Irritable Bowel Syndrome is also known as IBS is a functional gastrointestinal disorder. The signs and symptoms include abdominal pain and changes in the bowel movement. The cause of this condition has not been completely understood yet.
IBS is classified on the basis of;
- IBS-D >> Present with diarrhea
- IBS-C >> Present with constipation
- IBS-M >> Both constipation & diarrhea present
- IBS-U >> Neither present
- IBS-PI >> Acute onset & development after infections
SIGNS & SYMPTOMS
- Abdominal pain or discomfort
- Either diarrhea or constipation
- Change in bowel habit
- Urgency for bowel movements
- A feeling of incomplete evacuation (tenesmus)
- Chronic fatigue
- Depression and anxiety
- Reduction in libido
- Food intolerance.
The cause of IBS is still unknown, but researchers have believed that the following may be the causes:
- Gut–brain axis problems
- Gut motility disorders, pain sensitivity
- Infections including small intestinal bacterial overgrowth
- Genetic factors
- Food sensitivity
- Alcohol consumption
- Onset may be triggered by an intestinal infection
- Stressful life event
- Small intestinal bacterial overgrowth (SIBO)
- Vitamin D deficiency
- Prolonged muscle contractions of the intestines.
- Inflammation of the intestines.
RISK FACTORS OF IBS
- Gall bladder removal surgery
- Bladder pain syndrome
- People under the age of 50 are more prone to developing this condition.
- Higher rate in females
- Family history of diarrhea
- Mental health issues.
- Chronic IBS may lead to hemorrhoids
- Poor quality of life: Many people suffering from IBS miss work 3 times more often than those without bowel symptoms.
- Depression & mood disorders
- Blood in stool
- Iron deficient anemia
- Celiac disease
- Progression to IBD.
DIAGNOSIS OF IBS
- Rome criteria: These criteria include abdominal pain and discomfort 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 related to defecation
- Frequency of defecation is altered
- 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.
- Investigations performed for differential diagnosis
- Stool microscopy and culture (to exclude infectious conditions)
- Blood tests: Full blood examination, liver function tests, ESR, and serological testing for celiac disease.
- Abdominal ultrasound (for detection of gallstones and other biliary tract diseases)
- Endoscopy and biopsies
- Hydrogen breath testing (to exclude fructose and lactose malabsorption)
- Colon cancer
- Thyroid disorders
- Celiac disease
- Giardia infection
- Eating disorders.
Diet modification including avoiding:
- High gas foods
- Some people are sensitive to certain carbohydrates such as fructose, fructans, lactose and others, known as FODMAPs.
- Fiber supplements
- Anti-diarrhoeal drugs
- Anti-spasmodic drugs like dicyclomine
- H1 antihistamines
- Anti-depressant drugs
- Vitamin D supplements
- Stopping of PPI.
MANAGEMENT & PREVENTION OF IBS
- Regular exercise
- Eating high fiber foods
- Drinking plenty of fluids
- Stopping smoking & alcohol intake.