Irritable Bowel Syndrome - Causes, Symptoms And Treatment

Irritable bowel syndrome (IBS) is marked by chronic symptoms of abdominal pain, alternating constipation and diarrhea, excess flatus, a sense of incomplete evacuation, and abdominal distention. Irritable bowel syndrome is a common, stress-related disorder. However. 20% of patients never seek medical attention. IBS is a chronic condition that has no anatomical abnormality or inflammatory component. It occurs in women twice as commonly as men.

What causes Irritable bowel syndrome?

IBS appears to reflect motor disturbances of the entire colon in response to stimuli. Some muscles of the small bowel are particularly sensitive to motor abnormalities and distention; others are particularly sensitive to certain foods and drugs. The patient may be hypersensitive to the hormones gastrin and cholecystokinin. The pain of IBS seems to be caused by abnormally strong contractions of the intestinal smooth muscle as it reacts to distention, irritants, or stress.

Causes include:

• ingestion of irritants (coffee, raw fruit, or vegetables)
• lactose intolerance
• abuse of laxatives
• hormonal changes (menstruation).

Signs and symptoms of Irritable bowel syndrome

• cramping of the lower abdomen secondary to muscle contraction; usually occurring during the day and relieved by defecation or passage of flatus
• fever and chills
• pain that intensifies 1 to 2 hours after a meal from irritation of nerve fibers by causative stimulus
• constipation alternating with diarrhea, with one dominant; secondary to motor disturbances from causative stimulus
• mucus passed through the rectum from altered secretion in intestinal lumen due to motor abnormalities
• abdominal distention and bloating caused by flatus and constipation.

Diagnosis information

Stool samples for ova, parasites. bacteria, and blood rule out infection.

• Lactose intolerance test rules out lactose intolerance.
• Barium enema may reveal colon spasm and tubular appearance of descending colon without evidence of cancers and diverticulosis.
• Sigmoidoscopy or colonoscopy may reveal spastic contractions without evidence of colon cancer or inflammatory bowel disease.
• Rectal biopsy rules out malignancy.

Treatment of Irritable bowel syndrome

Treatment of IBS may include:

• stress relief measures, including counseling or mild anti-anxiety agents.
• investigation and avoidance of food irritants and gas-producing foods.
• application of heat to the abdomen.
• bulking agents to reduce episodes of diarrhea and minimize effect of nonpropulsive colonic contractions.
• antispasmodics (propantheline [Pro-Banthine] or diphenoxylate with atropine [Lomotil]) for pain.
• loperamide (imodium A-D) (possibly) to reduce urgency and fecal soiling in patients with persistent diarrhea.
• bowel training (if the cause of IBS is chronic laxative abuse) to regain muscle control.

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Irritable Bowel Syndrome diet

• Increase fiber content in your diet.
• Avoid large meals - smaller, more frequent meals may reduce symptoms.
• Avoid caffeine, alcohol, and sorbitol (a sweetener found in chewing gum).
• Decrease fat intake.
• Avoiding gas-forming foods from the cruciferous vegetable family (cabbage, broccoli, brussel sprouts, cauliflower, radishes, turnips), beans, and legumes may help.

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Special considerations and Prevention

Because the patient with IBS won't be hospitalized. focus your care on patient teaching.

• Tell the patient to avoid irritating or gas-producing foods and encourage her to develop regular bowel habits.
• Help the patient deal with stress associated with the disease's effects and warn against dependence on sedatives or antispasmodics.
• Eat a healthy diet, with plenty of fibre, fruit and vegetables.
• Encourage regular checkups because IBS is associated with a higher-than normal incidence of diverticulitis and colon cancer. For patients over age 40, emphasize the need for an annual sigmoidoscopy and rectal examination.
• Take regular exercise.
• Avoid using laxatives. They may weaken your intestines and cause you to be dependent on them.