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Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder, that is, a problem caused by changes in the functioning of the colon. 
People with a functional disorder have symptoms, but the organs of the digestive tract are not damaged.

IBS is not a disease, but it is a group of symptoms that occur together.

Irritable bowel syndrome has a major negative impact on health and quality of life, but only 30% of people with IBS symptoms go to the doctor.

Irritable bowel syndrome mainly affects women in the ratio of 2: 1.
There are several subtypes of IBS.
1. SII – d: predominant diarrhea
2. SII – c: predominant constipation ( constipation ).
3. SII – A or SII – m: in this group there are those who alternate between constipation and diarrhea
4. SII – PI: post infectious IBS

Irritable bowel syndrome particularly affects the colon (large intestine).
The main function of the colon is to absorb water and nutrients from the partially digested food.
Anything that is not absorbed, is pushed into the rectum through the colon and is expelled from the body in the form of feces.
The muscles of the colon to rid itself of the body’s residual products with relaxation and contractions push the undigested food through the intestine.
These muscles should also work in conjunction with other muscles of the body to push the waste out of the anus.
If the muscles of the colon do not function at the proper rate for digestion or if coordination with the muscles of the rectum or pelvis is  interrupted somehow, the contents of the colon do not move properly.
When this happens, the person may experience abdominal cramps , bloating, constipation and diarrhea may be a sign of irritable bowel syndrome.
Many teens have IBS, it is estimated that between 6% and 14% of all teens suffer from IBS symptoms and appear to involve more girls than boys.
The good news is that even though irritable bowel syndrome can be annoying, embarrassing and painful for some people, it is not a deadly disease.

 

Causes of Irritable Bowel Syndrome

The exact cause of IBS is unknown.
Experts believe that there are problems with the communication between the brain and the intestinal tract that cause this disease.
A complex combination of factors including psychological stress, hormones, the immune system and certain chemicals called neurotransmitters seem to interfere with signals from the brain to the gut.
Lack of communication causes abnormal muscle contractions or spasms that often cause pain and cramps. Spasms can accelerate the passage of stool (causing diarrhea) or may delay it, causing constipation or bloating and bloating.
People with IBS have a very sensitive bowel.
It is not known why the bowel reacts so strongly to the elements that cause this syndrome. People with IBS may start with symptoms caused by one or more factors, including:

  • Eating (even if no particular food was associated with IBS).
  • Stress. Stress can affect bowel movements and can also affect the way a person perceives the pain. ( Stress can also have the same effect in people who do not have IBS.)
  • Caught gas that causes bloating.
  • Hormonal changes, such as during the menstrual cycle .
  • Certain medications, such as antibiotics .
  • Genetics. IBS most likely affects people who have a family member who suffers from the disease.

 

How Does Stress Affect Irritable Bowel Syndrome?

Stress can trigger spasms (sudden and involuntary contractions of a muscle) of the colon in people with IBS.
The colon has many nerves that connect the brain. These nerves control normal bowel contractions.
In people with IBS, the colon can be overly sensitive to stressful situations.
The symptoms of IBS can also increase a person’s stress level.
Some options for stress management are:

  • Participate in stress reduction and relaxation therapies such as meditation,
  • Get advice and support,
  • Perform a regular exercise program such as walking or yoga,
  • Minimize stressful life situations as much as possible,
  • Sleep or enough.

 

What are the symptoms of irritable bowel syndrome?

The pain and discomfort they may feel in different parts of the abdomen. Generally, the pain comes and goes. The length of each pain attack can vary greatly. Generally, pain improves when stool or air passes.
Many people with IBS describe the pain as a spasm or colic.

The severity of pain can range from mild to severe, from person to person and varies according to the times or situations.
The swelling can develop over time.
It can pass more air and gas than usual.

Feces:

  • Some people only have bouts of diarrhea, while others only have periods of constipation.
  • Some patients have bouts of diarrhea alternating with periods of constipation.
  • Sometimes the stool becomes small and thin as wood pellets.
  • In some cases they may be watery.
  • Sometimes, along with the stool you will find mucus .

We may feel that the bowel does not empty after going to the bathroom.
Some people have urgency, this means they should run quickly to the bathroom.
In the morning the urge to defecate is frequent, meaning you have an urgent need to go to the bathroom right after waking up.
This usually happens during and after breakfast.

Sometimes other symptoms occur:

 

Some people have mild and occasional symptoms. Others have unpleasant symptoms for a long time. Many people relapse with exacerbation of symptoms from time to time.

Note: Blood in the stool is not a symptom of irritable bowel syndrome.

 

What are the complications of irritable bowel syndrome?

Complications of functional diseases of the gastrointestinal tract are relatively small. The symptoms are often caused by food, patients who alter their diet and reduce the amount of food they can lose weight.

Fortunately, weight loss is uncommon in functional diseases, so in this case you have to suspect the existence of a nonfunctional disease.
The symptoms that wake sleep patients are more likely to be caused by nonfunctional diseases.
Functional diseases often interfere with patients’ daily activities. For example, patients suffering from diarrhea in the morning can not leave the house until the diarrhea stops.
If diarrhea is constant, you can only go to places where there is a toilet.
Patients who develop pain after eating may skip lunch. Often, patients associate symptoms with specific foods, such as milk, fat, vegetables, etc.
Regardless of whether these associations are real, these patients must follow a strict diet.
Milk is the food that should be excluded more often but is generally useless and at risk of not taking an adequate amount of calcium.
Interference with daily activities can also create problems in interpersonal relationships, especially with your partner.
However, most patients with functional diseases tend to live with their symptoms and rarely visit the doctor for diagnosis and therapy.

 

Diagnosis

Irritable bowel syndrome can be diagnosed based on symptoms.
In most cases, only a few tests are needed.
The doctor comes to the diagnosis of irritable bowel syndrome when a person has the typical symptoms of the disease and after excluding other possible causes.
The tests to be done depend on several factors: age, severity of symptoms and how it responds to the initial treatment.
For example:
For a 20-year-old girl who has all the typical symptoms of IBS, routine blood tests may be the only test needed.
Irritable bowel syndrome is more common in young girls, so if the symptoms are typical of irritable bowel syndrome, there is no need for detailed tests.
For a 55-year-old man who has recently started to feel the symptoms, they go for more detailed tests. People over the age of 50 are less likely than young people to develop the symptoms of irritable bowel syndrome for the first time, it is likely that their symptoms are caused by another disease such as Crohn’s disease or ulcerative colitis .

If the patient is better after the initial treatment, there is no need for further exams.
Depedendo of the symptoms, the results of the exams and the response to the treatment, we can deepen the situation with other exams.

 

The exams are:

  • Clinical history and physical examination.
  • Blood tests for celiac disease that can be considered in case of diarrhea.
  • The complete blood count gives information about the type and number of red blood cells, white blood cells and platelets in the blood; the rate of sedimentation checks for the presence of inflammation in the body.
  • Stool analysis including fecal blood tests (fecal occult blood test), infections(stool culture) or parasites (egg and parasite test ).
  • Functional thyroid exams and instrumental exams, such as colonoscopy , are rarely performed.

Read about: Treatment of Irritable Bowel Syndrome

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