Irritable Bowel Syndrome
Irritable Bowel Syndrome or IBS is a 'syndrome' affecting the gastrointestinal system. A 'syndrome' indicates that the condition has a group of symtoms. It is also described as a ‘functional disorder’ – this means that there is a disorder in the functioning of the body’s normal activities in relation to the intestines. Irritable bowel syndrome is one of the most common diseases associated with gastroenterology. In IBS, even though the functioning of the intestines is impaired, there are no structural abnormalities that are found via blood tests, x-rays or endoscopies.
 Symtoms of Irritable Bowel Syndrome
There are a number of syptoms associated with irritable bowel syndrome including:
- Abdominal discomfort, pain and/or cramping
- Chronic or recurrent diarrhea, constipation or both (either mixed or in alternation)
- Mucus in the stool
Some people with IBS also report symptoms such as heartburn, nausea, early feeling of fullness, feelings of urgency (the need to go to a restroom fast) and feeling of ‘incomplete’ bowel emptying. A person suffering from IBS may have some or all of the symptoms at the same in varying degrees of intensity.
 Diagnosis of Irritable Bowel Syndrome
Irritable bowel syndrome indicates that the normal grinding, mixing, digestion and absorption functions of the gastrointestinal system are disturbed. The disease and its symptoms are not life threatening but can be disabling for people for people who experience them. Since IBS does not structurally affect the bowel, it cannot be diagnosed through tests (such as blood tests, x-rays or endoscopies). The diagnosis of IBS depends on complete medical history and is largely a process of elimination. To assist in the diagnosis, researchers have developed certain criteria known as Rome criteria. According to the Rome criteria (the most current version is Rome III), IBS can be diagnosed based on recurrent abdominal pain or discomfort at least 3 days per month in the last 3 months associated with 2 or more of the following:
- Improvement with defecation.
- Onset associated with frequency of stool
- Onset associated with a change in form (appearance) of stool
The criteria must be fulfilled for the last three months with the onset of symptoms at least 6 months prior to diagnosis. The other symptoms that support the diagnosis of IBS (but are not essential) include:
- Abnormal stool frequency (greater than 3 bowel movements a day or less than 3 bowel movement a week)
- Abnormal stool form (lumpy/hard/loose/watery stool)
- Passing mucus
- Bloating or feeling of abdominal distension
 Causes of Irritable Bowel Syndrome
The causes for IBS have not yet been identified. One theory is that people with IBS are more sensitive to the stretching of the bowel which leads to gas and/or bloating. Some researchers suggest that IBS is caused by changes in the nerves that control muscle contraction or sensation in the bowel. Women are more likely to have IBS than men, and many women have reported more severe symptoms around their menstrual cycle. Therefore, it is also possible that hormones play a role. Recent research linking seratonin to normal gastrointestinal activity may also shed some light on this disease. Seratonin is a neurotransmitter responsible for delivering messages from one part of the body to another. The gastrointestinal tract has 95% of he body’s seratonin, while the other 5% can be found in the brain. The seratonin is carried out of the gastrointestinal (GI) tract by cells that line the inside of the bowel, that work as transporters. People with IBS have diminished receptor activity causing abnormal levels of seratonin to exist in the GI tract. This results in problems with bowel movement and sensation.
 Factors that can affect symptoms
Patients have reported certain conditions that seem to trigger their syptoms or make them more severe. These include-
- Foods: Many people experience an onset or worsening of their symptoms when they eat certain foods. Chocolate, milk, alcohol, coffee and tea have been associated with worsening symtpoms. However, the role of allergies and reactions in IBS has not been well studied.
- Stress: People dealing with stressful events, changes in daily routine, and anxiety have reported worsening of symptoms. It is important to remember that though stress can aggravate symptoms, it does not cause them.
- Women sometimes experience worsening their symptoms during their menstrual cycle.
 Did You Know?
- IBS affects between 25 to 45 million people in the U.S alone which is about 10-15% of the population
- Approximately 60-65% of the IBS sufferers are female, whereas 35-40% men are affected by IBS
- IBS can cause constipation, diarrhea, bloating and abdominal cramps
- There is no known cause or cure for IBS
- Stress can make IBS symptoms worse
- Many IBS sufferers experience depression because of their symptoms - they feel uncomfortable talking about 'bowel trouble'
Since the exact cause of IBS is not known, there is no cure for IBS. However, there are treatments to alleviate the symptoms of the condition. The disease and its symptoms are not life threatening but can be disabling for people for people who experience them. In some cases, symptoms of IBS cause patients to suffer depression.
Many cases of IBS can be managed through changes in diet and lifestyle. In cases where symptoms are more severs, physicians may recommend:
- Taking fibre supplements that help control constipation
- Taking laxatives to help constipation
- Taking anti-diarhheal medication
- Taking anticholinergic medication – Anticholinergic medicines affect certain activities of the nervous system and may be required to relieve painful bowel spasms
- Eliminating high-gas foods – If a person suffers bloating and flatulence, physicians may recommend eliminating foods such as carbonated beverages, cauliflower, broccoli, raw fruits and vegetables
- If the person is experiencing depression on account of their IBS, a doctor may recommend an anti-depressant and/or counseling
There are two medications that exist that are meant specifically to treat IBS. These are:
Alosetron: This drug is supposed to relax the colon and slow the movement of waste in the bowel. In the U.S, the drug was removed from the market nine months after it was approved as it was linked to severe side effects in over a 100 people. In June 2002, the drug was re-approved by the FDA and was allowed to be sold with restrictions. Doctors enrolled in a special program can precribe this drug to women with severe diarrhea who have not responded to any other treatment. This drug is not approved for use by men. Since this drug is known to have side effects, it should only be taken on the prescription of a doctor who has experience treating IBS.
Lubiprostone: The U.S FDA approved this drug in April 2008. This drug is meant for women 18 years and above who suffer from IBS with constipation. It works by increasing the fluid secretion in the small intestine to improve the passage of stool. This drug may have side efects that include nausea, diarrhea and abdominal pain.
 Alternative Treatments
Many people who suffer IBS rely on alternative treatments to relieve the symptoms of IBS. As with most alternative therapies, there are few scientific studies that prove their effectiveness, therefore for every individual it is a process of trial and error to find the treatment that works best for them. It is also advised to check with a physician before trying out any alternative therapy to ensure that it does not interfere with any on going treatment.
Some of the alternative therapies that claim to help symptoms of IBS are:
- Acupuncture- This is often used to help relax muscle spasms and improve bowel function.
- Herbs – Peppermint is a natural antispasmodic that may relax the smooth muscles in the intestines. Peppermint may aggravate heartburn so it is advised to check with a physician before taking peppermint for IBS.
- Probiotics- Probiotics are the “good” bacteria present in yoghurt and other dietary supplements. It has been suggested that introducing probiotics into the diet may ease IBS symptoms.
- Other alternative treatments that claim to improve symptoms oof IBS include meditation, Polarity Therapy, and osteopathy.
 See Also
- What is Irritable Bowel Syndrome
- Symtpoms of IBS
- What I need to know about IBS
- What causes IBS
- Facts about IBS