Diseases

Irritable Bowel Syndrome

Usually, it is a disorder of the large intestine (colon), although other parts of the intestinal tract can be affected.

When IBS occurs, the colon does not contract normally. These abnormal contractions result in changing bowel patterns with constipation being most common but diarrhea and diarrhea alternating with constipation is also seen. A second major feature of IBS is abdominal discomfort or pain. This may move around the abdomen rather than remain localized in one area. Some patients see lot of mucous in the stool and become concerned.

Although the symptoms of IBS may be severe, the disorder itself is not a serious one. There is no actual disease present in the colon. Rather, it is a problem of abnormal function. It tends to run in families.

The most common factor associated with the symptoms of IBS is the interactions between the brain and the gut. The bowel has a rich supply of nerves that are in communication with the brain. Virtually everyone has had, at one time or another, some alteration in bowel function when under intense stress. People with IBS seem to have an overly sensitive bowel, so that the ordinary stresses and strains of living somehow result in colon malfunction.

The diagnosis of IBS often can be suspected just by a review of the patient's medical history. It is a diagnosis of exclusion; that is, other conditions of the bowel need to be ruled out before a firm diagnosis of IBS can be made. Other common conditions such as colitis, Crohn’s disease, diverticulosis, colon cancer and ulcer disease can be diagnosed with blood, urine and stool exams, x-rays of the intestinal tract and a lighted tube exam of the lower intestine. This exam is called endoscopy, sigmoidoscopy or colonoscopy.

Treatment

The treatment of IBS is directed to both the gut and the psyche. The diet requires review, with those foods that aggravate symptoms being avoided. There is good evidence to suggest that, where tolerated, a high roughage and bran diet is helpful. This diet can result in larger, softer stools which seem to reduce the pressures generated in the colon. Large amounts of beneficial fiber can be obtained by taking over-the-counter bulking agents such as psyllium mucilloid (Metamucil, Konsyl) or methylcellulose (Citrucel). Besides diet, eating small frequent meals, regular exercise, learning stress reduction, or at least how to control the body's response to stress, and use of antispasmodic medications are helpful in relieving symptoms of IBS.