Irritable bowel syndrome (IBS)
It is a common digestive system disorder that primarily affects the large intestine. It is a chronic condition of the gut (bowel) that you will need to manage long-term. It causes symptoms like stomach cramps, bloating, diarrhoea and constipation. Its symptoms can be managed by diet control, stress and lifestyle changes. More-severe symptoms need medical or surgical management.
Signs and symptoms include;
- Abdominal pain
- Abdominal cramping
- Alternative diarrhoea or constipation
- Mucus in the stool
The precise cause of irritable bowel syndrome is not known. Certain factors that appear to play a major role include:
Muscle contractions in the intestine: Strong muscle contractions that last longer than normal lead to hard, dry stools and can cause gas, bloating and diarrhoea.
Nervous system: Abdominal pain and alternative diarrhoea or constipation could be due to poorly coordinated signals between the brain and the intestines.
Inflammation of the intestines: People with IBS have an increased number of neutrophils and lymphocytes in their intestines that can cause chronic inflammation leading to abdominal pain.
Changes in microflora (bacteria in the gut): These are the “good” bacteria in the intestines that play a key role in intestinal health. Several studies show that microflora in IBS patients might differ from those in healthy people.
There is no definitive test to diagnose IBS. Your physician is likely to start with a detailed history, physical examination, and certain supportive tests to rule out other similar conditions.
Rome criteria: Diagnostic criteria that include abdominal pain and discomfort associated with at least two other factors; defecation and the frequency of defecation that last on average at least one-two days a week in previous three months.
Manning criteria: It focuses on mucus in the stool, having incomplete bowel movements, changes in stool consistency and pain relieved by passing stool. According to this, the more symptoms patients have, the greater the likelihood of irritable bowel syndrome.
Type of IBS: Based on above diagnostic criteria, IBS can be divided into three types for the purpose of treatment; diarrhoea-predominant, constipation-predominant or mixed.
For symptoms that are not typical or if you develop symptoms of IBS in later life, the more complicated tests such as gastroscopy or colonoscopy (to look into the bowel with a special endoscope) may be required.
If the signs and symptoms are mild, they can often be controlled by managing stress and making small changes in your diet and lifestyle. You may be advised to:
- Drink plenty of fluids
- Eat high-fibre foods
- Avoid foods that trigger your symptoms
- Get enough sleep
- Exercise regularly
Your doctor might suggest counselling if your problems are moderate or severe — especially if stress tends to worsen your symptoms. In addition, your physician might suggest some specific or non-specific medications such as:
- Alosetron (Lotronex)
- Eluxadoline (Viberzi)
- Rifaximin (Xifaxan)
- Lubiprostone (Amitiza)
- Linaclotide (Linzess)
- Fiber supplements
- Antidiarrheal medications
- Anticholinergic medications
- Tricyclic antidepressants
- SSRI antidepressants
- Pain medications