IRRITABLE
BOWEL SYNDROME.
It's wintertime. A time for gentle snowfall. Taking brisk walks while
holding hands with the one we love. And for Irritable Bowel Syndrome (IBS). WHAT?
How
can we go from light fluffy snow to irritable bowels? That's because during the
winter season, not only do we change our exercise patterns, but we also change
our eating patterns. Washing down some Super Bowl pizza with a soft drink while
waiting on that fresh plate of Cajun deviled eggs really might just take its
toll. Not only on your waistline, but your bowel mechanics. Does this sound familiar:
pain, bloating and diarrhea? This may be due to a change in eating habits during
this time of the year, yet this may be a more chronic problem. Your health care
provider may diagnose you with IBS.
What is Irritable Bowel Syndrome? IBS is a disorder of the
colon that involves digestion and proper functioning of the bowels. Primarily,
there is abnormal
motility of the colon and this may occur on both ends of the spectrum including
either low or excessive movements.
It is important to note that IBS is not a disease and there are no structural
abnormalities that can be identified on a physical exam, radiographic testing
or laboratory testing. This is purely a functional digestive disorder that is
related to the motility of the intestines.
What are the symptoms? The symptoms of IBS are very
nonspecific and range from abdominal pain, cramping, spasms, bloating, gas, and
bouts of diarrhea followed
by bouts of constipation.
The main hallmark of the disorder is the sudden onset of diarrhea that may be
followed by constipation. Patients may eventually pass only mucous in their bowel
movements. The irritating factors may include large meals and stress. This leads
to pain and bloating. Certain foods, beverages and medications may be irritating
factors.
The syndrome and the symptoms can be quite bothersome and painful. It is important
to remember that there is no structural damage that is occurring during the presentation
of the symptoms. IBS does not make one more susceptible to cancer or any other
more serious diseases. Most importantly, bleeding and weight loss are not consistent
with IBS and those symptoms must be thoroughly investigated!
Who is affected? In the United States, one in five
Americans has IBS. This is the most common digestive disorder diagnosed by health
care providers. The incidence
is more prevalent in women. The age of onset is usually in the late teens to
early 20's.
What is the cause? Researchers and physicians have
not identified a specific cause of IBS and it appears that it is not related
to one specific factor. It
does appear that patients with IBS are much more sensitive to stress and different
foods.
It has been shown that those who suffer from IBS have no physical abnormality
of the colon. The motility is affected during temporary periods. It can occur
in waves of spasms and then, the movement of the intestines stop leading to constipation.
The lining of the intestines has been studied physically and microscopically,
and there is no change at the cellular level. The rapid movement of the colon
does not allow for proper absorption of food leading to diarrhea. Conversely,
the slowing of the colon leads to constipation.
How is it diagnosed? IBS is a diagnosis of exclusion
meaning that all other physical and psychological causes of the disorder must
be ruled out prior to defining
a condition as IBS.
A careful history and physical examination must be completed documenting gastrointestinal
history and habits. Appropriate laboratory studies will be completed and x-rays
may be necessary. Eventually, it may be determined that a flexible sigmoidoscopy
or colonoscopy will be necessary to look at the inside integrity of the intestines.
If all testing is negative, then the diagnosis of IBS will be made. Specific
criterions are used and they include abdominal pain for a total of 12 weeks each
year. This does not mean constant pain for this time period. The patient must
also experience relief of pain from a bowel movement, pain with varied frequency
of stools or a change in stool consistency.
What is the treatment? Several physical and psychological
treatments have been known to be successful. There are some antimotility medications
that may slow
the colon. Constipation may need to be treated as well. Recently, hypnotherapy
and other forms of psychotherapy have been shown to work.
It is essential that the proper diagnosis be made prior to instituting any therapy.
Your health care provider must rule out any serious disease prior to improving
the disorder and it important that you seek treatment if you are bothered by
these symptoms.
