Irritable Bowel Syndrome

What is irritable bowel syndrome?

Irritable bowel syndrome (IBS) is a chronic disorder of the large intestine or colon. It is the most common gastrointestinal disorder. It affects twice as many women as men and usually begins in early adult life. Although IBS can cause much distress, it does not lead to life-threatening disease. It is also known as spastic colon. It is a condition of abnormally increased spontaneous movement of the small and large intestine, generally exacerbated by emotional stress.

How does it occur?

The cause of IBS is not fully understood. Most symptoms of IBS probably result from abnormal muscle movement or spasm of the lower part of the colon. Sometimes the spasm delays bowel movements. At other times it may lead to more rapid passage of stool, resulting in diarrhoea. In either case the spasm causes abdominal cramps.
A specific food item may trigger the attacks. Spasms may also be triggered by stress or depression.

What are the symptoms?

The most common symptoms include:

• Cramping and pain in the abdomen, which may be severe
  
• Constipation or diarrhoea
  
• A lot of gas
  
• Bloating
  
• A feeling of fullness in the rectum

How is it diagnosed?

There is no specific test for IBS. Depending on the clinical history and examination, the doctor may do the following tests to look for other possible causes of the symptoms:

• Stool test to check for blood and infection
  
• X-rays
  
• Colonoscopy or sigmoidoscopy procedures that allow the doctor to see the inside of the colon with a thin, flexible tube and tiny camera.
  
• Barium enema, a procedure in which a special liquid which is opaque to X-rays is passed into the colon through the rectum before x-rays are taken to check the colon lining.
  
• Blood tests

How is it treated?

There is no cure for IBS. However, controlling the diet and emotional stress usually relieves the symptoms. Some medicines may also help.

• Diet
  Increasing the fibre in the diet often helps, although sometimes a decrease in fibre is needed. Eating smaller meals more often helps.
  The doctor may ask for a food diary to be maintained to see if eating a particular food, for example, milk or cabbage worsens the symptoms.
  
  
• Stress
  The doctor will help identify things that cause stress and will suggest ways to help control them. Relaxation techniques may help manage stress.
  
  
• Medicines
  The doctor may prescribe a combination of bulk-forming agents (such as methylcellulose), antispasmodic drugs, and tranquilizers or antidepressants.
  As IBS is a chronic disorder, symptoms may flare-up throughout life. Although a cure has not been found yet, the disorder can usually be controlled. IBS will not progress to anything worse like cancer.

How can it be prevented?

Following these guidelines help relieve the symptoms of IBS:

• Learning stress-management techniques to reduce stress and anxiety. Professional counselling may be helpful.
  
  
• Drinking six to eight 8-ounce glasses of water a day.
  
  
• Avoiding alcohol, which can make symptoms of IBS worse.
  
  
• Selecting foods carefully. If a food appears to bring on symptoms, avoid it. Be sure that a food produces symptoms several times before you give it up. You should try to keep many different foods in your diet because a varied diet provides better nutrition.
  
  
• Ask your doctor if you should have a high-fibre diet, especially if you tend to be constipated. High-fibre foods may cause gas and bloating, but usually these symptoms lessen as the digestive tract gets used to the increased fibre.
  Some high-fibre foods include:
  
  
  • whole-grain breads and cereals
    
  • fruits, especially apricots, blackberries, coconut, peaches, pears, pineapple, and strawberries
    
  • nuts, especially almonds, pistachios, and walnuts
    
  • vegetables, particularly sprouts, corn, popcorn, beans
    
  • eat smaller meals more frequently. Eat smaller portions of foods at a meal.