Irritable bowel syndrome (IBS) is a chronic disorder that affects the large intestine. IBS is a long-lasting condition but it cannot increase a person’s risk of colorectal cancer. Severe signs and symptoms affects only a small number of people with IBS. Some people can control their symptoms by changing their livestyle, managing diet, and stress. Severe symptoms can be treated with medication.
Symptoms of IBS
The most common signs and symptoms of IBS include:
- Abdominal pain or cramping that is partially relieved after a bowel movement
- Excess gas
- Mucus in stool
- Diarrhea or constipation — sometimes sporadic sessions of diarrhea and constipation
Most people with IBS experience times when the symptoms aggravate and times when the symptoms improve or even disappear.
READ ALSO: Five Foods that Causes Diarrhea
Causes of IBS
The exact cause of IBS is yet unknown. However, factors that appear to play a role include:
- Muscle contractions in the intestine: The layers in the walls of the intestines contract as they move food through the digestive tract. However, gas, diarrhea, and bloating can occur if contractions are stronger and last longer than normal. Weak intestinal contractions can slow food passage leading to stools that are dry and hard.
- Inflammation in the intestines:Some people with IBS have an increased number of immune-system cells in their intestines. This immune-system response is associated with pain and diarrhea.
- Severe infection: IBS can develop after a severe bout of diarrhea (gastroenteritis) caused by bacteria or a virus. Also, IBS may be caused by bacterial overgrowth in the intestines.
- Nervous system: Abnormalities in the nerves in your digestive system may cause you to experience severe pain when your abdomen stretches from gas or stool. Poorly coordinated signals between the brain and the intestines can cause your body to overreact to changes that normally occur in the digestive process, causing diarrhea, constipation, or pain.
- Changes in bacteria in the gut (microflora): Microflora are the “good” bacteria that live in the intestines and play a vital role in health. Microflora in people with IBS might differ from microflora in healthy people, according to studies.
READ ALSO: Inflammatory Bowel Disease (IBD)
Factors That Triggers IBS
Symptoms of IBS can be triggered by:
- Food:A food allergy rarely causes IBS. However, many people with IBS experience worse symptoms when they eat or drink certain foods or beverages. Such foods may include beans, cabbage, wheat, citrus fruits, carbonated drinks, milk and dairy products.
- Stress:When people with IBS are stressed, they tend to experience worse symptoms. Stress may worsen symptoms, it doesn’t cause them.
- Hormones:Women are twice as likely to have IBS compared to men. Many women find that signs and symptoms get worse during or around their menstrual periods.
Most people have occasional signs and symptoms of IBS. But you’re more likely to have the syndrome if you:
- Are young: IBS occurs more frequently in people under age 50.
- Are female: In the United States, IBS is more common among women. Estrogen therapy before or after menopause also is a risk factor for IBS.
- Have a family history of IBS: A combination of genes and shared factors in a family may play a role.
- Have a mental health problem: Depression, anxiety, and other mental health disorders are linked with IBS.
Chronic constipation or diarrhea can lead to hemorrhoids. In addition, IBS is associated with:
- Poor quality of life.Many people with moderate to severe IBS report poor quality of life. Research indicates that people with IBS miss three times as many days from work as do those without bowel symptoms.
- Mood disorders.Experiencing the signs and symptoms of IBS can lead to depression or anxiety. Depression and anxiety also can make IBS worse.
Finding ways to deal with stress may help prevent or ease symptoms of IBS. Consider trying:
- Counseling:A counselor can help you change your responses to stress. Psychotherapy can provide lasting reduction of symptoms, according to studies.
- Biofeedback:Electrical sensors help you receive information (feedback) on your body’s functions. The feedback helps you focus on making subtle changes, like relaxing certain muscles, to relieve symptoms.
- Progressive relaxation exercises:There are exercises that can gradually help you relax muscles in your body. Begin by contracting the muscles in your feet, then slowly concentrate on letting all of the tension go. Tighten and relax your calves until the muscles in your body, including those in your eyes and scalp, are relaxed.
- Mindfulness training.This stress-reduction method helps you focus on being in the moment and letting go of worries and distractions.
When to see a doctor
See your doctor if you have a persistent change in bowel habits or other signs or symptoms of IBS. These may include:
- Diarrhea at night
- Iron deficiency anemia
- Weight loss
- Rectal bleeding
- Unexplained vomiting
- Persistent pain that isn’t relieved by passing gas or a bowel movement
- Difficulty swallowing
There’s no test to conclusively diagnose IBS. Your doctor is likely to start with a complete medical history, physical exam and tests to rule out other conditions. If you have IBS with diarrhea, you likely will be tested for gluten intolerance (celiac disease).
Also, your doctor may likely use one of these sets of diagnostic criteria for IBS including:
- Rome criteria.These criteria include abdominal pain lasting on average at least one day a week in the last three months, associated with at least two of these factors: Pain and discomfort are related to defecation, the frequency of defecation is changed, or stool consistency is altered.
- Manning criteria.These criteria focus on pain relieved by passing stool and on having incomplete bowel movements, mucus in the stool and changes in stool consistency.
Type of IBS
IBS can be divided into three types, based on your symptoms:
Your doctor will also likely assess whether you have other signs or symptoms that might suggest another, more serious, condition. These signs and symptoms include:
- Onset of signs and symptoms after age 50
- Weight loss
- Rectal bleeding
- Nausea or recurrent vomiting
- Abdominal pain, especially if it’s not completely relieved by a bowel movement, or occurs at night
- Diarrhea that is persistent or awakens you from sleep
- Anemia related to low iron
If you have these signs or symptoms, or if an initial treatment for IBS doesn’t work, you’ll likely need additional tests.
Treatment for IBS
Treatment of IBS focuses on relieving symptoms so that you can live a normal life. Mild signs and symptoms can often be controlled by managing stress and by making changes in your diet and lifestyle. Try to:
- Drink lots of fluid
- Eat foods high in fiber
- Exercise regularly
- Avoid foods that trigger your symptoms
- Get enough sleep
Your doctor might suggest that you STOP eating these foods:
- Gluten:Research shows that some people with IBS report improvement in diarrhea symptoms if they stop eating gluten. Gluten foods include barely, wheat, and rye, even if they don’t have celiac disease.
- High-gas foods:Avoid items such as carbonated and alcoholic beverages, caffeine, raw fruit, and certain vegetables, such as cabbage, broccoli and cauliflower if you experience bloating and/or gas.
- Some people are sensitive to certain carbohydrates such as fructose, fructans, lactose and others, known as FODMAPs — fermentable oligo-, di-, and monosaccharides and polyols. FODMAPs are found in certain grains, vegetables, fruits and dairy products. Your IBS symptoms might ease if you follow a strict low-FODMAP diet and then reintroduce foods one at a time.
Medications for IBS
Medications approved for certain people with IBS include:
- Alosetron (Lotronex): This drug is designed to relax the colon and slow the movement of waste through the lower bowel. Alosetron can be prescribed only by doctors enrolled in a special program, is intended for severe cases of diarrhea-predominant IBS in women who haven’t responded to other treatments.
- Eluxadoline (Viberzi):Eluxadoline can relieve diarrhea by reducing muscle contractions and fluid secretion in the intestine, and increasing muscle tone in the rectum.
- Linaclotide (Linzess):Linaclotide also can increase fluid secretion in your small intestine to help you pass stool freely.
- Lubiprostone (Amitiza):Lubiprostone can increase fluid secretion in your small intestine to help with the easy passage of stool.
- Rifaximin (Xifaxan):This antibiotic can decrease bacterial overgrowth and diarrhea.
Photo source: drdeborahmd.com
Culled from: mayoclinic.org
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