Definition & Clinical Appearance
Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder of unknown cause. Common symptoms include abdominal cramping or pain, bloating and gassiness, and altered bowel habits. Irritable bowel syndrome has been called spastic colon, functional bowel disease, and mucous colitis. However, IBS is not a true “colitis.” The term colitis refers to a separate condition known as inflammatory bowel disease (IBD). Irritable bowel syndrome is not contagious, inherited, or cancerous. However, IBS often disrupts daily living activities.
Signs and Symptoms
Irritable bowel syndrome affects each person differently. The hallmark of IBS is abdominal discomfort or pain.
The following symptoms are also common:
• Abdominal cramping and pain that are relieved after bowel movements.
• Alternating periods of diarrhea and constipation.
• Change in the stool frequency or consistency.
• Gassiness (flatulence).
• Passing mucus from the rectum.
• Bloating.
• Abdominal distension.
The following are not symptoms or characteristics of IBS:
• Blood in stools or urine.
• Vomiting (rare, though may occasionally accompany nausea).
• Pain or diarrhea that interrupts sleep.
• Fever.
• Weight loss.
Aetiology
The cause of irritable bowel syndrome is currently unknown. IBS is thought to result from an interplay of abnormal gastrointestinal (GI) tract movements, increased awareness of normal bodily functions, and a change in the nervous system communication between the brain and the GI tract. Abnormal movements of the colon, whether too fast or too slow, are seen in some, but not all, people who have IBS. Irritable bowel syndrome has also developed after episodes of gastroenteritis.
Contributing Factors
It has been suggested that IBS is caused by dietary allergies or food sensitivities, but this has never been proven. Symptoms of irritable bowel syndrome may worsen during periods of stress or menses, but these factors are unlikely to be the cause that leads to development of IBS.
Prophylaxis / Prevention
• Maintaining good physical fitness improves bowel function and helps reduce stress.
• Stopping smoking is important for overall good health.
• Avoiding coffee, gas-producing foods, and spicy foods may help.
• Reducing or eliminating alcohol consumption may help.
Prognosis
Because irritable bowel syndrome is a chronic (long-term) disease, symptoms usually return from time to time. This may be influenced by factors such as stress, diet, or other environmental causes. No known treatment cures IBS. Multiple factors may play a role in aggravating IBS, so it may be difficult to predict which may make IBS worse for a particular person. Establishing a good relationship with a doctor may help alleviate concerns over symptoms and allow rapid recognition of changing or worsening symptoms.
Medical Treatment
Most people with irritable bowel syndrome have problems only occasionally. A few may experience long-lasting problems and require prescription medications. A common treatment for IBS is the addition of fibre to the diet. This theoretically expands the inside of the digestive tract, reducing the chance it will spasm as it transmits and digests food. Fibre also promotes regular bowel movements, which helps reduce constipation. Fibre should be added gradually, because it may initially worsen bloating and gassiness. Stress may cause IBS “flares.” Doctors may offer specific advice on reducing stress. Regularly eating balanced meals and exercising may help reduce stress and problems associated with irritable bowel syndrome. Smoking may worsen symptoms of IBS, which gives smokers another good reason to quit. Since many patients with irritable bowel syndrome report food intolerances, a food diary may help identify foods that seem to make IBS worse.