By Dr Ananya Mandal, MD
Irritable bowel syndrome, commonly called IBS, is a chronic condition affecting the gastrointestinal system.
It is also called spastic colon or colitis, irritable colon or mucus colitis. It may be greatly distressing. At least one in five Americans has some symptoms of IBS and this makes the condition one of the commonest diagnosed disorders in the United States. (1, 2, 3, 4)
Symptoms of IBS
Common symptoms of the condition include abdominal pain, cramps, bloating, gas, flatulence, and diarrhoea alternating with constipation.
It affects women more than men and almost half individuals develop symptoms before the age of 35.
This may be severely disabling for patients who often miss work or social activities and vacations on accounts of these symptoms.
IBS however does not cause any lasting damage to the gut or raise the risk of bowel cancer.
IBS additionally unlike other serious gastrointestinal diseases like ulcerative colitis or Crohn’s disease does not cause inflammation in the inner walls of the gut. These two conditions are termed Inflammatory Bowel Disease. (1, 2, 3, 4)
Causes of IBS
The walls of the intestine are lined by layers over layers of mucous membranes, muscles and glands.
These muscles constrict and expand at regular intervals helping in digestion and propulsion of food through them. It is this contraction that eventually leads to expulsion of faeces as well.
Normally these movements are smooth and regular. The actual reasons behind irritable bowel syndrome are as yet unclear.
It is suggested that the bowel is connected to the brain via a network of nerves. Stress and other psychological triggers may sometimes bring on signals to the intestines making them squeeze more than needed.
Stress and anxiety also activate certain nerves and chemical releases in the gut. Thus the muscle contractility of the gut gets disturbed leading to characteristic symptoms of IBS.
If parts are stagnant and not moving or severely constricting for a while the faeces stagnate and become drier. This leads to constipation and bloating and cramping pains.
When movements of the gut are more than normal there may be diarrhoea and passage of mucus laden stools along with pain.
In addition since the nerves in IBS patients are more sensitive they may experience more pain than their healthy counterparts. A normal meal, passage of stools or even gas may trigger pain and cramps. (4)
Symptoms and progression of the disease may be controlled with relaxation techniques, healthy diet and regular exercise. Some people may need medications.
IBS is treated by a gasteroenterologist. Diagnosis is made based on reported symptoms and symptom diaries maintained by the patient.
Although investigations may be needed to exclude other gastrointestinal conditions, there are no specific tests to confirm the diagnosis of irritable bowel syndrome.
Although there are effective therapies, IBS patients often need long term care and follow up as they experience a waxing and waning course of the disease throughout life.
The problem increases when they face changes and upheavals in their lives. Best possible therapy thus lies in lifestyle and diet changes. There are several alternative therapies that have been tried with varying rates of success in IBS.
Edited by April Cashin-Garbutt, BA Hons (Cantab)