Irritable bowel syndrome, a chronic functional disorder of the large intestine is associated with high intestinal motility and sensitivity to pain. It is characterized by diarrhea or constipation or diarrhea alternating with constipation. Other symptoms include abdominal pain or discomfort, bloating, and passage of mucus in the stool.
Though not classified as a disease, IBS causes severe physical and emotional distress. It however does not damage the large intestine (colon) unlike other inflammatory bowel diseases. IBS is more common among women and is also called functional bowel syndrome, irritable colon, spastic bowel or spastic colon.
The etiology of IBS remains unknown.
The problem is triggered by food, notably fats or other stress related factors. Symptoms like fatigue, fibromyalgia, sleep disturbances, chronic headaches etc are also common. Many people with IBS also suffer from depression and anxiety.
Some of the IBS patients have low serotonin level in the brain. With IBS affecting how the body absorbs nutrients, some people may not be getting all of the nutrients they need. IBS is a chronic condition with the intensity fluctuating over a period of time.
Inspite of patients appearing healthy, palpation of the abdomen may reveal tenderness, particularly in the left lower quadrant, at times associated with a palpable, tender sigmoid.
A digital rectal examination, including a test for occult blood should be carried out. In women, a pelvic examination helps rule out ovarian tumors and cysts or endometriosis, which are similar to IBS.
Doctors also use standardized symptom-based criteria for diagnosing IBS called the Rome criteria. Because IBS symptoms can be triggered by stress and emotional conflicts, doctors ask questions to help identify stress, anxiety, or mood disorders.
Can my doctor prescribe medicine for IBS?
If you are suffering from pain, your doctor may prescribe antispasmodic medicines to reduce cramping. Heating pads and hot baths can also be used. If suffering from diarrhea loperamide (brand name: Imodium) may be of help. For constipation a laxative may be prescribed. You may also be prescribed a tranquilizer or sedative, an antidepressant, or an antibiotic depending on the symptoms. Your doctor may also recommend a probiotic or a fiber supplement.
Cognitive-behavioral therapy, standard psychotherapy, and hypnotherapy may help some IBS patients.
Frequent, smaller meals rather than less frequent, larger meals helps patients suffering from IBS. Apart from slowing their pace while eating, people with bloating and increased gas (flatulence) should avoid beans, cabbage, and other foods that are difficult to digest.
Sorbitol, an artificial sweetener can be of use. Fructose, a sugar found in fruits, berries, and some plants, should be eaten only in small amounts. A low-fat diet helps some people, particularly those whose stomach empties too slowly or too quickly. People who have both IBS and lactase deficiency should consume dairy products in moderation.
What to Expect at Your Doctor’s Office
Your doctor will feel your abdomen to check for signs of pain. Other tests may include a rectal exam, pelvic exam (for women), sigmoidoscopy, stool sample testing, blood and urine tests, ultrasound, and x-rays to rule out other conditions.
Doctors may also check to see if you are lactose intolerant. Lactase is an enzyme the body needs to digest sugars found in dairy products. If a person lacks this enzyme, they may have problems digesting dairy products, causing symptoms similar to IBS.
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Adding more fiber and avoiding stimulants, such as caffeine, may help. Reducing anxiety by getting regular exercise and seeking counseling may also be helpful. Alternative and complementary therapies including herbs, supplements, and lifestyle changes may help relieve symptoms as well.