When I volunteered to write this article, I was hoping to make this a desirable subject to keep the reader's attention. I wanted to add a little wit to lighten up the content; however, the more I researched, the more it became apparent to me that Irritable Bowel Syndrome (IBS) is no laughing matter, and for some, quite difficult to tolerate day to day. So this won't be a funny, light-hearted article. But if you have experienced significant abdominal discomfort, please read on. This information may be very helpful to you.
What is IBS?Irritable* Bowel Syndrome is one of the most common medical diagnoses in primary care practice today. IBS is now second only to the common cold as the reason for days missed from work and school.
Symptoms of IBS include chronic abdominal pain and a change in the frequency and character of bowel movements without a clear-cut cause. For many patients, IBS is a chronic problem that seriously affects all aspects of their daily lives.
To be considered an IBS diagnosis, the intermittent or constant pain must be present for at least 12 months. The two most common presenting complaints are abdominal pain and altered bowel habits. Typically, symptoms are intermittent. Symptom-free periods can last days, weeks or, rarely, months. However, some patients can have daily symptoms without relief. The abdominal pain will be chronic, rather than just one episode, and will be related usually to defecation in some way. Some patients describe the pain as crampy, while others describe it as sharp or burning.
The bowel pattern for an IBS patient includes defecation from three times a day to three times a week, so the IBS patient can either be constipated or have episodes of diarrhea. The IBS patient will often describe increased stool frequency and urgency following meals. Any of these symptoms warrants an investigation by a clinician.
IBS has been given a number of different labels, including nervous colitis, spastic colitis, mucous colitis, unstable colon and irritable colon. All of these labels should be discarded, because they are inaccurate.
Who gets IBS?
IBS may be present in all age groups, including children. Important for college students to know -- most patients begin their typical symptoms in the late teenage years or early 20s, although the problem may not be diagnosed for many years. Women are nearly three times more likely to be diagnosed with IBS than men are, but the experts don't know why.
What causes IBS?
Patients with IBS may process sensory information from the intestinal tract differently than the patients without IBS. Stimulation, such as stress, anxiety or depression, may change sensory processing and influence the perception of pain. These findings have significant implications, especially in regard to the treatment of IBS. The realization that the gut and the brain are intimately connected now plays a central role in the theory of the process of IBS.
In some cases, the cause of IBS may be an infectious process that injured the nerve responsible for activity in the gastrointestinal tract. Another possibility involves immune hypersensitivity that can cause inflammation in the intestine. Psychological stressors may play a role as well.
Many adults can develop intolerance to lactose. This should be ruled out by following a lactose free diet.
How is IBS treated?
Because the underlying cause of IBS is unknown, treatment is focused on the relief of symptoms. Treatment begins with a physical examination, including attention to all contributing factors including diet, emotions, relationships and the patient's fears and concerns. IBS can usually be successfully managed through cooperation of the patient and the caregiver.
Diet is a concern for the IBS patient. There is no absolute proof that certain food groups are more harmful that others. But there are some foods IBS patients can react badly to, including carbonated beverages, caffeine, fatty or greasy foods, alcohol, high fructose beverages, spicy foods and foods high in roughage. While foods that precipitate symptoms should be avoided, patients should also be careful not to make themselves dietary cripples.
If you have read this far, you know that even undesirable subjects can be discussed -- it sure isn't funny, but it is what happens to some people in real life. Word to the wise: Follow up with your clinician appointments, avoid food and alcohol that result in unwelcome symptoms, attempt to relieve life's stressors, keep yourself educated on IBS changes and be willing to absorb new information on the subject. Stay well!
*In this article, irritable refers to an underlying abnormality or an alteration to what is normal, and words ending in the suffix "-itis" mean "inflammation of."
