Irritable Bowel Syndrome (IBS)

Definition

Irritable bowel syndrome (IBS) is a gastrointestinal syndrome characterized by chronic abdominal discomfort and altered bowel habits (diarrhea or constipation) in the absence of any organic cause. IBS commonly affects men and women, young patients and the elderly. However, younger patients and women are more likely to be diagnosed with IBS.

Causes

The cause of IBS remains uncertain. Abnormal movement within the gastrointestinal tract, organ hypersensitivity (the abnormal perception of abdominal gas or bloating), post infection, psychological dysfunction such as depression or anxiety, and emotional stress may all play a role in this condition. Clinically, patients present with a wide range of symptoms which include both gastrointestinal and non gastrointestinal complaints. Chronic abdominal discomfort and altered bowel habits remain the primary issues of IBS. Patients may experience a large amount of bloating. The  pain location can vary, the amount of pain range from mildly annoying to unbearable. Emotional stress and eating may make the pain worse while having a bowel movement often gives some relief. Patients with IBS can have diarrhea, constipation, alternating diarrhea and constipation, or normal bowel habits alternating with diarrhea and/or constipation. Blood in the stool, weight loss, and nighttime symptoms are not commonly associated with IBS.

Diagnosis

There are certain criteria your GI doctor may use to diagnose IBS. A careful history may find dietary factors or medications that look like or make symptoms  worse of IBS. Routine lab tests including a basic blood count and chemistry panel are usually required. Flexible sigmoidoscopy or colonoscopy may be used to exclude inflammatory bowel disease or malignancy.

  1. Treatment Medical: Certain medications, over the counter and/or prescription, may be used. Common agents used for abdominal pain, gas, and bloating include dicyclomine (Bentyl) and hyoscyamine (Levsin). Medications for diarrhea-prone IBS patients include loperamide (Imodium) and diphenoxylate (Lomotil) Antidepressant medications are sometimes prescribed for their pain relieving properties independent of their mood improving effects..
  2. Lifestyle Changes: A careful dietary history may reveal patterns of symptoms related to dairy and gas-producing foods which may need to be excluded from the diet. An increase in fiber is generally recommended, either through diet or the use of bulking supplements. Increase of water intake and regular exercise are encouraged.

Summary

IBS is a condition that the cause is not quite certain. Patients may have diarrhea or constipation. They may vary between these two conditions also. There are life style changes along with medications that can be used to help control symptoms of IBS.

Organizations

  1. American Gastroenterological Association - www.gastro.com
  2. American College of Gastroenterology - www.acg.gi.org

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