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Irritable bowel syndrome (IBS) is one of the most common diseases in the world. According to statistics, one in four people suffers from this condition. However, only one of three consults a doctor. The disease is also known as intestinal neurosis.
Description and causes of the disease
Irritable bowel syndrome stands apart from other diseases of the gastrointestinal tract. In patients with IBS, there is no damage to the intestinal mucosa by pathogens, as well as any pathology of the tissues of the intestinal tract of inorganic origin. And, nevertheless, the disease has symptoms, and sometimes numerous surveys cannot establish what really happens to the human body.
In most cases, stress is a direct cause of irritable bowel syndrome. This is confirmed that anxiety, depression and other neurotic disorders are observed in about 60% of IBS patients.
To understand why this happens, you need to understand the mechanism of the intestine. The main functions of the thick intestine are the absorption of water and minerals from food debris, the formation of fecal masses and their progression to the rectum. The last tasks are carried out due to the reduction of the muscular walls and the release of mucus.
Probably, it will seem surprising to you but the intestine does not always work by itself, in a completely autonomous mode. The intestine has its own nervous system, which is called enteral. It is part of the autonomic nervous system and does not directly depend on the central nervous system. However, the regulating departments of the brain are responsible for the production of substances that control the work of the autonomic nervous system, including the nervous system of the intestine. This connection is called the axis of the intestine-brain and is two-sided. Under stressful situations, malfunctions in the functioning of this mechanism occur. The brain gives the wrong signals to the intestines, and the latter, in turn, incorrectly informs the brain of the processes occurring in it. There is a violation of intestinal motility, the slightest discomfort in the intestines causes bouts of pain. This is due to another important circumstance in which the disease develops - an increased level of sensitivity to pain.
However, stress and low pain threshold are often not the only factors causing the disease. In most cases, there is a whole range of reasons.
Rick factors for irritable bowel syndrome:
- Irregular and unbalanced nutrition;
- Sedentary lifestyle, sedentary work;
- Genetic predisposition. It was found that the majority of patients suffering from IBS have close relatives who also had a similar disease;
- Violation of the hormonal background in women (for example, during pregnancy or during menstruation).
An important role in the development of irritable bowel syndrome is played by the nutritional factor.
There are certain categories of products that contribute to the emergence of IBS. Such products include:
- Carbonated drinks;
- Snacks and fast food products;
- Caffeinated drinks;
- Fatty food.
Also, IBS can be observed after the completion of treatment of some infectious diseases of the intestine. This type of irritable bowel syndrome is called postinfection.
Sometimes IBS can be caused by a excessive growth of microflora. However, useful microorganisms cannot cause problems with the intestine and there is no scientific evidence for their connection with IBS. However, the growth of pathogenic microorganisms can cause diseases that are contagious and require very different approaches and methods of treatment.
Irritable bowel syndrome is almost two times more common in women than in men. Perhaps this is due to the greater emotionality of the weaker sex, as well as the fact that women are more likely to undergo changes in the level of hormones. It is also possible that women are more likely to consult doctors. IBS is a disease of middle age since the greatest frequency of the disease falls on the age of 25-40 years. In elderly people (over 60), the disease is much less common.
Irritable bowel syndrome is not uncommon in children and adolescents, but there is no precise statistics on this aspect. Often, IBS in children is ignored, parents think it's an infectious intestinal disorder. Many experts believe that the cases of irritable bowel syndrome detected in adulthood are formed in childhood.
Symptoms of irritable bowel syndrome
Irritable bowel syndrome is characterized by such chronic symptoms as an increased gas formation (flatulence), bloating, constipation, diarrhea, pain and colic in the lower abdomen. Approximately every third disease accompanied by similar symptoms is IBS. An important feature is that unpleasant sensations in the abdominal area usually occur after meals and disappear after defecation.
Pain usually has a cramping character. However, a patient can also have pains of the aching or thrusting character.
Also, the symptoms include changes in the consistency of the stool, irresistible or false urges for defecation, a feeling of incomplete bowel movement after defecation.
There are three main types of irritable bowel syndrome:
- accompanied by diarrhea (approximately 2/3 of the total number of patients);
- accompanied by constipation (about 1/4);
- accompanied by constipation and diarrhea (less than 10%).
In some cases, stool changes are not observed, and all the symptoms of irritable bowel syndrome are reduced to an increase in flatulence and intestinal colic.
A diarrhea is a condition of having at least three loose or liquid bowel movements a day. As a rule, people suffering from this type of disease feel despondent in the morning. At night hours, diarrhea is usually absent. Also, diarrhea can occur due to stress or intense feelings. This syndrome is sometimes called "bear illness".
Constipation is a stool which occurs more often than once every three days. Constipation may also be accompanied by dyspepsia, nausea, dry mouth, colic.
If you find symptoms similar to those of IBS, it is recommended to undergo a screening. You should consult a gastroenterologist. Diagnosis of IBS is not an easy task. Usually, IBS is diagnosed if all attempts to find any infectious agents or intestinal pathologies in analyzes or research results fail.
It is also important to consider the incidence of symptoms and the length of the period during which they are observed. The following criteria are proposed by the world's leading gastroenterologists. It is generally believed that IBS includes stool disorders that occur at least 3 days per month. They should also be observed for 3 consecutive months. It is necessary to take into account the relationship between symptoms of IBS and the change in the frequency and appearance of the stool.
When diagnosing the disease, it is necessary to exclude the following ailments:
- infectious diseases of the digestive tract;
- helminthic invasions;
- ulcerative colitis;
- short bowel syndrome;
- intestinal tuberculosis;
- Crohn's disease.
Intestinal disorders resembling IBS may also be characteristic of some forms of diabetes mellitus, thyrotoxicosis, carcinoid syndrome. Disorders of the intestinal function in the elderly require a very careful examination since IBS is not typical for the elderly.
It's important not to mix IBS with single cases of a digestive tract disorder, which can occur in healthy people after heavy foods, large amounts of alcohol, carbonated drinks, unusual or exotic food, for example, during travel.
Fever, acute symptoms or their increase over time, night pain, spotting for several days, lack of appetite, weight loss are not IBS symptoms. Therefore, their presence indicates some other disease.
When diagnosing irritable bowel syndrome, you need to get some tests:
- General blood analysis;
- Blood chemistry;
- Stool analysis;
- A blood test for a reaction to gluten.
Colonoscopy, irrigoscopy, esophagogastroduodenoscopy, and ultrasound of the abdominal cavity are used to exclude pathologies of the colon. In some cases, a biopsy of the intestinal wall can also be used. With severe pain syndrome, the doctor can offer to undergo electrogastroenterography, manometry, balloon-dilatation test.
With a predilection for diarrhea, you need to get a test for lactose tolerance and analysis of the intestinal microflora. If you have no diarrhea, the method of radioisotope study of transit can be used. After passing the initial course of treatment, some diagnostic procedures can be repeated in order to establish the effectiveness of therapy.
Treatment of irritable bowel syndrome
Complete recovery from the disease is difficult due to the fact that it is caused not by one reason but by their complex. In addition, medicine has not yet established the exact mechanism of the disease development, therefore the treatment of irritable bowel syndrome generally does not exist. But this does not mean that it is completely unknown how to treat and prevent the disease. Practice shows that the irritated intestine can be cured in about a third of cases, and in others, the severity of symptoms may be reduced.
On the other hand, irritable bowel syndrome cannot be called a disease that threatens life and health. Irritation of the intestines causes patients a lot of trouble but usually does not lead directly to any complications, dysfunctions, and lesions of the gastrointestinal tract.
Many people who have been diagnosed with IBS are gradually getting used to their symptoms and are treated independently or adjust their lifestyle so that the disease does not interfere with it.
However, the disease should not be ignored, and symptomatic therapy of the disease is more than desirable. After all, such symptoms of IBS as frequent diarrhea and constipation are dangerous, as they create an increased burden on the rectum and can lead to such diseases as hemorrhoids, cracks in the anus and paraproctitis. This can be mainly caused by constipation. Diarrhea also contributes to the dehydration of the body. Also, we should not ignore the hidden causes of the disease - anxious and depressive conditions, which can lead to much more serious problems.
But the most important thing is that attacks of pain and stool disorders lead to a decrease in the quality of life. At sudden attacks of illness can cause problems with work obligations. This exacerbates the stressful state of a person, which creates a kind of vicious circle from which it is difficult to get out. IBS treatment is always conservative. It can include both medicamentous and non-medicinal methods.
The main non-drug method of IBS treatment is diet. A diet should not be strict. First of all, it should be aimed at systematizing and streamlining the process of nutrition and also improving the balance between different products. Food should be taken in small portions and you should avoid overeating.
The choice of a diet depends on a type of the disease. If you have diarrhea, you should limit fruits, vegetables, and fermented milk products. If you suffer from constipation, you should exclude fatty and salty foods and drink more water. People suffering from flatulence should limit carbonated drinks, beans. But do not give up some types of products completely, especially vegetables and fruits.
Sometimes doctors recommend adding more vegetable fibers to a diet. However, many scientists believe that following such instructions does not reduce the intensity of symptoms. Moreover, in the case of IBS with diarrhea, the increased fiber intake can only enhance them. Of course, you should not completely give up the fiber, as it plays an important role in the proper functioning of the intestine and prevents many diseases.
In general, a diet should be selected on an individual basis. A diet suitable for one patient does not always help the other. Therefore, you'd better note after what products the unpleasant sensations decrease and to exclude them from your diet. A consultation with a professional nutritionist will also be helpful.
IBS medication list
Drug treatment of irritable bowel syndrome is mostly symptomatic.
The main groups of drugs include:
- Antidiarrheal agents (for IBS with diarrhea);
- Laxatives (for IBS with constipation);
- Regulators of intestinal microflora (probiotics and prebiotics).
To eliminate the psychological causes of the disease, antidepressants and tranquilizers are used. However, not every type of depressant is suitable in the case of irritable bowel syndrome. Tricyclic antidepressants, such as Amitriptyline, showed the greatest effectiveness in the disease. Serotonin reuptake inhibitors can also be used, for example, fluoxetine. In some cases, benzodiazepines are recommended. But the choice of drugs can be done only by a qualified doctor. Independent selection of psychotropic drugs can worsen the condition of the intestines and aggravate neurological problems - depression or anxiety.
In some cases, sedatives based on plant components can be effective (valerian and motherwort). They have a minimum of side effects and therefore they can be used without fear.
If you need a remedy for diarrhea, you can use loperamide-dased drugs (Loperamide). The effect of these drugs are based on slowing the progress of food through the intestines. You can also use sorbents, such as Polisorb.
Remember that not every laxative will be able to treat constipation caused by this disease. You need to use laxatives that increase the volume of stool and the content of water in it. These drugs are usually produced from the extract of psyllium seeds or synthetic cellulose. They should not be taken before bedtime, as this can cause bloating. Laxatives based on senna and aloe are not recommended since they are able to increase the volume of gases and intensify abdominal pain.
To treat meteorism, you need to take defoamers - drugs that reduce the amount of gases in the intestine. Typically, they are based on simethicone and dimethicone. The most common defoamers are Maalox, Mylanta, and Gas-X.
Antispasmodics are most suitable for meteorism and frequent urges for defecation. To reduce spasms and associated pains, you can use a traditional universal spasmolytic Bentyl. This is a specialized antispasmodic used to treat spasms in the digestive system. The remedy relaxes muscle but it's contraindicated in pregnancy. Bentyl is an IBS medication which you can buy over the counter in many online stores, such as Pharmacy Mall. Visit their website for more details: canadianhealthcarepharmacymall.com.
To treat dysbacteriosis, you need to take probiotics (preparations containing organisms of the intestinal microflora) or prebiotics (preparations that improve the microorganism habitat). The best probiotics contain lactic acid bacteria Bifidobacterium infantis or fungi Sacchromyces boulardii (Linex and Enterol).
Herbal medicine has also many ways to treat intestinal disorders. You can use herbal preparations based on mint leaves, chamomile flowers, and valerian root. With diarrhea, you should pay attention to plantain, walnut, sage, and blueberries. Yarrow, licorice root, and buckthorn bark can treat constipation.
Physical exercises are one of the auxiliary methods of treatment. They improve the psycho-emotional state and stimulate the contractile capacity of the intestine. Type of exercise may be different and should be selected on an individual basis. Someone may do simple morning exercises or walk. Others may swim. Studies show that more than half of patients who started exercise every day felt a reduction in the symptoms very soon
Also, the patient needs to improve the daily routine, establish a normal sleep. Bed rest is contraindicated with this disease since it can only worsen the mental state of the patient. It is also necessary to find out which stressful situations can exacerbate the symptoms and, if possible, avoid them.
If the underlying cause of the disease is stress, you need to add psychotherapy to non-medicamental methods of treatment. This can include hypnosis, relaxation sessions, psychological training, and self-training.
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