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IBS (Irritable Bowel Syndrome)

Irritable Bowel Syndrome (IBS) is the most common condition affecting the gastrointestinal tract.  It is a functional disease, which results from the abnormal function of the muscles and nerves controlling the colon.  IBS is difficult to discern because, as a functional disease, it causes abnormalities which cannot be seen with the naked eye or under a microscope.  Unlike other conditions, which are systematic and have clear-cut signs, such as an ulcer, IBS does not have an exclusive set of symptoms or warning signs that can help a physician diagnose or treat IBS easily and effectively.  Furthermore, the nervous system governing the colon and gastrointestinal (GI) tract are very complex.  This system includes nerves which are located not only in the colon, but also in other parts of the GI tract, as well as the spinal cord and brain.  Therefore, the abnormal function causing IBS may be sourced out in any one of these locations.

Symptoms

Fortunately, because the digestive system overcompensates its abilities, functions such as grinding, mixing, digestion and absorption of food is only disturbed to a minor degree, if at all, in patients with IBS.  The function that is most affected is the transportation of food.  Poor transport leads to the following symptoms:

bulletnausea
bulletvomiting
bulletbloating
bulletdistention
bulletconstipation
bulletdiarrhea
bulletpain
bulletincreased gas
bulletabnormal passage of stool
bulletabnormal form of stool
bulletincreased amounts of mucus in the stool

A poor diet, which is high in calories and fat may trigger these symptoms and overwork the colon causing further discomfort.

Complications

There are few complications associated with IBS.  This condition mostly affects the lifestyle and comfort of the patient.  The unfortunate effects of IBS, such as elevated discomfort when eating, may cause an individual to skip meals or reduce intake of certain foods such as milk.  This type of behavior is detrimental because a proper diet is necessary in order to deliver the nutrients your body needs to remain healthy.  Diarrhea can also affect comfort and lifestyle by minimizing the locations to which an individual will travel.  IBS can also affect interpersonal relationships--especially with a spouse.

Diagnosis

Due to the functional nature of this condition, diagnosis is very difficult because there are no hard tests or specific symptoms that outline the disease.  Symptoms are often varied between patients.  This difficulty spawned the creation of the Rome II Criteria, created by international investigators who met in Rome for a second time (Rome II),  to determine a set of criteria that could assist in diagnosing IBS.

According to the Rome II Criteria, the following is necessary in order to make an IBS diagnosis:

bulletAbdominal pain and discomfort must be present for at least 12 weeks within a 12 month span.  The weeks of discomfort do not have to be consecutive.  However, the pain must be associated with 1) relief upon defecation 2) change in frequency of stools 3) change in form of stools. 

Other symptoms mentioned above should further support this diagnosis, but due to their non-specific and varied nature among patients, they alone cannot confirm an IBS diagnosis.

Furthermore, other "non-functional" GI conditions should be excluded using blood tests, x-rays, endoscopies and biopsies before an IBS diagnosis is made.

Exclusion of "non-intestinal" conditions may also be made, if symptoms suggest such diseases, using Computerized Axial Topography (CAT or CT) Scan or Magnetic Resonance Imaging (MRI).  These procedures are not common in diagnosing IBS.

Finally, evaluation of intestinal transport should be used to determine the functionality of intestinal muscles.  Transit studies using radioactive substances or compounds viewable via x-ray can be used to determine intestinal transport.  Catheters can also be inserted into the rectum or colon to test muscles.

Treatment

The source of IBS is, oftentimes, very difficult to determine.  The source of abnormal muscle function may be anywhere in a complex array of nerves and muscles within the GI tract, spine or brain.  Therefore, IBS treatment mostly focuses on the symptoms rather than the causes of IBS.

Proper diet can help control the onset of symptoms.  Learn to monitor and not which foods cause symptoms such as pain, bloating or gas.  Discuss these foods with your physician and learn how to avoid these foods while supplementing your body with the nutrients it needs to remain healthy.  Dietary fiber is known to reduce symptoms such as cramping and hard stools.  Learn to avoid eating large meals. 

Some medications can be administered to control pain, diarrhea and constipation--the three main symptoms of IBS.  Tranquilizers or smooth-muscle relaxants can be prescribed to reduce abdominal pain.  Fiber supplements or laxatives can be prescribed to help avoid constipation.  In cases where diarrhea is a consistent symptom, loperamide (Imodium) may be prescribed.  Anti-depressant medication may also be prescribed to help control symptoms that may stem from the parts of the nervous system which are located in the brain.

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BrooklynGI.com with offices in New York City Brooklyn Queens and Manhattan. Treating patients from New York, New Jersey and Connecticut. is dedicated to helping patients and physicians receive accurate and up-to-date information on the Gastrointestinal tract (GI Tract) The organs that compose the GI tract include, Esophagus, Stomach, Small Intestine, Large Intestine (Colon), Pancreas and the Liver and Gall Bladder (Hepato-Biliary Tree) Dr. Scott Tenner
Physicians include Dr. Scott Tenner Dr. Robin Baradarian Dr. Susan Ramdhaney Dr. Nison Badalov
Private Practice at 2211 Emmons Ave. Other locations include Maimonides Medical Center 1025 48th Street, Beth Israel Medical Center at KD3201 Kings Highway, Kingsbrook Jewish Medical Ctr at 585 Schenectady Ave, Brookdale Hospital at One Brookdale Plaza, and Kings Highway Hospital at 2525 Kings Highway
We treat a variety of gastrointestinal GI diseases and conditions including Achalasia
Barrett's Esophagus Chronic Hepatitis Cirrhosis of the liver Celiac disease Collagenous Colitis Colorectal cancer Colorectal polyps Constipation Crohn's disease Diverticulosis And Diverticulitis Fatty liver (Steatohepatitis) Gallstones Gas Gastritis Gastric Cancer GERD Helicobacter pylori infection Hemochromatosis Hemorrhoids Hepatitis (Viral Hepatitis A, B, C etc) Hiatus Hernia Irritable Bowel Syndrome Lactose Intolerance Liver failure and transplantation Lymphocytic Colitis Microscopic Colitis Esophageal Cancer Pancreatitis Peptic Ulcer Primary biliary cirrhosis Reflux esophagitis Ulcerative colitis
A premier site for the diagnosis, treatment and management Gastrointestinal diseases, Drs. Tenner and Baradarian provide a variety of Patient Services.
Drs. Tenner and Baradarian are Board Certified Gastroenterologists performing a variety of tests and procedures at their private offices and at Maimonides Medical Center.
We perform many tests & procedure, including: Barium Enema Barium Esophagram Capsule Endoscopy Colonoscopy Colon Cancer Screening EGD (Esophagogastroduodenoscopy) Endoscopic Ultrasound ERCP (Endoscopic Retrograde Cholangiopancreatography) Esophageal Dilation Esophageal pH Fundoplication Hemorrhoid Banding Hemorrhoidectomy Lactose Tolerance Test Liver Biopsy PEG (Percutaneous Endoscopic Gastrostomy) Sigmoidoscopy Stool Acidity Test Upper GI Series
BrooklynGI.com with offices in New York City Brooklyn Queens and Manhattan. Treating patients from New York, New Jersey and Connecticut. is dedicated to helping patients and physicians receive accurate and up-to-date information on the Gastrointestinal tract (GI Tract) The organs that compose the GI tract include, Esophagus, Stomach, Small Intestine, Large Intestine (Colon), Pancreas and the Liver and Gall Bladder (Hepato-Biliary Tree) Dr. Scott Tenner. Physicians include Dr. Scott Tenner Dr. Robin Baradarian Dr. Susan Ramdhaney Dr. Nison Badalov.
Gastrointestinal GI diseases and conditions including Achalasia Private Practice at 2211 Emmons Ave. Other locations include Maimonides Medical Center 1025 48th Street, Beth Israel Medical Center at KD3201 Kings Highway, Kingsbrook Jewish Medical Ctr at 585 Schenectady Ave, Brookdale Hospital at One Brookdale Plaza, and Kings Highway Hospital at 2525 Kings Highway
Barrett's Esophagus Chronic Hepatitis Cirrhosis of the liver Celiac disease Collagenous Colitis Colorectal cancer Colorectal polyps Constipation Crohn's disease Diverticulosis And Diverticulitis Fatty liver (Steatohepatitis) Gallstones Gas Gastritis Gastric Cancer GERD Helicobacter pylori infection Hemochromatosis Hemorrhoids Hepatitis (Viral Hepatitis A, B, C etc) Hiatus Hernia Irritable Bowel Syndrome Lactose Intolerance Liver failure and transplantation Lymphocytic Colitis Microscopic Colitis Esophageal Cancer Pancreatitis Peptic Ulcer Primary biliary cirrhosis Reflux esophagitis Ulcerative colitis
A premier site for the diagnosis, treatment and management Gastrointestinal diseases, Drs. Tenner and Baradarian provide a variety of Patient Services.
Drs. Tenner and Baradarian are Board Certified Gastroenterologists performing a variety of tests and procedures at their private offices and at Maimonides Medical Center.
We perform many tests & procedure, including: Barium Enema Barium Esophagram Capsule Endoscopy Colonoscopy Colon Cancer Screening EGD (Esophagogastroduodenoscopy) Endoscopic Ultrasound ERCP (Endoscopic Retrograde Cholangiopancreatography) Esophageal Dilation Esophageal pH Fundoplication Hemorrhoid Banding Hemorrhoidectomy Lactose Tolerance Test Liver Biopsy PEG (Percutaneous Endoscopic Gastrostomy) Sigmoidoscopy Stool Acidity Test Upper GI Series

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