Irritable Bowel Syndrome: What is it, Causes, Symptoms and Treatment
Irritable bowel syndrome is a chronic disorder characterized by changes in bowel movements and habits.
Irritable bowel syndrome is a chronic disorder characterized by changes in bowel movements and habits. This disease, which causes symptoms such as abdominal pain, diarrhea and constipation, usually lasts a lifetime.
What is Irritable Bowel Syndrome?
Irritable bowel syndrome affects the digestive system, especially the abdominal intestine. This disorder, also known as mucous colitis, spastic colon, and irritable bowel syndrome, follows a chronic course.
There are 4 different types of irritable bowel syndrome. These:
- IBS with constipation predominance
- IBS where diarrhea predominates
- Mixed type IBS where constipation and diarrhea co-predominate
- In patients who do not fit these three types, it can be listed as IBS.
As the names suggest, this classification is made by looking at which of the constipation or diarrhea symptoms that occur in the disease are seen more intensely.
What are the symptoms of Irritable Bowel Syndrome?
The number, severity and duration of symptoms seen in irritable bowel disease vary from person to person. In some people, symptoms increase during an exacerbation and decrease afterwards. In some people, symptoms occur continuously without interruption. Symptoms seen in IBS patients:
- Change in bowel movements and habits
- Abdominal pain, cramps
- It can be listed as bloating and gas pain.
Symptoms in women may be more severe during menstruation. It has been determined that IBS symptoms are milder in women who have gone through menopause than in those who have not. It has been observed that IBS symptoms increase in some female patients during pregnancy.
IBS symptoms in men are the same as in women. However, the rate of consulting a doctor and receiving treatment for IBS symptoms is lower in men.
What Causes Irritable Bowel Syndrome?
Although the cause of irritable bowel disease has not been fully elucidated, various factors are thought to play a role in the development of this disease. These factors:
- Muscle Contractions in the Intestine: There is a muscle layer in the intestinal wall that contracts and allows food to move through the digestive system. As the duration or intensity of contractions in this muscle layer increases, conditions such as gas, bloating and diarrhea occur in the person. Weakness in muscle contractions also causes digestive movements to slow down and problems such as constipation occur. These changes in muscle contraction may play a role in the development of IBS.
- Nervous System: Abnormalities in the nervous system within the digestive system cause the person to feel more discomfort than normal in situations such as gas or bloating. Irregularities in signal transmission between the intestine and the brain; It causes the body to overreact to events that occur naturally in the digestive system. While events such as gas formation and bowel movements cause a slight feeling of discomfort in healthy people, these events cause conditions such as pain, constipation and diarrhea in patients with signal transmission disorders.
- Infection: IBS may occur as a result of an infection in the intestine with a virus or bacteria (gastroenteritis). Bacteria normally found in the intestine can also play a role in the formation of IBS by increasing in numbers in some cases.
- Exposure to Stress in Early Life: The incidence of IBS increases in people who live under stress for various reasons in the first years of life, that is, in childhood. This suggests that stress experienced at an early age may cause IBS.
- Change in Intestinal Flora: Under normal conditions, more than 500 different types of bacteria live in the intestine. These bacteria, which are quite numerous, are in a mutually beneficial relationship with the human body and play critical roles in the health of the person. Changes that may occur in this group, called intestinal flora, are important for the development of IBS.
Some factors can trigger IBS symptoms. These factors:
- Foods: Food allergies, although rare, can increase IBS symptoms. Cereals, milk and dairy products, citrus fruits, legumes, cabbage and carbonated drinks may aggravate IBS symptoms.
- Stress: Stress can cause symptoms to be more severe or occur more frequently in IBS patients.
How Is Irritable Bowel Syndrome Diagnosed?
There is no single diagnostic test for irritable bowel syndrome. The doctor makes a diagnosis by evaluating the patient’s complaints, history and physical examination findings together. Since IBS symptoms are similar to those seen in many other intestinal diseases, diagnosis can be difficult. Other causes must be ruled out (excluded) when making a diagnosis.
After excluding possible diagnoses that may cause the patient’s symptoms, the Rome criteria can be used to diagnose IBS. In these criteria, for the diagnosis of IBS, there must be abdominal pain that continues for at least 3 months and occurs at least one day a week. In addition, for diagnosis, the patient; Two of the three items must be present: pain or discomfort with defecation, change in the frequency of defecation, or change in stool consistency.
Determining which type of IBS the patient has is also important for the treatment plan. Therefore, when questioning the patient’s history, it is necessary to determine whether diarrhea or constipation is dominant in the symptoms.
If the patient does not respond to initial treatment for IBS and the patient
- Symptoms begin to appear after age 50
- rectal bleeding
- Unexplained, unintentional weight loss
- Nausea, vomiting
- Abdominal pain at night
- If there are conditions such as diarrhea that wakes you up from sleep, further tests may be required to evaluate the patient.
Methods such as endoscopy, colonoscopy, abdominal CT, stool examination, lactose intolerance test can be applied as further examination in these patients.
What are the symptoms that occur with irritable bowel syndrome?
In addition to the intestinal symptoms seen in IBS patients;
- frequent urination
- Symptoms such as heartburn may occur.
How is Irritable Bowel Syndrome Treated?
The main purpose of irritable bowel syndrome is to alleviate the symptoms seen in the patient.
Some lifestyle changes help improve the person’s quality of life in patients with mild to severe IBS symptoms. These changes:
- Avoiding situations that trigger symptoms
- Consuming foods high in fiber
- drinking plenty of fluids
- exercising regularly
- It can be listed as developing methods to cope with stress.
It may also be beneficial for the person to consult a dietitian to regulate their eating habits.
To help relieve IBS symptoms, the doctor advises the patient;
- Laxatives to relieve constipation
- anti-diarrheal medications
- Anti-cholinergics to help regulate bowel movements
- Tricyclic antidepressants for pain relief or for depression in the patient, if any
- Painkillers containing pregabalin and gabapentin may be prescribed.
In recent years, as knowledge about IBS has increased, various drugs have emerged that are promising in healing the disease. However, these drugs are generally used in patients who are unresponsive to other IBS treatments. Alosetron, eluxadoline, rifaximin, lubiprostone can be given as examples of these drugs.
Irritable bowel syndrome is a lifelong health problem. In order to minimize the effects of this disease on life, nutritional habits must be regulated as well as medication. For this reason, it would be beneficial for people with suspected IBS to apply to a well-equipped center and plan their treatment in cooperation with a doctor and a dietitian.