IRRITABLE
BOWEL
This
is perhaps the most common disease affecting the GI tract.
It is estimated that 30 to 50 million people may suffer
from this problem at some time in their life. Approximately
20 to 40 percent of all visits to gastroenterologists are
due to IBS symptoms. IBS symptoms affects men and
women of all ages and of all races. IBS affects 14-24%
of women and 5-19% of men. The most common symptoms
of irritable bowel syndrome are:
- Chronic
abdominal pain and cramping
- Relief
of abdominal pain with defecation
- Looser
stools with the onset of pain
- More
frequent bowel movements at onset of pain
- Abdominal
bloating and/or distention
- Feelings
of incomplete evacuation after moving onešs bowels
- Passage
of mucus from the rectum.
Since
many other gastrointestinal diseases can present with similar
symptoms, a diagnosis of IBS should only be made in the
right clinical setting.
Many
people with IBS report that their symptoms began during
periods of major life stressors such as a death of a loved
one, divorce or school exams. Many patients also report
the onset of symptoms during or shortly after recovering
from a gastrointestinal infection or abdominal surgeries.
Symptoms of IBS have also been known to appear after eating
certain foods to which an individual might be sensitive.
The type of food which causes symptoms varies with the individual.
(e.g., there is no one universal food that is known to trigger
IBS.) Similarly, a flare of symptoms in a patient
with long-standing IBS may be triggered by all of the symptoms
listed above, or for no apparent reason.
The
cause of IBS is not known, though recent studies have shown
that approaching the problem from both a physiological and
psychological perspective works best in treating the problem.
Treatment therefore consists of lifestyle changes,
pharmacological treatment, and psychological treatment,
depending on how troublesome this disease effects the patient.
In
addition to lifestyle and psychological treatment (e.g.,
counseling, biofeedback, etc.), medication treatment can
be quite helpful. One of the first medications used
for IBS is usually fiber. As noted above, fiber is
the non-digested part of plant food and adds bulk to the
stools by absorbing water. Fiber increases the transit
time of the colon and decrease the pressures within the
colon. Despite its common use by the medical community,
the role of fiber in the treatment of IBS has not been well
established in clinical studies. One study showed
that the response to bran in terms of daily stool weight,
bowel frequency and symptoms was determined more by pre-existing
psychometric variables such as anxiety and depression that
the amount or nature of the bulking agent administered.
Fiber
can be added to the diet through the eating of more fiber-rich
foods (e.g., vegetables), or by taking fiber supplements
(common brands are Metamucil, Citrucel, and FiberCon).
Other
common medications prescribed by physicians to treat IBS
are anti-spasmodics that help slow the gut and prevent cramping
(e.g., Levsin and Bentyl), antacids/antigas medications
(e.g., Simethicone), and anti-diarrheal medications (e.g.,
loperimide (Immodium)). Be sure to consult your physician
before taking these medications to treat what you believe
to be IBS since you may have another problem whose symptoms
will be masked by using one of these drugs.
