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Irritable Bowel Syndrome

Definition


Disease: Irritable Bowel Syndrome Irritable Bowel Syndrome
Category: Digestive diseases
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Disease Definition:

A common disorder affecting the large intestine (colon) is known as irritable bowel syndrome (IBS), where it commonly results in bloating gas, diarrhea, abdominal pain, constipation and cramping. Despite these uncomfortable signs and symptoms, it doesn’t result in an irreversible damage to the colon.

Most people suffering from IBS find that symptoms get better as they learn to control their condition. Only a small number of people suffering from irritable bowel syndrome have severe signs and symptoms.

Unlike more-serious intestinal diseases like ulcerative colitis and Crohn’s disease, irritable bowel syndrome doesn’t result in inflammation or changes in bowel tissue or increase the risk of colorectal cancer. Irritable bowel syndrome may be managed in several cases by managing the diet, stress and lifestyle.

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

Irritable bowel syndrome signs and symptoms can vary widely from a person to another, usually being similar to those of other diseases. The following are among the most common ones:

 

 

  • A bloated feeling
  • Gas (flatulence)
  • Abdominal pain or cramping
  • Mucus in the stool
  • Diarrhea or constipation, occasionally alternating bouts of constipation and diarrhea.

 

One may have only mild signs and symptoms of irritable bowel syndrome like several other people. However, sometimes these problems can be disabling. One may have severe signs and symptoms in certain cases that do not respond well to medical treatment. It’s best to discuss these symptoms with a doctor, because the symptoms of irritable bowel syndrome occurring with other diseases.
IBS is a chronic condition for most people, even though there will likely be times when the signs and symptoms are worse and times when they get better or even go completely away.
It’s necessary to consult a doctor when experiencing persistent change in bowel habits or when experiencing any other signs or symptoms of IBS because these may indicate a more serious condition like colon cancer.

The doctor may be able to help the person in finding ways to relieve symptoms as well as eliminate more-serious colon conditions, like Crohn’s disease and ulcerative colitis that are types of inflammatory bowel disease, and colon cancer. Possible complications from problems like chronic diarrhea may be avoided with the doctor’s help as well.

Causes:

It's not known exactly what causes irritable bowel syndrome. The walls of the intestines are lined with layers of muscle contracting and relaxing in a coordinated rhythm as they move food from the stomach through the intestinal tract to the rectum. The contractions may be stronger and last longer than normal when experiencing irritable bowel syndrome. Food is forced through the intestines more quickly, causing gas, diarrhea and bloating.
In some cases, the opposite occurs. Food passage slows, and stools become hard and dry. Discomfort may be experienced which is greater than normal when abdomen stretches from gas due to abnormalities in the nervous system or colon.
Triggers bother some, not others
There’s a likelihood of strong reaction to stimuli that do not bother other people when experiencing IBS for unknown reasons. Triggers for IBS can range from gas or pressure on the intestines to certain foods, emotions or medications. For Instance:


Foods: Many people find that their signs and symptoms get worse when they eat certain foods. For example, alcohol, milk and chocolate may result in constipation or diarrhea. Bloating and discomfort may result in certain people suffering from IBS from carbonated beverages and some fruits and vegetables. The role of food allergy or intolerance in irritable bowel syndrome has yet to be clearly understood.
When having cramping and bloating mainly after eating dairy products, caffeine with food, candies, or sugar-free gum the problem may not be irritable bowel syndrome, the body may rather be unable to tolerate the sugar (lactose) in dairy products, caffeine or the artificial sweetener sorbitol.
Stress: One is more likely to find that signs and symptoms are getting worse or more often during stressful events like family arguments or a change in the daily routine just like most people suffering from IBS. But while stress may aggravate symptoms, it doesn’t result in them.
Hormones: Researchers believe that hormonal changes play a role in this condition, because women are twice more likely to have IBS. Several women find that signs and symptoms are worse during or around their menstrual periods.
Other illnesses: IBS can be triggered sometimes by another illness like an acute episode of infectious diarrhea (gastroenteritis).
Many people have occasional signs and symptoms of irritable bowel syndrome, but more probably have IBS when they:


Are female: Overall, about twice as many women as men have the condition.
Have a family history of IBS: Studies have indicated that people who have a first-degree relative like a sibling or parent suffering from IBS are at high risk of the condition
Are young: IBS starts before the age of 35 for 50% of people.
Researchers are studying whether the influence of family history on IBS risk is linked to genes, to shared aspects in family’s environment, or both.

Complications

Complications:

Hemorrhoids can be aggravated by both constipation and diarrhea which are signs of irritable bowel syndrome. When avoiding certain foods, one may additionally be getting insufficient amount of the nutrients needed, contributing to malnourishment.
But the condition’s impact on the overall quality of life may be the most significant complication. IBS is likely to limit the ability to:


Make or keep plans with friends and family: One may avoid social engagements because of the difficulty in copying with symptoms away from home when experiencing IBS.
Enjoy a healthy sex life: The physical discomfort of IBS may make sexual activity unappealing or even painful.
Reach the professional potential: People suffering from IBS miss three times as many workdays as do people who do not have the condition.
Due to the effects of IBS, one may feel unable to live life to the fullest which leads to discouragement or even depression.

Treatments:

Treatment focuses on the relief of symptoms so that one will be able to live as normally as possible because it's not clear what causes irritable bowel syndrome.
One is able to successfully manage mild signs and symptoms of irritable bowel syndrome in most cases, through learning to manage stress and making changes in the diet and lifestyle. But one may need more than lifestyle changes when the problems are moderate or severe:


Anti-Diarrheal Medications: Over-the-counter medications like loperamide, are able to help controlling diarrhea.
Fiber Supplements: Taking fiber supplements, like methylcellulose or psyllium with fluids may help managing constipation.
Eliminating High-Gas Foods: When experiencing bothersome bloating or are passing considerable amounts of gas, the doctor may suggest that one cut out such items as carbonated beverages, raw fruits, vegetables and salads, particularly cauliflower, broccoli and cabbage.
Anticholinergic Medications: Some people need medications affecting certain activities of the autonomic nervous system to relieve painful bowel spasms. These may be beneficial for those who have bouts of diarrhea, but can worsen constipation.
Antidepressant Medications: A tricyclic antidepressant or a selective serotonin reuptake inhibitor (SSRI) may be recommended when experiencing pain or depression among the symptoms. These medications help relieve depression as well as inhibit the activity of neurons that manage the intestines. A lower than normal dose of tricyclic antidepressants, like amitriptyline and imipramine may be suggested to be used when experiencing diarrhea and abdominal pain without depression. Drowsiness and constipation are included among the side effects of these medications. SSRIs, like paroxetine or fluoxetine , may be helpful when one’s experiencing constipation, have pain or is in depression.

Antibiotics: It’s unclear what role, if any, antibiotics might play in treating IBS. Some people whose symptoms have resulted from overgrowth of bacteria in their intestines may benefit from antibiotic treatment. But more research is required for that.
Counseling: Better results may be received from counseling when stress seems to worsen the symptoms in case antidepressant medications hasn’t been efficient.
Medication specifically for IBS


The following two medications are currently approved for specific conditions of IBS:


Alosetron: Alosetron is a nerve receptor antagonist that's designed to relax the colon and slow the movement of waste through the lower bowel. The drug was removed from the market soon after its original approval because it was linked to serious complications. FDA has since allowed alosetron to be sold again, with restrictions. The drug can be prescribed only by doctors enrolled in a special program and is intended for severe cases of diarrhea-predominant IBS in women who haven't responded to other treatments. Alosetron is not approved for use by men.
Generally, alosetron should only be used if usual therapy for IBS has failed. Additionally, it should only be prescribed by a gastroenterologist with expertise in IBS because of the potential side effects.


Lubiprostone: Lubiprostone is approved for women age 18 and older who have IBS with constipation. It hasn’t been proved whether it works on men or not. Lubiprostaone is a chloride channel activator that one takes twice a day. It works by increasing fluid secretion in the small intestine to help with the passage of stool. Common side effects include abdominal pain, diarrhea and nausea. More research is required to fully understand the effectiveness and safety of lubiprostone. The drug is currently prescribed in general only for women suffering from IBS and severe constipation for whom other treatments haven’t been successful.

Prognosis:

Not Available

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