Irritable bowel syndrome is problem with how bowel works. There is otherwise nothing wrong with bowel.Irritable bowel syndrome (IBS) may not cause any harm to the body but it sometimes causes lot of discomfort. It isn’t known what causes the IBS. The symptoms can range from the mild to severe. There is no cure for the IBS but some simple lifestyle changes and the treatments usually make symptoms much better.
What is it and who gets it?
Irritable bowel syndrome (IBS) is common. It is thought to affect about 1 in 5 people. In IBS, function of the gut is upset, yet all parts of the gut look normal, even when looked at under the microscope. IBS can affect anyone at any age but it most often first develops in the young adults. Women are affected more often than the men.
What are the symptoms of IBS?
The symptoms if the irritable bowel syndrome (IBS) vary from the person to person.
Pain and discomfort may occur in different parts of the tummy (abdomen). Pain usually comes and goes. The length and the severity of each bout of pain can vary greatly. The pain often eases when the pass stools (faeces) or wind. Many people with the IBS describe the pain as the spasm or colic.
Bloating and swelling of the tummy may develop from time to time. You may pass more the wind than usual.
Changes in the stools:
Some people have the bouts of diarrhoea, some have the bouts of the constipation and some get combination of both.
The stools may become very small and pellet-like. Sometimes the stools become either watery or more loose. At times,the mucus may be mixed with stools.
There may be feeling of not emptying back passage (rectum) after going to toilet.
Some people have the urgency, which means they have to get to toilet quickly. You may feel an urgent need to go to toilet several times shortly after getting up.
Is your poo normal?
Concerns should be raised if bowel habit changes significantly from what is the ‘normal’ for an individual, particularly if frequency increases and stool becomes looser, if there is the blood visible on wiping or mixed in with stool, or if it is associated with the abdominal pain or the weight loss.
Other symptoms which sometimes occur – these include:
- Feeling sick (nausea).
- Poor appetite.
- Muscle pains.
- Feeling quickly full after eating.
Bladder symptoms (an associated irritable bladder).
Some the people have occasional mild symptoms. Others have the unpleasant symptoms for long periods. Many people fall somewhere in between, with the flare-ups of symptoms from time to time.
Some doctors group the people with IBS into one of three categories:
Those with the abdominal pain or discomfort, and the other symptoms are mainly the bloating and the constipation.
Those with the abdominal pain or discomfort, and the other symptoms are mainly urgency to get to toilet, and the diarrhoea.
Those who alternate between the constipation and the diarrhea.
However, in practice, many people will not fall neatly into any one of the category, and considerable overlap occurs.
What causes IBS?
Exactly what causes the irritable bowel syndrome (IBS) isn’t known. It may have something to do with the overactivity of part or parts of gut (bowel).
Food is passed along bowel by regular squeezes (contractions) of muscles in wall of the bowel wall. Pain and other symptoms may develop if contractions become abnormal or overactive. The area of the overactivity in gut may determine exactly where you feel pain and whether the constipation or the diarrhoea develops.
The cause of the overactivity in parts of gut is not clear. One or more of the following may play a part:
Overactivity of nerves or muscles of the gut. It is not known why this may occur. It may have something to do with the overactivity of messages sent from brain to the gut.
Stress or the emotional upset may play a role. About half of people with the IBS can relate start of symptoms to a stressful event in their lives. Symptoms tend to become very worse during times of the stress or anxiety.
Intolerance to certain foods may play a part in some of the cases. However, this is thought to be only in small number of cases.
Infection and the germs (bacteria) in gut. IBS is not caused by an ongoing the gut infection. However, in some cases, onset of the symptoms seems to follow a bout of gut infection with diarrhea and being sick (vomiting), called the gastroenteritis. So, perhaps virus or other germ may sensitize or trigger gut in some way to cause the persisting symptoms of IBS.
Oversensitivity to the pain. People with the IBS feel more pain when their gut is expanded (dilated) than those without IBS. They may have the lower threshold for experiencing the pain from the gut.
How is IBS diagnosed?
There is no test that confirms diagnosis of the irritable bowel syndrome (IBS). A doctor can usually diagnose the IBS from the typical symptoms.
Your doctor will check that there is nothing else going on in you. Usually this will include the examination of your tummy (abdomen) and some of the simple tests.
A blood test and the stool (faeces) test are often taken to help rule out the other conditions such as the Crohn’s disease, ulcerative colitis, the coeliac disease, cancer of the ovary, or a gut infection. The symptoms of these other diseases can sometimes be confused with the IBS. The tests that are often considered to rule out with the other conditions include:
Full blood count (FBC) – to rule out lack of the iron in blood (anaemia), which is associated with the various gut (bowel) disorders.
Erythrocyte sedimentation rate (ESR) or the C-reactive protein (CRP) – which can show if there is inflammation in the body (which does not occur with IBS).
A blood test for the coeliac disease.
In women, the blood test to rule out the cancer of the ovary, called the CA 125.
A stool test to look for the protein called the faecal calprotectin. This may be present if you have the Crohn’s disease or ulcerative colitis, but is not present in the IBS. A stool test may also be used to check whether you have any of the bleeding from your bowel.
More complicated tests such as the gastroscopy or the colonoscopy (to look into the bowel with the special telescope) are not usually needed. However, they may be done if the symptoms are not typical, or if you develop the symptoms of IBS in later life (over the age of about 50) when the other conditions need to be ruled out.
How is IBS treated?
There are many different treatments that may be tried for the IBS. All will have effect on some people, but none will help in every person with the IBS.
Many people with the mild irritable bowel syndrome (IBS) symptoms don’t need any treatment. No treatment is likely to take away the symptoms completely; however, the treatment can often ease symptoms and improve quality of life.
What lifestyle changes can help?
Exercise. Regular exercise is known to help to ease the symptoms.
Managing stress levels. Stress and the emotional factors may trigger symptoms in some people. So, anything that can reduce your level of the stress or the emotional upset may help.
Keeping the symptom diary. It may help to keep the food and the lifestyle diary for 2-4 weeks to monitor the symptoms and activities. Note everything that you eat and drink, times that you were stressed, and when you took any the formal exercise. This may identify triggers, such as the food, alcohol, or the emotional stresses, and may show if the exercise helps to ease or to prevent the symptoms.
What dietary changes can help?
Some people with the irritable bowel syndrome (IBS) find that certain foods can trigger the symptoms or make symptoms worse. See separate leaflet called the Irritable Bowel Syndrome Diet
IBS Management Options
Each treatment option for the IBS has various benefits, risks and consequences. we’ve put together the summary decision aid that encourages the patients and the doctors to discuss and assess what’s available.
Antispasmodic medicines for the tummy (abdominal) pain
These are the medicines that relax the muscles in the wall of gut. There are several types of the antispasmodics. For example, the alverine citrate, mebeverine, hyoscine and the peppermint oil. The pain may ease with the medication but may not go away completely.
Treating constipation: Constipation is sometimes main symptom of the IBS. If so, it may help if you increase fibre in your diet. Sometimes the laxatives are advised for the short periods if increasing fibre is not enough to ease troublesome bout of the constipation. It is best to avoid the lactulose if you have IBS.
A medicine called the linaclotide works in a completely different way to the other medicines for treating constipation. It has been shown to the reduce pain, bloating and the constipation symptoms.
An antidiarrheal medicine (for example, loperamide) may be useful if the diarrhea is a main symptom. The dose of the loperamide needed to control the diarrhea varies considerably.
Eluxadoline -This is an option for the treatment of the irritable bowel syndrome with the diarrhea in adults, only if the condition has not responded to other medicines or they are contraindicated or not tolerated, and it is started by specialist. Eluxadoline should be stopped after four weeks if there is inadequate relief of the symptoms of the irritable bowel syndrome with diarrhea. The most common side-effects are the nausea, constipation and the abdominal pain.
Peppermint oil may help with the bloating and wind. For some people peppermint oil also helps with the tummy pains and the spasms.
A tricyclic antidepressant is sometimes used to treat the IBS. An example is amitriptyline. Tricyclic antidepressants are used in variety of the painful conditions, including IBS. SSRI antidepressant medicines for example, fluoxetine can also be used for the IBS. They may work by affecting the way you feel pain.
Alternative IBS treatments
Any stressful situation for example, the family problems, work stress, the examinations may trigger the symptoms of the irritable bowel syndrome (IBS) in some people. Examples of the psychological therapies are the cognitive behavioural therapy (CBT), the hypnotherapy and the psychotherapy. Psychological therapies can be very effective for some people with the IBS.
Irritable bowel syndrome (IBS) usually causes the symptoms long-term and often stays with you for rest of your life. However, symptoms tend to come and go. You may have the long spells without any of the symptoms, or may have only the mild symptoms. Treatment can often help to ease the symptoms when they flare up. IBS often improves with the time and, in some cases, the symptoms clear up for good at some stage. (source)
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