What is Irritable Bowel Syndrome (IBS)?
Irritable bowel syndrome is one of the functional disorders of the bowel. It is one of the most common clinical entities nowadays. The estimated incidence of irritable bowel syndrome is about 15%. The name of this disorder is a misnomer as the bowel is not always irritable as the name implies; it can be spastic.
What are Irritable Bowel Syndrome (IBS) Facts?
- Irritable bowel syndrome is one of the functional disorders of the bowel
- Irritable bowel syndrome is one of the most common clinical entities nowadays
- The exact cause of irritable bowel syndrome is unknown
- Many symptoms may be associated with irritable bowel syndrome; the primary symptoms are diarrhea, constipation and abdominal pain
- Irritable bowel syndrome has very limited complications; mainly on the quality of the patient’s life
- There is no specific diagnostic test for irritable bowel syndrome; we use Rome III criteria to make the diagnosis of it
- The poor understanding of the underlying etiologies of irritable bowel syndrome make it very difficult for us to direct the treatment toward it thus we try to treat* the annoying symptoms thus improving* the quality of the patients’ life
- Till now, there is no proved relation between irritable bowel syndrome and small intestine bacterial overgrowth
What Causes Irritable Bowel Syndrome (IBS)?
The exact cause of irritable bowel syndrome is unknown. Multiple theories are available; following are the most relevant:
- Abnormalities in the sensory nerves of the intestine thus the defect is on the input of data
- Abnormalities in the processing of data via the sensory nerves of the intestine
- Abnormalities in the muscular stimulation of the intestine due to defect in the motor nerves
What are Symptoms of Irritable Bowel Syndrome (IBS)?
Many symptoms may be associated with irritable bowel syndrome; some of them are primary while others are secondary, following are the two most important primary symptoms:
- Chronic constipation followed by periods of diarrhea
- Frequent pain in the abdomen that is relieved by defecating
Other less important secondary symptoms are:
- Abdominal bloating
- Change in the stools’ form
- Presence of mucous in stools
- Distention in the abdomen
- Frequent passage of flatus
What are the Complications of Irritable Bowel Syndrome (IBS)?
Although irritable bowel syndrome is very common illness nowadays, it has very limited complications. Most of patients adopt a healthy lifestyle with eating healthy diet and doing regular exercises.
However, irritable bowel syndrome has a bad effect on the patient’s daily life; for example; patients with frequent diarrhea have a difficulty going to their jobs and performing their normal life activities.
How is Irritable Bowel Syndrome (IBS) Diagnosed?
There is no specific diagnostic test for irritable bowel syndrome thus in order to diagnose irritable bowel syndrome; there are special criteria for this; which is known as Rome III criteria, based on the international meeting of the gastroenterologists in Rome. Depending on the Rome III criteria, we can diagnose a patient with irritable bowel syndrome if his symptoms met the following points:
- The patient is complaining from discomfort in the abdomen; not necessarily pain, at least one time every week during the last two months
The patient must have two of the following symptoms; in addition to previous point:
- The abdominal discomfort is relived completely after passing stools
- There is a history of diarrhea or constipation; increase* or decrease* in the number of bowel motions
- There is a history of changes in the appearance of the stools
- The doctor must exclude any possible other anatomical causes before diagnosing irritable bowel syndrome
How is Irritable Bowel Syndrome (IBS) Treated?
Treatment of irritable bowel syndrome aimed at treating the symptoms of it. The doctor may prescribe some laxatives to treat* diarrhea or he may prescribe some medications to relieve constipation. To relieve the pain of the abdomen, the doctor may give the patient some pain killers. Some patients may need other medications; for example, anti-depressants, to treat* the possible underlying etiology of his disease.
The effects of dietary changes on irritable bowel syndrome patients are not documented yet. Adding more fibers to the diet may help in treating constipation rather than the whole syndrome. Some patients documented good outcome after adopting the healthy diet and doing exercises frequently so it is recommended for those patients to do so.
Is there a relationship between IBS and small intestinal bacterial overgrowth?
Many recent hypotheses said that irritable bowel syndrome is caused by an overgrowth of bacteria in the small intestine; till now there is no strong medical background to support or discard these hypotheses.
Add to that, there is no prove that using antibiotics in the course of irritable bowel syndrome treatment has any effect in the outcome of the treatment.
Using probiotics in treating irritable bowel syndrome is also questionable. In addition, there is a separate medical entity known as small intestine bacterial overgrowth; which may share some symptoms with irritable bowel syndrome but it is totally different disease.