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Irritable bowel syndrome

Irritable bowel syndrome (IBS) is a set of gastrointestinal symptoms such as abdominal pain, discomfort, cramping, and bloating occurring together due to the abnormal functioning of the gastrointestinal tract (usually the large intestine).

Anatomy

The gastrointestinal tract is made up of the mouth, oesophagus (food pipe), stomach, large and small intestines, and the anus. There are many axillary organs such as the gallbladder, pancreas, and liver, which aid in digestion and absorption as food passes from the mouth and wastes exit through the anus. The large intestine is the primary region for food absorption and is lined by a layer of muscle that rhythmically contract and relax to push food particles from the stomach across the intestinal tract.

Causes

The exact cause for IBS is unknown; however, in patients with IBS, the contraction of the intestinal muscles becomes stronger or overactive. There are other factors that may be responsible for triggering irritable bowel syndrome. Some of these factors include:

  • Food allergy: A wide range of foods such as spices, fats, beans, fruits, and cabbage, may lead to IBS.
  • Stress: Stress plays a major role in increasing the symptoms of IBS. You may notice a steep increase in the symptoms of IBS under stressful situations.  
  • Hormones: Changes in the hormonal levels in your body may also cause IBS. Women are highly prone to hormonal changes during menstruation and are more likely to experience symptoms of IBS at these times.
  • Other illnesses: Other illnesses such as diarrhoea, infectious diseases or overgrowth of bacteria in the intestine are also responsible for IBS.  
  • Brain-gut signalling: Problems in the nerve signals passing between your brain and intestine can cause IBS.

Impact

IBS is a chronic disease. While it can be mild and manageable for some, for others it can severely affect their quality of life and interfere with daily activities.


Symptoms

The symptoms of IBS include:

  • Changes in bowel movements
  • Abdominal pain and cramps
  • Bloating and gas
  • Diarrhoea
  • Constipation
  • Presence of whitish mucus in stools

Diagnosis

If your symptoms continue at least three times a month for 3 months, your doctor will review your medical history and perform a physical examination of your abdomen (checking abdominal bloating, tenderness, and pain) to diagnose IBS. To confirm IBS, your doctor usually rules out the possibility of other conditions with X-rays, CT scan, colonoscopy, and flexible sigmoidoscopy of the abdomen, stools test, and blood tests.

Untreated

When left untreated, severe constipation and diarrhoea can lead to haemorrhoids. IBS can lead to severe cases of GI tract conditions such as gastroesophageal reflux disease and indigestion. In some cases, you can also experience problems related to other parts of your body such as joint disorder, chronic pelvic pain, chronic fatigue syndrome, anxiety, and depression.

Treatment

IBS can be treated to relieve symptoms; however, this condition cannot be cured. Your doctor will be able to treat this condition with the help of:

  • Lifestyle changes: Bringing about changes to your lifestyle with regular exercises, reducing your stress levels, and getting sufficient sleep can help you to reduce the symptoms gradually.
  • Dietary changes: Having meals at regular timely intervals helps reduce IBS symptoms. It is also advisable to drink up to 8 cups of water or fluids per day to soften and ease the passage of stools. Your doctor will also advise you to increase your fibre intake if constipation is one of your main symptoms of IBS.
  • Medications: Your doctor may prescribe medications that relax the muscles of the gut, increase the secretion of fluid in the small intestine, encourage smooth passage of stools, and provide relief to abdominal pain, cramping, and constipation. Fibre supplements, antibiotics, and antidepressants may also be prescribed.

Others

Since the symptoms of IBS are usually triggered by stress, various therapies to reduce stress are recommended. These may include psychological treatment, hypnosis, and behavioural therapy.

Outcome

Although IBS cannot be cured, with effective treatment and regular monitoring of symptoms, the condition can be controlled and your quality of life will improve.

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