All you need to know about the Irritable Bowel Syndrome

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Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine.

Signs and symptoms include cramping, abdominal pain, bloating, gas, and diarrhoea or constipation, or both. IBS is a chronic condition that needs patience & persistence. Only a small number of people with IBS have severe signs and symptoms. Some people can control their symptoms by managing diet, lifestyle and stress. Moresevere symptoms can be treated with medication and counselling.

Symptoms

The signs and symptoms of IBS vary. The most common include:

Abdominal pain, cramping or bloating that is typically relieved or partially relieved by passing a bowel movement.

Excess gas

Diarrhoea or constipation — sometimes alternating bouts of diarrhoea and constipation.

Mucus in the stool

Most people with IBS experience times when the signs and symptoms are worse and times when they improve or even disappear completely.

When to see a doctor

See your doctor if you have a persistent change in bowel habits or other signs or symptoms of IBS. They may indicate a more serious condition, such as colon cancer. More-serious signs and symptoms include:

-Weight loss

-Diarrhoea at night

-Rectal bleeding

-Iron deficiency anemia

-Unexplained vomiting

-Difficulty swallowing

-Persistent pain that isn’t relieved by passing gas or a bowel movement

Causes

The precise cause of IBS isn’t known. Factors that appear to play a role include:

-Muscle contractions in the intestine: The walls of the intestines are lined with layers of muscle that contract as they move food through your digestive tract. Contractions that are stronger and last longer than normal can cause gas, bloating and diarrhoea. Weak intestinal contractions can slow food passage and lead to hard, dry stools.

-Nervous system: Abnormalities in the nerves in your digestive system may cause you to experience greater than normal discomfort when your abdomen stretches from gas or stool. Poorly coordinated signals between the brain and the intestines can cause your body to overreact to changes that normally occur in the digestive process, resulting in pain, diarrhoea or constipation.

-Inflammation in the intestines: Some people with IBS have an increased number of immune-system cells in their intestines. This immunesystem response is associated with pain and diarrhoea.

-Severe infection: IBS can develop after a severe bout of diarrhoea (gastroenteritis) caused by bacteria or a virus. IBS might also be associated with a surplus of bacteria in the intestines (bacterial overgrowth). All you need to know about the Irritable Bowel Syndrome

Changes in bacteria in the gut (microflora): Microflora are the “good” bacteria that reside in the intestines and play a key role in health. Research indicates that microflora in people with IBS might differ from microflora in healthy people.

Triggers

Symptoms of IBS can be triggered by:

-Food – The role of food allergy or intolerance in IBS isn’t fully understood. A true food allergy rarely causes IBS. But many people have worse IBS symptoms when they eat or drink certain foods or beverages, including wheat, dairy products, citrus fruits, beans, cabbage, milk and carbonated drinks.

-Stress – Most people with IBS experience worse or more frequent signs and symptoms during periods of increased stress. But while stress may aggravate symptoms, it doesn’t cause them.

-Hormones – Women are twice as likely to have IBS, which might indicate that hormonal changes play a role. Many women find that signs and symptoms are worse during or around their menstrual periods.

Complications

Chronic constipation or diarrhoea can cause hemorrhoids. In addition, IBS is associated with:

-Poor quality of life – Many people with moderate to severe IBS report poor quality of life. Research indicates that people with IBS miss three times as many days from work as do those without bowel symptoms.

-Mood disorders – Experiencing the signs and symptoms of IBS can lead to depression or anxiety. Depression and anxiety also can make IBS worse.

Diagnosis

There’s no test to definitively diagnose IBS. Your doctor is likely to start with a complete medical history, physical exam and tests to rule out other conditions. If you have IBS with diarrhoea, you likely will be tested for gluten intolerance (celiac disease). After other conditions have been ruled out, your doctor is likely to use one of these sets of diagnostic criteria for IBS:

Your doctor may recommend several tests, including stool studies to check for infection or problems with your intestine’s ability to take in the nutrients from food (malabsorption). You may also have a number of other tests to rule out

other causes for your symptoms.

Cont. in next issue

Dr. Pargat Singh Bhurji
MD,FRCP ( C ) Consultant Pediatrician Surrery BC

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