Irritable Bowel Syndrome

A number of disorders may present with similar symptoms. Examples include colonic neoplasia, inflammatory bowel disease, hyper or hypothyroidism, causes of chronic diarrhea (especially celiac disease, bacterial overgrowth, and lactase deficiency), and endometriosis. In gastroenterology , irritable bowel syndrome ( IBS ) or spastic colon is a functional bowel disorder characterized by abdominal pain and changes in bowel habits which are not associated with any abnormalities seen on routine clinical testing. In people with IBS, the intestines squeeze too hard or not hard enough and cause food to move too quickly or too slowly through the intestines.Since that time, the syndrome has been referred to by sundry terms, including spastic, irritable, and nervous colon It is fairly common and makes up 20�50% of visits to gastroenterologists For some people, however, IBS can be disabling. A functional disorder refers to a disorder or disease where the primary abnormality is an altered physiological function (the way the body works), rather than an identifiable structural or biochemical cause. This post-infective syndrome has consequently been termed "post-infectious IBS" ( IBS - PI ) and is acute onset Rome II criteria positive. This condition is more homogenous, being mostly IBS-D and is drawing much clinical investigation.

The discomfort often begins after eating and goes away after a bowel movement. Irritable bowel syndrome has been called spastic colon, functional bowel disease, and mucous colitis. It is mainly characterized by a pattern of symptoms that is often worsened by emotional stress. Irritable bowel syndrome is understood as a multi-faceted disorder. The key word here is categories � most people with IBS drive themselves bonkers trying to find that one specific food that is triggering their Irritable Bowel Syndrome It occurs more often in women than in men, and it begins before the age of 35 in about 50 percent of people. Psychiatric disorders such as depression and anxiety must be considered as well. Women with refractory symptoms have an increased incidence of prior physical abuse.

Causes of Irritable Bowel Syndrome

Here are the list of the possible causes of Irritable Bowel Syndrome :

• Colonic muscle hyperreactivity and neural and immunologic alterations of the colon and small bowel may persist after gastroenteritis.
• The patient may present with sigmoid tenderness or a palpable sigmoid cord.
• Irritable bowel syndrome (IBS) can occur at any age, but often begins in adolescence or early adulthood.
• Psychological comorbidity independently predisposes the patient to the development of postinfectious IBS.
• Ordinary events such as eating and distention from gas or other material in the colon can cause the colon to overreact in the person with IBS.

Symptoms of Irritable Bowel Syndrome

Symptoms such as pain, bloating, and altered bowel habits may lead to anxiety and distress which in turn may further exacerbate bowel disturbances due to disordered communication between the gut and the central nervous system. A symptom diary in which patients record the time and severity of symptoms, food intake, and life events may help uncover aggravating dietary or psychosocial factors. Physicians will earn the confidence of their patients by being nonjudgmental and attentive. Fears that the symptoms will progress, require surgery, or degenerate into serious illness should be allayed. The patient should understand that irritable bowel syndrome is a chronic disorder characterized by periods of exacerbation and quiescence. The physician can help but cannot "cure" such a disorder. The emphasis should be shifted from finding the cause of the symptoms to finding a way to cope with them. Physicians must resist the temptation to chase chronic complaints with new or repeated diagnostic studies. Some sign and Symptoms related to Irritable Bowel Syndrome:

• Chronic and frequent constipation, usually accompanied by pain
• Diarrhea, especially after eating or first thing in the morning
• Abdominal fullness , gas, bloating
• Abdominal pain and cramping that may go away after having a bowel movement
• feelings of uncontrollable urgency to have a bowel movement
• discomfort in the upper stomach area or feeling uncomfortably full or nauseous after eating a normal size meal
• swollen or bloated stomach area

Treatment of Irritable Bowel Syndrome

As with other functional disorders, the most important interventions the physician can offer are reassurance, education, and support. An ongoing therapeutic relationship may be the most important factor in successful management of this disorder. This includes identifying and responding to the patient's concerns, careful explanation of the pathophysiology and natural history of the disorder, setting realistic treatment goals, and involving the patient in the treatment process. Because irritable bowel symptoms are chronic, the patient's reasons for seeking consultation at this time should be determined. These may include major life events or recent psychosocial stressors, dietary or medication changes, concerns about serious underlying disease, or reduced quality of life and impairment of daily activities. In discussing with the patient the importance of the mind-gut interaction, it may be helpful to explain that alterations in visceral motility and sensitivity may be exacerbated by environmental, social, or psychological factors such as foods, medications, hormones, and stress.

• Emphasize the expected chronicity of symptoms with periodic exacerbations.
• Judicious water intake in patients who predominantly experience constipation is recommended.
• Tegaserod maleate (Zelnorm), which has been approved by the FDA for the short-term treatment of women with IBS whose primary symptom is constipation.
• Anxiety-reducing measures, such as regular exercise
• Counseling (in cases of severe anxiety or depression)
• milk products, like cheese or ice cream (people who have trouble digesting lactose, or milk sugar could be extra sensitive)
• Sorbitol, a sweetener found in dietetic foods and in some chewing gums

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