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:
| nausea |
| vomiting |
| bloating |
| distention |
| constipation |
| diarrhea |
| pain |
| increased gas |
| abnormal passage of stool |
| abnormal form of stool |
| increased 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:
| Abdominal 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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