Important Things To Know
About Irritable Bowel Syndrome IBS
Irritable bowel syndrome (IBS) is a functional disorder, motor or sensory
disturbance defined by bowel habits, abdominal pain, bloating, constipation or diarrhea and absence of organic disease. Irritable bowel syndrome causes great discomfort in the person, as to affect their quality of life. Most times, people with this disorder miss work or are unable to attend social events such as birthdays, meetings or even short distance trips. Despite these symptoms and the characteristic chronic disease, the prognosis is good with no major complications.
About 20% of the general population suffer from irritable bowel syndrome and is a major cause of absence from work. It is the most common cause of referral to a gastroenterologist and is more common in younger women (20 to 30 years old) than in men.
What Are The Symptoms of IBS?
Irritable bowel syndrome is characterized by;
- Abdominal pain
- Constipation/ Diarrhea
Symptoms vary from person to person. In some people, constipation is predominant. Constipation is the retention of stool in the intestine for a longer period than normal or the inability to move the bowel. When defecation is achieved, the patient can eliminate a small amount of stool and has the feeling of incomplete defecation. In addition, stool mucus is often present. Mucus is a substance that coats the lining of the digestive tract and serves to lubricate and to protect it.
Another group of patients suffer from irritable bowel syndrome with a tendency to have diarrhea. Diarrhea is the increased number of stools with a change in consistency. Some patients experience periods of constipation followed by diarrhea or vice versa. These symptoms can persist for months and then return or stay for a period of time, and get worse.
What Causes IBS?
There is no specific cause that determines the development of the disease. Several theories have been proposed: Abnormal intestinal motor response (the gastro colic reflex that occurs after eating is too intense). Researchers have shown that serotonin is related to the functioning of the gastrointestinal tract. Serotonin is a neurotransmitter that is responsible for delivering messages from one body part to another. 95% of serotonin receptors are located in the digestive tract and the remaining 5% in the brain. Cells found in the edge of the bowel function as serotonin transporters (receptors). People suffering from irritable bowel syndrome, have a decrease in the activity of these receptors and, therefore, there is a decreased activity of this neurotransmitter in the digestive system. This results in changes in colonic motility and increases the pain receptors in the digestive system.
- Perception altered (abnormal sensitivity to colon distension caused by the arrival of food).
- Intolerance to certain foods
- Loss of normal function of fluid absorption: the epithelium of the colon, which is affected by the immune system and nervous system, regulates the absorption of fluids in the colon. In IBS, the colon loses its function to absorb fluid properly. This results in watery stool. For other people, this change is seen as excessive fluid absorption and the result is constipation.
In addition, people with irritable bowel syndrome often suffer with depression and anxiety, which can worsen symptoms. Researchers have shown that irritable bowel syndrome can be caused by an intestinal infection. Studies show that people who have had gastroenteritis sometimes develop irritable bowel syndrome. In this case it is called irritable bowel syndrome post-infection.
Another finding of medical researchers is some degree of celiac disease in people with symptoms similar to irritable bowel syndrome. People with celiac disease cannot digest gluten. Gluten is a protein found in wheat, oats, rye and barley. The immune system of people with celiac disease reacts in the presence of this protein damaging throughout the intestinal mucosa. As a result, it generates a malabsorption syndrome with diarrhea, loss of fat in the stool, bloating and other symptoms. A blood test can determine if you are celiac or not.
Some factors are related to irritable bowel syndrome’s symptoms:
- Larger meals
- Bloating from gas in the colon
- Wheat, rye, chocolate, barley, dairy, alcohol, caffeinated drinks, like coffee, tea or cola
- Stress, emotional conflicts, depression, anxiety
Scientists have proven that women with irritable bowel syndrome have more symptoms during their menstrual periods, suggesting that reproductive hormones can worsen the symptoms.
What Happens To The Colon?
The colon, which measures about 5 feet long, connects the small intestine to the rectum and anus. The main function of colon is to absorb water, nutrients and minerals from predigested food coming from the small intestine. The difference between the amount of liquid that reaches the small intestine and is excreted in the feces is the amount of water absorbed by the colon each day.
Colonic motility (contractions of the muscles of the colon and the movements of its contents) is controlled by the peripheral nervous system, hormones and impulses that reach the colon. These contractions are called peristaltic movements and move the contents of the colon to the rectum. As the intestinal contents progresses, there is absorption of water, nutrients and salts.
Several times in the day there are movements in the colon that push the intestinal contents toward the rectum. However, if intestinal muscle does not contract well these movements can result in abdominal pain, bloating, cramping, constipation or diarrhea.
How Is IBS Diagnosed?
The indispensable part of irritable bowel syndrome’s diagnosis is a physical examination and analysis of symptoms with a thorough history. There are no specific tests for the diagnosis of irritable bowel syndrome, though some tests are performed to rule out other diseases. These tests include: blood test, stool examination and x-rays. To rule out organic disease, your doctor will order a sigmoidoscopy or colonoscopy to observe the state of the intestinal mucosa.
If results are negative and the colonic mucosa is normal, the doctor will diagnose IBS based on symptoms presented by the patient and the taking of their health history. This includes knowing how often they feel abdominal pain, if they are related to a period of stress or the menstrual period in the case of women, what is the consistency of stool and how bowel habits have been recently changed.
Some doctors make a diagnosis of irritable bowel syndrome based on the presence of the following symptoms; Abdominal pain, or discomfort for at least 12 weeks during the past year. These 12 weeks do not have to be consecutive. Abdominal pain has one of the following features;
- Worsens with bowel movements
- When it starts, there is a change in frequency of bowel movements
- When it starts there is a change in the stool consistency
- Other symptoms that must be present for the diagnosis of irritable bowel syndrome are:
- Change in frequency of bowel movements
- Change in appearance of stool
- Urgent need for defecation
- Difficulty or inability to produce a bowel movement
- Mucus in the stool
- Presence of bleeding, fever, weight loss, persistent abdominal pain are not symptoms that characterize IBS and may indicate the presence of another disease such as inflammatory bowel disease or cancer less frequently.
What Is The Treatment For IBS?
Unfortunately, there are many people who do not seek medical treatment in the presence of these symptoms and delay diagnosis. Many of them are self-medicated. No cure has been found so far for irritable bowel syndrome. However, symptoms can be controlled. The doctor will indicate the appropriate treatment based on symptoms presented by the patient. A consultation with a nutritionist will be necessary to adopt a proper diet. You will also need to incorporate techniques for managing stress, anxiety and depression if they exist.
How Does Stress Affect IBS?
Feeling emotional with tension, worry, anger can stimulate colon spasms in people with irritable bowel syndrome. The colon has a connection with the brain through nerves. The colon is an organ that is controlled by the autonomic nervous system, which responds to stress. These nerve endings are sensitive to the stress level of individuals and stimulating movements react in the large intestine to a stressful situation. People with IBS often have cramps or “butterflies” when they are nervous. The colon creates an exaggerated motor response to these situations.
There is scientific evidence that IBS is affected by the immune system that fights infection and foreign bodies in the body. The immune system is affected by the level of stress.
For the reasons discussed above, stress management constitute a mainstay of treatment of irritable bowel syndrome.
Some Stress Management Techniques Include:
- Stress reduction (relaxation), relaxation therapies such as meditation
- Counseling and support
- Regular exercise like walking or yoga
- Change stressful situations of everyday life
- Adequate sleep
Can Changes In Diet Help IBS?
Dietary changes improve symptoms of irritable bowel syndrome. It’s good that you keep a record of the foods you eat and show tolerance to them. Then, tell your doctor or nutritionist. For example, milk products are often poorly tolerated by most patients. To replace them the nutritionist will fit your diet according to your tolerance. Yogurt is usually better tolerated than the cheese and milk because it has the precipitated protein (predigested), simple sugars and beneficial bacteria to colonize your gut.
Dietary fiber is not always well tolerated. It is very useful in cases of irritable bowel syndrome with constipation tendency. To raise the amount of fiber in your diet you can increase the consumption of cereals and grains, fruits and vegetables. Too much fiber in the diet can have adverse effects such as gas and bloating, so it is advisable to increase your intake of 2 to 3 grams per day and assess tolerance.
The intake of 6 to 8 glasses of water a day will help keep your bowels hydrated and prevent constipation. If you suffer from irritable bowel syndrome with a tendency to diarrhea, it is important to replace fluids lost in the feces. Avoid fizzy drinks and sugar because they irritate the bowel. Chewing gum and eating fast can cause gas and bloating. Try to chew slowly and eat in a relaxed atmosphere.
Large meals can cause diarrhea, so it is recommended to consume smaller meals more frequently. This will help control the symptoms of irritable bowel syndrome. Consuming foods rich in complex carbohydrates and low in fat (pasta, rice, cereals, fruits and vegetables) may help improve the performance of your bowel.
Is IBS Linked To Other Diseases?
As its name implies, irritable bowel syndrome is a cluster of symptoms and signs. It has been shown that this disease doesn’t bring complications in the long term, nor does it contribute to the development of serious diseases.
If you are not local to the clinic, Michelle can conduct telephone appointments with you very easily. So if you are anywhere in North America, you can now successfully receive high end, specialized help for your Crohn’s disease or ulcerative colitis. If you are local to the clinic in Hamilton, Toronto or Mississauga Ontario – by all means come in for your appointment. If not, telephone appointments are very popular and convenient.