rhythmically. In people with IBS, this process suffers alterations meaning that the passage of food is slower or faster than normal. In the first case, the digestive system absorbs too much water, thus causing constipation while in the second case it does not have time to absorb the water, resulting in diarrhea.

Both of them are manifestations of irritable bowel syndrome. Digestive system provokes various sensations in a person’s body. For instance, it sends signals to the brain when the stomach needs food or is full. Starting from this fact, experts suggest that people with irritable bowel syndrome show increased sensitivity to those nerve signals of the digestive system, thus experiencing abdominal pain while normal people will easily get away with a mild indigestion.

Psychological factors can significantly contribute to irritable bowel syndrome. Intense and negative emotions like anxiety and stress lead to chemical changes that impede the digestive system to work properly and this can happen to anyone going through a difficult or stressful situation, during an exam or business interview. Sometimes, people with IBS had to face trauma, abuse, illness or negligence during childhood. Obviously, these experiences create a higher sensitivity to stress and abdominal discomfort or pain. Apparently, the consumption of certain foods and beverages may represent a trigger for IBS symptoms. These include high-fat or processed foods, chocolate, drinks high in caffeine, alcohol and carbonated beverages.

Health problems associated with IBS include digestive disorders like dyspepsia, mental disorders like somatic symptoms disorder and other conditions involving fibromyalgia, chronic pelvic pain and chronic fatigue syndrome. Even though irritable bowel syndrome does not represent a major danger because it usually does not lead to serious life threatening complications, it causes mood disorders and poor quality of life. Risk factors for IBS refer to gender, age, family history and mental health. This chronic condition is more common among young women, especially those who experience mental health issues including anxiety and depression.


Signs and Symptoms of Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome does not have the same effects on every person. The most distinctive sign in both children and adults consists in discomfort or pain in the stomach area. Other symptoms of IBS doctors take into account before establishing a diagnosis are bloating, excess gas, acute episodes of diarrhea caused by violent bowel movements, constipation, alternating diarrhea and constipation, nausea and mucus in the stools. Young women with this condition may notice more symptoms during menstruation. Because irritable bowel syndrome is a chronic disorder, people must live with these manifestations for many years, although not constantly. Approximately 70% of people with IBS experience indigestion but doctors do not view it as a symptom.

Furthermore, they make a clear distinction between IBS or irritable bowel syndrome and IBD or inflammatory bowel disease. IBD is a disease, also more serious than IBS, which represents a functional disorder. Although they both manifest with similar symptoms, IBD is a major concern because it causes intestinal and rectal bleeding, inflammation, ulcers and even permanent intestinal damage. Moreover, it can lead to severe complications.  Thus, the name and symptoms of the first one resemble with the ones of the second, but there is a solid difference in terms of severity.


Prevention Methods for Irritable Bowel Syndrome (IBS)

Fortunately, people can prevent developing irritable bowel syndrome or ease the symptoms by eliminating or managing the stress in their life.  There are several effective ways, such as counseling, mindfulness training, biofeedback and progressive muscle relaxation. A counselor knows exactly how to control the response to stress and can help the patient in this department. According to studies, psychotherapy can significantly reduce IBS manifestations. Mindfulness training represents a method that helps a person concentrate and eliminate distractions and concerns from her mind. Biofeedback therapy has the purpose to help a person take control over involuntary functions and it works for other conditions as well including high blood pressure, incontinence, headaches and chronic pain. Practically, it allows the individual to become aware of how the body functions in order to adopt a healthier lifestyle. Progressive muscle relaxation helps the individuals let go of the stress accumulated inside.

Diagnosis of Irritable Bowel Syndrome (IBS)

Before diagnosing a patient with irritable bowel syndrome, doctors follow several steps that will allow them to eliminate the possibility of other conditions with similar manifestations. This process can be tricky so they start by attentively reviewing all the signs and symptoms experienced by the patient, acquiring information regarding medical and family history and continue by performing a thorough physical examination. Finding a certain pattern in the patient’s symptoms is very important for diagnosing IBS, taking into account that they vary from person to person. Furthermore, even though this chronic disorder cannot be detected with laboratory tests, doctors still perform several tests in order to rule out food allergies, lactose intolerance, enzyme deficiencies, infections and inflammatory bowel diseases, among others. During the physical examination, the doctor uses a stethoscope for listening to sounds within the patient’s abdomen, looks for signs of bloating in the stomach and tenderness or pain in the same area.

Because irritable bowel syndrome does not provoke obvious abnormalities in a person’s digestive system, the only option for detecting the condition is performing blood and stool tests. Other tests include X-rays for the small intestine, colonoscopy, which enable doctors examine the intestines with a small tube in order to determine signs of blockage and upper endoscopy, which helps to discover the presence of heartburn or indigestion. Once again, making a clear distinction between IBS and IBD is also very important taking into consideration the severity of the second and the involvement of the immune system. Before establishing a diagnosis for IBS, they may also inspect the bowel muscles for potential issues.

Signs of Irritable Bowel Syndrome


Treatment for Irritable Bowel Syndrome (IBS)

When providing a treatment for IBS, doctors focus primarily on helping the patient to live as normal as possible by relieving the unpleasant and for some quite embarrassing symptoms. Making changes in terms of diet and lifestyle represents the first step towards this goal as well as finding efficient was of managing daily stress. In certain cases, medications and mental health therapies may be a solution.

Because doctors do not have a wonder diet that works for all the patients with irritable bowel syndrome, the involvement of a dietitian becomes imperative for creating a personalized diet that will suit every individual’s specific needs. The symptoms and the reaction to different foods are essential aspects during this process. In order to avoid consuming foods that worsen his symptoms, the patient should keep a diary or make a list where he can mark them down. This advice is not available for his entire life. Generally, the patient’s condition should improve if he does not miss important meals or rush when eating, if he does not consume great amount of alcohol and carbonated drinks, if he does not exceed three cups a day of coffee, if he reduces the intake of processed foods and if he keeps the body constantly hydrated by drinking water. Apparently, oats and linseeds help when the patient deals with bloating and flatulence.

Apart from making changes in terms of diet, the doctor will recommend getting enough sleep and doing regular exercise. Many patients confirm that daily exercise, such as fast walking and cycling ease the symptoms caused by irritable bowel syndrome. Stress reduction also plays an important part in the treatment because it reduces the severity and frequency of the manifestations. There are many ways to fight or eliminate stress including Pilates, yoga, breathing exercises and mediation, among others.

Doctors can include in the treatment for IBS some medications and supplements. For instance, fiber supplements have the purpose to control constipation but if they do not provide the much-needed results, the doctor resorts to laxatives because they help food pass easier through the digestive system. However, if taken without plenty of water, they may obstruct it. At the beginning, the patient takes a low dosage but along the way the doctor increases the dose. Side effects involve wind and bloating.

  • Antispasmodics can relax the muscles in the patient’s digestive system. Although in the majority of cases they do not cause side effects, some people do occasionally experience irritation around the bottom area and heartburn.
  • Anti-diarrheal medicines control the contractions of bowel muscles and implicitly the passage of food through the person’s digestive system, thus impeding chronic episodes of diarrhea. Side effects include drowsiness and dizziness, bloating and abdominal cramps.
  • Antidepressants can ease the pain caused by the IBS symptoms while helping with constipation and depression. In the lack of depression, the doctor will recommend a lower dosage of tricyclic antidepressants. Side effects like drowsiness, blurred vision, constipation and dry mouth may appear when taking these types of medications.

Alternative medicine is quite controversial when it comes to applying it for irritable bowel syndrome so consulting a doctor before opting for alternative therapies will offer safety and peace of mind.

  • Peppermint represents a natural antispasmodic used for relaxing smooth intestinal muscles and relief symptoms on the short term but according to studies, it does not always provide guaranteed results.
  • Hypnosis: A trained and experienced professional helps the patient completely relax focusing on his abdominal muscles with the goal to ease bloating and pain. Researchers support this method due to its long-term efficiency.
  • Mindfulness training consists in being extremely aware of the moment, experiencing only the present while removing any judgment or interpretation. This psychological process allows a person to develop wisdom and self-knowledge in order to free herself from suffering.
  • Other psychological treatments like psychotherapy and cognitive behavioral therapy (CBT) may represent solutions that help patients gain at least some control over their condition, namely irritable bowel syndrome. For instance, CBT teaches a person the connection between thoughts and feelings or beliefs and behavior and how to use it for coping with the problem.

Last updated on March 2nd, 2018

Chris Riley

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