Know About Irritable Bowel Syndrome

By Dr. Ghulam Nabi Yattoo (Consultant Gastroenterology)

What is Irritable Bowel Syndrome?

Irritable bowel syndrome (IBS) is a common condition that affects the digestive system. It causes symptoms like stomach cramps, bloating, diarrhea and constipation. These tend to come and go over time, and can last for days, weeks or months at a time. It’s usually a lifelong problem. It can be very frustrating to live with and can have a big impact on your everyday life. There’s no cure, but diet changes and medicines can often help control the symptoms. The exact cause is unknown – it’s been linked to things like food passing through your gut too quickly or too slowly, oversensitive nerves in your gut, stress and a family history of IBS.

The main symptoms of IBS are:

Stomach pain or cramps – usually worse after eating and better after doing a poo Bloating – your tummy may feel uncomfortably full and swollen Diarrhea – you may have watery poo and sometimes need to poo suddenly Constipation – you may strain when pooing and feel like you cannot empty your bowels fully.

There may be days when your symptoms are better and days when they’re worse (flare-ups). They may be triggered by food or drink.

Some symptoms may point to a more serious problem. Contact your provider as soon as possible if you have:

Bleeding, Fever, Weight loss &Severe pain

Other symptoms of IBS

IBS can also cause:

farting (flatulence) passing mucus from your bottom tiredness and a lack of energy feeling sick (nausea) backache Problems peeing, like needing to pee often, sudden urges to pee, and feeling like you cannot fully empty your bladder not always being able to control when you poo (bowel incontinence

What are the different types of IBS?

Researchers categorize IBS based on the type of bowel movement problems you have. The kind of IBS can affect your treatment. Certain medicines only work for certain types of IBS.

Often, people with IBS have normal bowel movements some days and abnormal ones on other days. The type of IBS you have depends on the abnormal bowel movements you experience:

IBS with constipation (IBS-C):Most of your poop is hard and lumpy. IBS with diarrhea (IBS-D):Most of your poop is loose and watery. IBS with mixed bowel habits (IBS-M):You have both hard and lumpy bowel movements and loose and watery movements on the same day.

What are other names for IBS?

You may hear these names for IBS:

Irritable bowel. Irritable colon. Spastic colon.

Nervous stomach, since symptoms often happen when you’re feeling emotional stress, tension and anxiety

How is IBS diagnosed?

If you’ve been having uncomfortable GI symptoms, see your healthcare provider. The first step in diagnosing IBS is a medical history and a physical exam. Your provider will ask you about your symptoms:

Do you have pain related to bowel movements? Do you notice a change in how often you have a bowel movement? Has there been a change in how your poop looks? How often do you have symptoms? When did your symptoms start? What medicines do you take? Have you been sick or had a stressful event in your life recently?

Depending on your symptoms, you may need other tests to confirm a diagnosis. Blood tests, stool samples and X-rays can help rule out other diseases that mimic IBS.

Will I need a colonoscopy?

Depending on your symptoms, medical history and other factors, your provider may recommend a flexible sigmoidoscopy or colonoscopy to examine your colon in more detail. These two outpatient procedures are similar. The difference is that a sigmoidoscopy examines just the lower half of the colon. A colonoscopy examines the entire colon.

A flexible sigmoidoscopy can help evaluate bowel disorders, rectal bleeding or polyps. Your provider will:

Insert a sigmoidoscope, a long, thin, flexible instrument, into the rectum. Advance the sigmoidoscope to the colon. View the lining of the rectum and lower part of the colon.

What is IBS treatment?

No specific therapy works for everyone, but most people with IBS can find a treatment that works for them. Your healthcare provider will personalize your IBS treatment plan for your needs. Typical treatment options include dietary and lifestyle changes. A dietitian can help you create a diet that fits your life.

Many people find that with these changes, symptoms improve:

Dietary changes:

Increase fiber in your diet — eat more fruits, vegetables, grains and nuts. Add supplemental fiber to your diet, such as Metamucil® or Citrucel®. Drink plenty of water — eight 8-ounce glasses per day. Avoid caffeine (from coffee, chocolate, teas and sodas). Limit cheese and milk. Lactose intolerance is more common in people with IBS. Make sure to get calcium from other sources, such as broccoli, spinach, salmon or supplements. Try the low FODMAP diet, an eating plan that can help improve symptoms.

Activity:

Exercise  Don’t smoke. Try relaxation techniques. Eat smaller meals more often. Record the foods you eat so you can figure out which foods trigger IBS flare-ups. Common triggers are red peppers, green onions, red wine, wheat and cow’s milk.

Medical therapy:

Your provider may prescribe antidepressant medications if you have depression and anxiety along with significant abdominal pain. Other medicines can help with diarrhea, constipation or abdominal pain. Probiotics may be an option for you. These “good bacteria” can help improve. Talk to your provider if your symptoms don’t improve. You may need more tests to see if an underlying condition is causing the symptoms.

Some drugs are used to treat all symptoms of IBS, while other drugs are focused on specific symptoms.

Drugs that are used include:

medications to control muscle spasms anti-constipation drugs tricyclic antidepressants to ease pain antibiotics If your main IBS symptom is constipation, there are two drugs recommended by the American College of Gastroenterology (ACG): linaclotide lubiprostone

What happens if medications don’t work?

In some cases, symptoms don’t respond to medical treatment. Your provider may refer you for mental health therapies. Some patients find relief through: Cognitive behavioral therapy (CBT). Hypnotherapy. Biofeedback.