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IRRITABLE
BOWEL SYNDROME (IBS)
 WHAT
IS IBS?
Irritable bowel syndrome is the most common
functional gastrointestinal disorder. The symptoms come
from the colon and include abdominal pain and bloating,
as well as disturbances in defecation.
WHAT
CAUSES IBS?
We know that these conditions are not caused
by infection, inflammation, or blockage. In fact, evaluation
with X-rays, endoscopy, and blood testing usually fails
to show any abnormality.
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Disturbances of the normal activity and function of the
digestive tract
A disturbance in normal motility and peristalsis
causes symptoms like cramping abdominal pain, diarrhoea,
constipation, and relief of pain with the passage of loose
bowel movements.
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Increased sensitivity to what is happening in the gut
and abdomen
Many people with irritable bowel syndrome
have enhanced sensation and perception of bowel function.
They can feel things in their GI tract, chest, abdomen,
and rectum that people without irritable bowel syndrome
cannot. Sensitive GI tract can have a hyper-reaction
to things that activate or "trigger" pain
and symptoms.
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Problems related to the Brain-Gut Connection
The Mind-Body/Brain-Gut Connection is
the key to understanding these disorders and to the
healing process, and you will study it throughout the
book. There is a powerful "connection" between
the mind and the body/gut. Gut sensations reach the
brain through the circuitry of nerves in the wall of
the intestine, then to the spinal cord, and finally
the brain. Transmission is bi-directional: it is a two-way
street. The gut affects the brain, and the brain affects
the gut.
THE
BRAIN-GUT CONNECTION
Stress
Psychological stress or emotional responses
to life stress can influence GI function in anyone through
the Brain-Gut Connection and produce GI symptoms such
as pain and altered bowel function. But people with a
functional GI disorder such as irritable bowel syndrome
are more likely to experience
symptoms which are more severe and occur more frequently.
Psychological
Disorders
Studies now show that patients with irritable
bowel syndrome and other function GI disorders who see
doctors for the symptoms are more likely to have psychological
problems than are people with the symptoms who do not
consult with a doctor about them. This means that psychological
disorders such as anxiety, panic, depression, somatoform
disorders (unexplained bodily symptoms), a history of
abuse (mental, emotional, physical, or sexual), alcohol
or substance abuse, or an eating disorder can lead to
increased symptoms and illness and reduce the person's
ability to cope. Psychological problems are not the
cause of the functional disorders. Instead, such problems
increase the need to consult with doctors, which leads
to more testing, procedures, and sometimes unnecessary
surgery.
What
can I do to relieve my symptoms?
Each person's therapy is tailored
to their symptoms and may include one or more of the
following: lifestyle changes, pharmacological treatment,
and psychological treatment. Therefore, there really
is no "one" good general treatment for IBS.
Dietary
modifications required?
In some cases, certain foods can
aggravate IBS symptoms and should be avoided. In particular,
lactose in lactose deficient individuals, gas producing
vegetables such as beans and broccoli, fatty foods,
and alcohol. It should be noted however that while these
foods can exacerbate IBS symptoms, they are not the
sole cause of typical IBS symptoms. To determine which
foods trigger which symptoms, one often needs to start
with very basic bland diet and gradually add one new
food each day and record any symptoms associated with
that particular food.
HOW
WILL A DOCTOR TREAT IBS?
a) Anti-spasmodic drugs
b)
Antacids/anti-gas medications
Aid in the reduction of embarrassing flatulence and
the accompanying lower abdominal pain.
c)
Anti-diarrhoea medications
Aids in delaying small and large bowel transit. Some
studies have shown improvement in diarrhea, rectal urgency,
and abdominal pain in IBS.
d)
Prokinetic Agents
Treats the gastrointestinal symptoms by restoring
normal gastrointestinal motilidy.
e)
Antidepressants.
Are often used in patients with associated depression,
antidepressants appear to improve symptoms independent
of their antidepressive effects.
WHAT
ARE SOME OF THE PSYCHOLOGICAL TREATMENTS AVAILABLE?
Psychological treatment such as cognitive-behavioral
therapy, biofeedback therapy, relaxation therapy, and
hypnotherapy should be considered when symptoms are severe
and are associated with psychological distress.
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