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Irritable Bowel Syndrome

What is Irritable bowel syndrome?

Irritable bowel syndrome (or simply called IBS) is a chronic gastrointestinal condition that affects the colon, or large bowel, which is the part of your digestive tract that stores stool (faeces). IBS is a very common problem. It is different from inflammatory bowel disease, hence should not be confused with it. It is estimated that as much as 20% of people in the general population experience symptoms of IBS, although only less than quarter of them actually seek professional medical help.
1. Symptoms of Irritable bowel syndrome
The most common symptoms by persons with IBS are:
  • Crampy abdominal pain, which is often relieved after passing a bowel movement.
  • Some women experience IBS symptoms in association with their menstrual cycle.
  • Changes in bowel habits, which includes diarrhea, constipation, or alternating diarrhea and constipation.
  • Diarrhea is mostly during the day time. Diarrhea occurring during the night is very unusual with IBS.
  • Mucus in the stool
  • Extreme urgency
  • Feeling of incomplete emptying after bowel movement.
  • Abdominal bloating, gas, and belching.
Most persons suffering from irritable bowel syndrome DO NOT experience fever, bleeding with the stool, weight loss, fever or severe diarrhea at night time. If you are experiencing these symptoms, then there may be another cause of your symptoms. Your doctor will advise further tests to confirm the condition causing these symptoms.
The exact cause of irritable bowel syndrome is not known. People with IBS appear to have sensitive bowels that are easily ‘upset’. This sensitive bowel is triggered easily in susceptible persons due to various suggested risk factors, for example,
  • Food intolerance
  • Low fiber diet
  • Stress and anxiety
  • Gastrointestinal infection, and
  • Certain medications.
Irritable bowel syndrome is not a life-threatening condition and does not result in more serious complications if left untreated. But recurrent waxing and waning symptoms may cause great anxiety and discomfort. Chronic constipation may cause hemorrhoids.
Your doctor will first take a detailed history and will perform the relevant physical examination. If you have a characteristic history, further testing may not be needed. There are different clinical criteria available, which helps in the diagnosis of IBS. But since multiple other conditions can produce the same symptoms as IBS, your doctor will suggest various medical tests to exclude other causes of your symptoms.The tests often include some blood tests and may also include invasive tests, for example a colonoscopy or sigmoidoscopy. In IBS, all the test results are within normal limits.
Irritable bowel syndrome is a chronic condition. There are a number of therapies and treatments available to control the symptoms and to improve the quality of life.Monitor symptoms — The first step is to make a diary and monitor your symptoms and daily bowel habits. Look for any associations of your symptoms with food intolerance, certain diets, and stress. Diet changes — Avoid diets that exacerbate your symptoms.Psychosocial therapies — Stress and anxiety relieving techniques.Medications — Multiple medicines are available to control your symptoms but they give symptomatic relief and do not cure the condition. These include:
  • Anti-diarrheal agents
  • Pain-relieving medications
  • Constipation treatments
  • Antispasmodic agents
  • Antidepressants

    Your doctor will advise you depending upon your symptoms and general health.

  • Surgical Management of Irritable bowel syndrome

    Surgery is often not needed in the management of irritable bowel syndrome

  • Eliminate foods that may aggravate IBS, especially milk products. As increased association of IBS is seen in persons with lactose intolerance. All dairy products are avoided for two weeks. If IBS symptoms improve, it is reasonable to stop dairy products. If symptoms do not improve, you may resume the dairy products again.
  • Green vegetables — Avoid legumes (such as beans) and cruciferous vegetables (such as cabbage, Brussels sprouts, cauliflower, and broccoli), as they increase the production of abdominal gas.
  • Increase dietary fiber and bulk-forming fiber supplement — Increasing fiber intake relieves constipation and normalizes bowel habits. Some persons may feel more bloated and uncomfortable with fiber intake. If you are among these persons, the fiber intake should be decreased.
  • Physical activity is encouraged. Aerobics alleviate stress and anxiety, and also has a mood-enhancing effect.

Symptoms of Irritable bowel syndrome

The most common symptoms by persons with IBS are:
  • Crampy abdominal pain, which is often relieved after passing a bowel movement.
  • Some women experience IBS symptoms in association with their menstrual cycle.
  • Changes in bowel habits, which includes diarrhea, constipation, or alternating diarrhea and constipation.
  • Diarrhea is mostly during the day time. Diarrhea occurring during the night is very unusual with IBS.
  • Mucus in the stool
  • Extreme urgency
  • Feeling of incomplete emptying after bowel movement.
  • Abdominal bloating, gas, and belching.
Most persons suffering from irritable bowel syndrome DO NOT experience fever, bleeding with the stool, weight loss, fever or severe diarrhea at night time. If you are experiencing these symptoms, then there may be another cause of your symptoms. Your doctor will advise further tests to confirm the condition causing these symptoms.

Causes and Risk Factors of Irritable bowel syndrome

The exact cause of irritable bowel syndrome is not known. People with IBS appear to have sensitive bowels that are easily ‘upset’. This sensitive bowel is triggered easily in susceptible persons due to various suggested risk factors, for example,
  • Food intolerance
  • Low fiber diet
  • Stress and anxiety
  • Gastrointestinal infection, and
  • Certain medications.

Complications of Irritable bowel syndrome

Irritable bowel syndrome is not a life-threatening condition and does not result in more serious complications if left untreated. But recurrent waxing and waning symptoms may cause great anxiety and discomfort. Chronic constipation may cause hemorrhoids.

Diagnosis of Irritable bowel syndrome

Your doctor will first take a detailed history and will perform the relevant physical examination. If you have a characteristic history, further testing may not be needed. There are different clinical criteria available, which helps in the diagnosis of IBS. But since multiple other conditions can produce the same symptoms as IBS, your doctor will suggest various medical tests to exclude other causes of your symptoms.The tests often include some blood tests and may also include invasive tests, for example a colonoscopy or sigmoidoscopy. In IBS, all the test results are within normal limits.

Treatment of Irritable bowel syndrome

Irritable bowel syndrome is a chronic condition. There are a number of therapies and treatments available to control the symptoms and to improve the quality of life.Monitor symptoms — The first step is to make a diary and monitor your symptoms and daily bowel habits. Look for any associations of your symptoms with food intolerance, certain diets, and stress. Diet changes — Avoid diets that exacerbate your symptoms.Psychosocial therapies — Stress and anxiety relieving techniques.Medications — Multiple medicines are available to control your symptoms but they give symptomatic relief and do not cure the condition. These include:
  • Anti-diarrheal agents
  • Pain-relieving medications
  • Constipation treatments
  • Antispasmodic agents
  • Antidepressants

    Your doctor will advise you depending upon your symptoms and general health.

  • Surgical Management of Irritable bowel syndrome

    Surgery is often not needed in the management of irritable bowel syndrome

Diet and Exercise

  • Eliminate foods that may aggravate IBS, especially milk products. As increased association of IBS is seen in persons with lactose intolerance. All dairy products are avoided for two weeks. If IBS symptoms improve, it is reasonable to stop dairy products. If symptoms do not improve, you may resume the dairy products again.
  • Green vegetables — Avoid legumes (such as beans) and cruciferous vegetables (such as cabbage, Brussels sprouts, cauliflower, and broccoli), as they increase the production of abdominal gas.
  • Increase dietary fiber and bulk-forming fiber supplement — Increasing fiber intake relieves constipation and normalizes bowel habits. Some persons may feel more bloated and uncomfortable with fiber intake. If you are among these persons, the fiber intake should be decreased.
  • Physical activity is encouraged. Aerobics alleviate stress and anxiety, and also has a mood-enhancing effect.
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