Irritable bowel syndrome

Irritable bowel syndrome (IBS) is a functional disorder of the intestinal tract that lasts for 3 months or more and is accompanied by abdominal pain with violations of the act of defecation or transit in the intestine. The muscles lining its walls are normally periodically contracted and relaxed during the passage of food, but during IBS this process is disrupted. As a result, there is discomfort with unpleasant sensations, which significantly impairs the quality of life of the patient.

The incidence of this disease is the same among children and adults. However, if in women this figure is about 70-80%, among men it is only 10-20% of the total number of cases. In general, according to research, IBS are found in 10-20% of the world's population. It is associated primarily with the close influence of the emotional state of man on the occurrence and nature of the disease, pointing to psychosomatics as one of the most common causes of exacerbation of its manifestations.

Symptoms

It should be noted that since one of the main requirements for diagnosis is the absence of organic lesions of the intestinal tract, most of the symptoms are collected from the subjective (but very real) complaints of the patient:

• Abdominal pain (convulsive, sharp, spastic, localized mainly in the lower and lateral abdomen and almost never occurs at night)
• Tenesmus (constant sharp pain radiating to the rectum)
• Flatulence (increased)
• Disorders of defecation.

There are also three main forms of the disease, according to the type of defecation disorders, which predominate:

• With diarrhea. Characteristic sharp urge, usually after eating, in the morning or before an important event (public speaking, travel, flight, unwanted conversation). Stools are not increased in volume, semi-liquid or liquid, with mucus impurities.
• With constipation. The feces is solid, collected in small, nut-like breasts. The act of defecation may be delayed and accompanied by pain, and then there is a feeling of incomplete defecation.
• Mixed. A form in which constipation may change to diarrhea or be absent altogether. It is also possible to have a predominantly painful syndrome with sensations of spasms, flatulence and bloating.

Etiology

Unfortunately, it is still impossible to determine the exact cause of this disease. However, there are a number of factors that can cause it alone or in combination with each other.

• Transferred infectious lesions of the intestine with subsequent disorders of the microflora.
• Violation of the synthesis and balance of biologically active substances that regulate the colon (histamine, bradykinin, serotonin).
• Deviations from the recommendations on the rules of healthy eating (eating unhealthy, fast food, irregular and eat cold food).
• Psycho-emotional disorders with manifestations of depressive or anxiety disorders.
• Genetic predisposition (in the presence of the same disease in first-line relatives (parents, children, brothers or sisters) the risk of its occurrence is much higher)

Diagnostic methods

The examination includes a direct examination by a doctor and a collection of medical history. At suspicion of IBS first of all diagnostics for an exception of other organic (or inflammatory) defeats of a digestive tract is carried out.

• According to the CDC (Centers for Disease Control and Prevention in the United States), additional screening methods can also be performed if a person is too severe to tolerate symptoms or does not respond to previously prescribed blood test to rule out the presence of an inflammatory process (platelets, erythrocytes, leukocyte formula, C-reactive protein);
• fecal analysis (coprogram and calprotectin (marker of intestinal inflammation);
• endoscopic examination (colonoscopy to check for additional formations or affected areas of the intestine with the possibility of taking material for histological examination);
• external methods of visualization (CT or MRI method for obtaining images of the digestive tract and other soft tissues from the outside.)

Treatment

Treatment of irritable bowel syndrome is aimed at reducing or eliminating the influence of one or another factor that causes it and can be both non-drug and through the use of certain groups of drugs.

Non-drug include:

• Modification of lifestyle with normalization of sleep and rest to reduce the impact of stressors.
• Consumption of sufficient clean liquids during the day to maintain and quickly restore water balance.
• Repeated feeding in small portions and giving preference to heat-treated products with restriction of dairy and careful use of fiber (increases flatulence).
• Exclusion of food that provokes increased symptoms of flatulence (fast food, fried or spicy foods, legumes, beans, cabbage, broccoli, caffeinated beverages, raisins, chocolate and carbonated beverages). During diarrhea, for example, the consumption of products containing lactose and fructose (pear, plum, grapes) is limited  and for constipation, it is recommended to add to the diet of cereals and bread made from wholemeal flour (or with the addition of bran).

Medication groups of drugs are used as prescribed by a doctor, depending on which symptom predominates:

• Antispasmodics to reduce spasms and peristalsis, which improves the passage of food through the intestines.
• Prokinetics to reduce flatulence.
• Laxatives in the presence of constipation.
• Antidiarrheals and astringents.
• Sedatives or antidepressants in the presence of a psychological problem (anxiety or depression)

Advice

The main and most important complication of irritable bowel syndrome is a violation of the quality of social life of the patient. Caused symptoms not only create physical discomfort, but also negatively affect a person's ability to actively travel, work and interact with others. Despite this, the world is still struggling to ensure that patient do not hide the presence of IBS for fear of shedding light on the problem. That is why it is very important to understand that its solution and restoration of a normal way of life directly depends on the earliest possible start of the necessary treatment.

So the main tips are:

• Pay attention in time and identify the problem that worries you.
• See a doctor to rule out other lesions and get advice.
• Adhere not only to drug therapy, but also to regulate stimuli in the form of stress and nutrition.

Literature

• https://www.cdc.gov/ibd/what-is-IBD.htm