gastroenterologist
Irritable Bowel Syndrome (IBS)
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What is irritable bowel syndrome?

Irritable bowel syndrome is one of the most common gastric disorders that affect the large intestine; it is a chronic condition that needs to be managed in the long term.

Only a small number of people with irritable bowel syndrome develop severe signs and symptoms. In some cases, symptoms can be managed by maintaining a healthy diet and lifestyle and managing stress. On the other hand, severe symptoms can be treated with medication and counseling.

Irritable bowel syndrome does not cause changes in bowel tissue, nor does it increase the risk of colon cancer.

What are the signs and symptoms of irritable bowel syndrome?

There are various signs and symptoms of irritable bowel syndrome. The most common of which include:

  • Abdominal pain, cramping, or bloating that usually goes away completely or partially after a bowel movement
  • Excess gas
  • Diarrhea or constipation
  • Mucus in the stool

You should seek medical help if you have persistent changes in bowel habits or other signs and symptoms of irritable bowel syndrome, as it may indicate a life-threatening condition such as colon cancer. More severe signs and symptoms include:

  • Weight loss
  • Diarrhea at night
  • Rectal bleeding
  • Anemia associated with iron deficiency
  • Unexplained vomiting
  • Difficulty swallowing
  • Constant pain that does not go away after a bowel movement

What are the causes of irritable bowel syndrome?

The exact cause of IBS is unknown; however, the following factors may play a role in this condition:

  • Muscle contractions in the intestine. The walls of the intestine are lined with muscle layers that contract when food moves through the digestive system. Strong muscle contractions that last longer than usual can cause gas, bloating, and diarrhea. On the other hand, weak intestinal contractions can slow the passage of food and lead to hard and dry stools.
  • Nervous system. Abnormalities of the nerves in your digestive system can cause more than normal discomfort when your stomach expands due to gas or stool. Poor coordination between the brain and the gut can cause the body to overreact to the naturally occurring changes in the digestive process. This overreaction leads to pain, diarrhea, or constipation.
  • Inflammatory bowel. In some cases, the immune system may respond to IBS by increasing the number of immune system cells in the gut. Pain and diarrhea are associated with this immune system response.
  • Severe infection. IBS can develop after a severe attack of diarrhea (gastritis) caused by a bacteria or virus. Irritable bowel syndrome may also be associated with an excess of bacteria in the intestine (bacterial overgrowth).
  • Changes in gut bacteria (microflora). The microscopic flora is the “good” bacteria in the gut that play a major role in your health. Research indicates that the microflora of people with IBS may differ from the microflora in the healthy.

What are the triggers of irritable bowel syndrome?

Symptoms of irritable bowel syndrome can be triggered by the following factors:

  • Food. Many people experience the worst symptoms of irritable bowel syndrome when consuming certain foods or beverages, including wheat, dairy products, citrus fruits, beans, cabbage, milk, and soft drinks.
  • Psychological stress. Most people with irritable bowel syndrome have their worst signs and symptoms or have frequent recurrences during periods of increased stress. But although psychological stress may aggravate symptoms, it does not cause them to appear.
  • Hormonal changes. Women are twice as likely to have irritable bowel syndrome than men, and this may indicate the role hormonal changes play, so many women find that signs and symptoms worsen during or when approaching the menstrual cycle.

How is irritable bowel syndrome diagnosed?

There is no test to definitively diagnose irritable bowel syndrome. Your doctor will likely start by reviewing your medical history, performing a physical examination, and conducting tests to rule out other conditions.

Your doctor may also evaluate whether you have other signs or symptoms that might indicate another, more serious condition. These signs and symptoms include:

  • Weight loss
  • Rectal bleeding
  • Fever
  • Frequent nausea or vomiting
  • Abdominal pain, especially if it is not completely relieved by a bowel movement
  • Anemia associated with iron deficiency

If you have these signs or symptoms, or if the initial treatment for irritable bowel syndrome isn’t working, you will likely need additional tests, which include stool studies to detect inflammation or disturbances in the intestine’s ability to absorb nutrients from food (nutritional malabsorption). You may need several other tests to rule out other causes behind your symptoms.

Imaging and lab tests may include the following:

  • Flexible sigmoidoscopy
  • X-ray or CT scan
  • Colonoscopy
  • Lactose intolerance test
  • Breath test to detect germs overgrowth
  • Upper endoscopy
  • Stool tests

How to treat irritable bowel syndrome?

Irritable bowel syndrome treatment focuses on relieving symptoms so that you can live as normal as possible.

You can control minor signs and symptoms by managing stress and making adjustments to your lifestyle habits such as:

  • Avoid the types of foods that trigger your symptoms
  • Eat foods rich in fiber
  • Drink a lot of fluids
  • Maintain regular exercise
  • Get enough sleep

Your doctor may suggest that you exclude the following foods from your diet:

  • Foods that cause gas. If you suffer from bloating or gas, you should avoid some types of food such as carbonated and alcoholic drinks, caffeine, raw fruits, and some types of vegetables such as cabbage, broccoli, and cauliflower.
  • Gluten. Research shows that some people with IBS have improved symptoms of their diarrhea after they stop eating gluten (wheat, barley, and rye) even if they do not have celiac disease.
  • FODMAPs. Some people are allergic to certain types of carbohydrates, such as fructose, fructans, lactose, and other substances called FODMAPs – polysaccharides, disaccharides and monosaccharides, and fermentable polyols. FODMAPs are found in certain types of grains, vegetables, fruits, and dairy products.

Our dietitian can help you familiarize yourself with these changes in your diet.

Furthermore, your doctor may suggest medications depending on your symptoms, such as fiber supplements, laxatives, anticholinergic drugs, anti-diarrheal medicines, Tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), and analgesics.

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