What is IBS?
Irritable bowel syndrome is a gastrointestinal (GI) disorder known to account for close to 50% of all referrals to GI specialists. Women are twice more likely than men to suffer from IBS and over 50% of cases occur in people younger than 35 years. IBS is one of those clinical conditions not really understood by the medical community. Initially it was thought to be due to an emotional or psychological process. Several recent studies, however, propose that IBS might be actually caused by problems with GI motility or increased sensitivity. Foods such as caffeine, carbonated drinks, chocolate, dairy products or artificial sweeteners in addition to infectious agents have been shown in these studies to over-stimulate the GI system. Since IBS seems to occur disproportionately in women, some researchers have explored the link between hormones and the disease. So far they have found a greater correlation between flares of IBS and menstrual periods. Other researchers have focused on the role mal-absorption or GI inflammation might play and so far several interesting theories have been suggested. However, further research is needed to tease out the real cause of IBS.
What are symptoms of IBS?
Regardless of cause, the millions of people who suffer from this disorder describe the following symptoms:
Common
- chronic abdominal cramping or pain that can increase in intensityà having a bowel movement usually relieves the pain associated with IBS
- altered bowel habits with periods of diarrhea and/or constipation for days to months
- gas/flatulence and bloating
- nausea
- esophageal reflux
Less common
- pain or difficulty swallowing
- sexual dysfunction (e.g. pain with intercourse)
- painful periods
- urinary frequency and urgency
- hypertension
- reactive airway disease
- rheumatologic disorders (e.g. fibromyalgia)
Diagnosing IBS
Your doctor usually diagnoses IBS based on the history of episodes you provide. Given the diversity of patient presentations, the medical community has developed several key symptoms to help with the diagnosis process. A person must have abdominal pain lasting at least 12 weeks. The pain does not have to be present continuously for the entire 12 weeks, however. In addition to pain, you need to have at least two of the following for diagnosis:
Table 1: Manning criteria for diagnosis of irritable bowel syndrome*
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* The likelihood of IBS is proportional to the number of Manning’s criteria that are present.
How is IBS treated?
Currently most treatment for IBS targets the symptoms associated with the disease since the real cause unknown.
- Antidiarrheals such as Imodium control diarrheal episodes
- Fiber supplements like Metamucil decrease constipation
- Antidepressants such as Paxil, Prozac and Tofranil might help decrease the depression which sometimes comes with the abdominal pain
- Antibiotics are used only in situations where patients might have overgrowth of bacteria in their gut. This is done only under close supervision by a physician and for a short period
- Counseling to help address the stress and depression associated with IBS
- Dietary changes that remove or reduce intake of gas-producing foods such as beans, dairy products, carbonated drinks, raw fruits and vegetables might decrease abdominal pain and bloating.
- Regular exercise, massage and/or meditation has been found to be helpful with reducing incidence of episodes and more importantly coping well with the disease process.
Sources and for more information visit:
1) MayoClinic.com- Irritable Bowel Syndrome at http://www.mayoclinic.com/health/irritable-bowel-syndrome/DS00106/DSECTION=alternative-medicine
2) National Digestive Diseases Information Clearinghouse, NIH at http://digestive.niddk.nih.gov/ddiseases/pubs/ibs/
3) Table 1: UpToDate.com- Clinical manifestations and diagnosis of irritable bowel syndrome