Irritable Bowel Syndrome

What is Irritable Bowel Syndrome?

IBS means Irritable Bowel Syndrome. “Syndrome” is a word referring to a disease that is not very understood, especially in terms of what causes it and the way it makes a person sick. A much more well-known disease that uses this word is AIDS. Acquired Immunodeficiency Syndrome was a big mystery when it was first encountered by medical researchers during the 1980s.

IBS is a disease of mysterious origin with symptoms resulting from irritation of the bowels. Medical researchers know even more about AIDS than IBS, even though both were discovered within the same era of the last century.

This disease has been given many names like nervous colon, spastic colon, irritable colon, and mucous colitis. These names are not considered correct now since other parts of the bowels are affected, not just the colon. IBS has been studied and encountered by doctors for decades. But up to now, the knowledge of how it happens and its frequency is still incomplete. Estimates of how many patients are affected are not the same around the world. However, the seriousness of its bad effects on people is consistently known.

Symptoms of IBS

IBS produces sudden, drastic changes in the contraction of muscles in the walls of the intestine. Contractions can become too strong and long causing spasms and pain. A lot of gas can form within the bowels. Diarrhea can happen as well.

Contractions become too weak as well, and the movement of food or waste matter slows down. These get “stuck”, resulting in constipation. The toilet routine gets quite difficult if the stools become ‘hard’ and ‘dry’.

The following symptoms are closely associated with IBS:

• Abdominal pain or cramping which normally goes away if the patient is successful in the toilet.
• Bloating or having gas in the bowels.
• Constipation.
• Diarrhea.
• Mucus but no blood in the stool.
  

IBS can have contrasting  symptoms during the same episode. There could be alternating bouts of constipation, and diarrhea, and bloat. In IBS, the function, or movement, of the bowel is not quite right.

IBS has symptoms similar to other bowel illnesses, but inflammation is usually not included. Only rarely that it happens with it, and probably is not the cause of IBS. So this is one feature of IBS which could distinguish it.

Impact of IBS on a Patient’s Health and Daily Life

IBS is normally not life-threatening. But it is a chronic disease that can last for many years.  The patient’s lifestyle can suffer seriously if not treated or even diagnosed properly. 

IBS is quite common around the world. But in spite of numerous researches and case studies, it is still poorly understood. No specific cause of this illness can be identified. There are only conditions that could increase the chance of a person having IBS. A combination of symptoms happens that enables a doctor to diagnose IBS.

There are no medical tests to confirm a diagnosis. Yet IBS is among the most common bowel diseases affecting patients. This puzzle is one of the reasons why it is considered a “syndrome.”

• Food can contribute to a person having IBS, although the “how” is not clear to medical researchers. Certain foods are known to produce serious symptoms, more than other types of food. These include wheat bread,  milk dairy items, citrus fruits, beans, cabbage, soda drinks.
• People who are always stressed by work or personal problems have increased symptoms of IBS. Doctors and researchers do not think stress causes IBS, but it makes the illness worse.
• Women have greater chances of having this illness. So the balance of hormones, specifical estrogen, could be a reason. Patients who are given hormone therapy or had their menopause may have a greater chance of having IBS.

• There are more patients below the age of 50. Studies also seem to point out that the physical and mental state at the beginning can influence the impact of IBS on a person.

The impact of IBS on a patient is well documented, not just on the physical effects on daily living but also on the emotional and psychological state of patients. It brings about a financial burden because of the numerous visits to the clinic and lab tests needed before a diagnosis and treatment is made.

Diagnosis

IBS is a gastrointestinal disorder that affects the proper functioning of the bowels. It is commonly diagnosed by doctors but often confused with other diseases like colitis or Crohn’s. There is a clear difference, however. Inflammation or infection is usually absent in IBS.
Most people with IBS experience times when the signs and symptoms are worse. There are times when these improve or disappear completely.

IBS does produce findings or clues that can be seen under laboratory examination. Even tissue samples of the bowels taken and examined under a microscope, or if examined directly using a colonoscope with a camera produce negative signs. Everything looks quite normal. However, a person who is sick for more than six months, with symptoms that repeats at least three days per month during the last three months, should be suspected for IBS.

A positive diagnosis requires that doctors be skilled and experienced when recording the patient’s symptoms to identify IBS as the cause. This makes diagnosing IBS more of an ‘art’, instead of the science gained from laboratory tests.

Confirmation relies on observing certain symptoms that happen in combination – like a “package” of symptoms. The presence of all or nearly all of these will make the correct diagnosis of IBS more likely. There should be a careful review of the patient’s history of symptoms and the treatment already received. The patient and doctor require good communication with one another during the consultation. The patient can open up and give details to the doctor for clues leading to diagnosis. This means the doctor must have the skill and patience to recognize possible clues. A successful diagnosis is then possible.

The ‘Rome’ Criteria

To help doctors around the world, a standard guideline for observing symptoms for positive diagnosis was needed. Specialists pooled their experience and expertise. Research results from previous cases of IBS were collected to adopt a standard set of symptoms as criteria for diagnosing IBS.

The most useful and relevant guide for examining patients is called the Rome Criteria, adopted since 1988 in Rome, Italy. There have been changes to this guideline and the latest version is called Rome IV. Through the years, these criteria were regularly updated as more medical information became available.

The latest criteria present the following to guide doctors and other medical workers. The diagnosis of IBS focuses on the occurrence of pain in the abdomen. If it happens at least one day a week for the last three months, then the condition is a candidate for IBS.

The pain being felt must be associated with one or more of the following conditions:

1. The pain must come and go depending on the difficulty and success of defecating during toilet time.
2. The pain coincides or happens with a change in the frequency of bowel movement.
3. The pain coincides or happens with a change in the form (appearance) of the stool.
   

This implies that the skill and experience of the doctor plays a big part in the proper diagnosis. The patient may very well need to see a doctor who specializes in bowel diseases – such as a gastroenterologist. In the end, this could result in the patient needing to see two or even more doctors to have his condition diagnosed and treated with positive results.

Other factors can make a diagnosis of IBS more complicated:

• Symptoms can change over time. These changes can confuse even a medical specialist who is making the diagnosis.
  
• A few or more of the symptoms can appear to be similar to other illnesses. The appearance of diarrhea is also the same as that which happens in lactose (from milk) intolerance. The doctor can treat the condition as intolerance. If the condition does not improve, it adds to the confusion.
  
• Proper diagnosis might require that the physician or doctor be updated about the latest information on IBS.
  

Treating IBS – Conventional and Alternative Options

Even with the exhaustive efforts by doctors and medical researchers, there is no definite cure for IBS up to now. The standard treatment prescribed by doctors is to use pharmacy drugs to reduce the symptoms of the suffering patient. This is to give the patient comfort and make daily living more bearable. Even then, this approach is not very successful.

Because of this, IBS is one of the few diseases where doctors ironically are more open to using the non-conventional approach in treatment.

1.   Pain – There are two types of pharma drugs given by doctors to relieve pain. Each uses a different way to counteract pain:

• One tackles pain by lessening the intensity of muscle spasms in the bowels. However, the effectiveness is only modest at best. So this type is not used much by doctors. The most effective under this category is called hyoscine, considered best for symptom relief. But this drug unfortunately has a side effect that makes constipation worse.
• Because of this, doctors have turned to use natural peppermint oil instead as an external application through massage. Numerous studies have shown the effect of peppermint oil to counteract involuntary spasms by the cells of the muscle. It was found to significantly reduce symptoms during experimental trials on human patients.
  
• Antidepressants meanwhile act on the central nervous system (or simply the brain itself). It dulls the pain ‘receptors’ so pain is not felt as much. These types of drugs were found to more significantly relieving the symptoms of pain.  However, many doctors do not use antidepressants because of possible risks. These drugs are meant to affect the whole nervous system. For IBS, there are not many studies to standardize a safe dosage for patients while giving pain relief. These drugs need strict and careful supervision of the doctor. Patients are instructed to start with a low every day for about 4  to 6 weeks and then evaluated if effective before increasing the dosage.

2.  Diarrhea – The type of drugs used for diarrhea target the nerves which control the contractions of muscles in the bowel walls. When the muscles contract less, there is reduced movement of the walls which controls the flow of food and waste matter through the intestines. This should lessen diarrhea. The problem arises when these drugs are used too often and can make the flow of digestion more irregular. There will be an increased risk of constipation. The most commonly used drug of this type is Loperamide with the brand name Imodium.

3.  Constipation – Pharma drugs under this category are classified as laxatives. These prevent the absorption of water from the bowels in order to maintain the softness of the stool. However, doctors do not usually prescribe them since dehydration and an imbalance of electrolytes in the body could happen. These drugs of last resort and rarely use. Doctors prefer to administer natural products with a laxative effect like psyllium husk or food with high soluble fiber.

Psychological Approach and Physical Conditioning to help support the Patient.

There are not many options useful for IBS, and these only have limited success. Furthermore, the disease brings on much mental and emotional distress with it. Many doctors are beginning to realize it requires a more holistic approach. Psychiatrists and counselors can help patients to cope with it.

Doctors who specialize in IBS recommends that psychological and emotional support should begin even during the consultation itself. An experienced doctor can immediately recognize the IBS symptoms and explain the situation with calmness and encouragement. This will go a long way to reassure the patient. Allowing the patient to ask questions and express his concern will already bring about a positive impact. An appropriately conducted consultation can be therapeutic for a patient with irritable bowel syndrome.

For more information about healing the body from the effects of IBS, we have put all that we have researched into a booklet available for download. You can get your very own copy here.