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Understanding the irritable bowel syndrome (IBS)

irritable bowel syndrome - IBS

Irritable bowel syndrome (IBS)

Have you heard of the irritable bowel syndrome? This syndrome is one of the most common conditions encountered by medical practitioners, but it is unfortunately one of the least understood. The irritable bowel syndrome is a collective impairment or defect in terms of gut motor and sensory activity, psychological issues and disturbances, central neural dysfunction, luminal factors and stress; these are reported to be involved in its pathophysiology. A gastrointestinal tract infection may also be one of the culprits of the syndrome. Worldwide, there are approximately 10-20% of individuals with symptoms consistent with the irritable bowel syndrome.

The symptoms associated with the irritable bowel syndrome (or IBS) overlap with a number of other disorders, such as fibromyalgia, backache, headache, as well as genitourinary symptoms. The severity of symptoms greatly varies and may change the quality of life enormously, and along with it can cause spending a great deal of money for health care alone. As time progressed and technology advancements have enabled a great deal of improvement in terms of understanding the condition, this may also imply improvement in terms of treatment.

What are the clinical features of the irritable bowel syndrome? IBS does not have a specific preponderance for age, but most patients report having their first bouts of symptoms before reaching the age 45. Females are reported to be more susceptible to IBS, making up approximately 80% of the population with severe form of IBS. The chief presenting symptom of IBS patients is pain or abdominal discomfort. Pain associated with IBS has a wide range of severity, from being mild enough to be ignored, to severe enough to hamper with daily routines. It is also reported to be exacerbated through eating or by emotional stress, and often alleviated upon defecation.

Constipation is actually not part of the diagnostic criteria in order for a condition to be classified as IBS. Aside from constipation, other symptoms that are not part of the diagnostic criteria are defecation straining, changes in bowel movement (whether there is urgency or incomplete defecation), passage of mucus along with the feces, as well as the feeling of satiety or bloating. However, the most common pattern in terms of altered bowel habits includes constipation alternating with diarrhea. Initially the constipation is only episodic, but as time progresses the constipation becomes continuous and unresponsive to laxatives. This symptom may extend to as long as weeks or months, and may be occasionally interrupted by bouts of diarrhea in small amounts. Unless hemorrhoids are present, bleeding may not be associated with IBS.

A feeling of satiety is also a common complaint among patients with IBS. This is attributed to increased gas retention in the gastrointestinal tract, as revealed upon gas measurements. But then, most of the patients who present with this complaint only have a normal amount of gas in the abdomen! This may be due to defective transit and impaired tolerance to gas, part of which may be a reflux from the retained feces in the colon.

There are also upper gastrointestinal symptoms associated with IBS. These include dyspepsia, vomiting, heartburn and nausea. But then, this may be bad news, since it implies that there are other areas in the gut that may be affected, aside from the colon. There are reports that most of these symptoms occur upon waking up hours. It is also discovered that there is a significant overlap between dyspepsia and IBS, thus there are hypotheses that functional dyspepsia and IBS are simply manifestations of a more extensive gastrointestinal tract disorder.

There are no symptoms that are unique for IBS alone, so its diagnosis is very much dependent on its clinical features and ruling out of other possible diseases. It is every physician's challenge to come up with the right diagnosis of IBS, since a lot of ruling out has to be done. But then, features that may suggest IBS include a recurrent abdominal pain with alterations of bowel movements over a period of time in the absence of progressive decline in body function. Treatment options for IBS depends on its severity, and since most of IBS patients only have mild symptoms, education, reassurance and dietary or lifestyle changes are often enough for patients to recover. For moderate to severe conditions, patients may need to pay their physicians a visit in order to be prescribed with the right pharmacologic intervention.

The irritable bowel syndrome may be very common, but then, nothing beats prevention. Increased fluid intake and fiber intake are still among the best rules for preventing IBS!

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