Irritable Bowel Syndrome
Irritable bowel syndrome or IBS, not to be confused with
IBD or inflammatory bowel disease, which is a much more serious
condition, is a bowel disorder characterized primarily by
changed in bowel habits and abdominal pain which cannot often
be linked to other possible causes of such
Irritable bowel syndrome is responsible for anywhere up
to fifty percent of visits to gastrointestinal doctors, and
is a fairly common affliction. The most common indicators
of irritable bowel syndrome are altered bowel habits, pain
in the lower abdomen, and a bloated sensation, all of which
may be temporarily relieved by defecation.
Irritable bowel syndrome is not a life-threatening condition,
but more of an inconvenience. It is important to make this
distinction clear to the patient in order to stave off any
possible psychological side-effects. Treatment generally involves
lifestyle and dietary changes, and many different kinds of
medication are available to help relieve the symptoms of IBS.
Dietary changes are mainly undertaken with a view to lessening
pain and discomfort, often by attempting to prevent an overreaction
of the gastrocolic reflex which is often at the center of
irritable bowel syndrome. Foods which are high in fiber, as
well as fibrous dietary supplements, are highly recommended
to relieve strain on the gastrointestinal system.
Replacing dairy products with rice or soy alternatives can
often be helpful, as dairy products are generally difficult
to digest and can put extra strain on the bowel. Fruits and
vegetables are also good for both their soluble fiber, vitamin
and mineral content. Eating small portions more frequently,
rather than the traditional ‘three square meals’ a day can
also help to make life easier for the colon and thereby relieve
symptoms of irritable bowel syndrome.
Foods and drinks which are known to aggravate the condition
in many patients include oily and fatty foods, fried foods,
dairy foods, caffeinated beverages including tea, coffee and
sodas, alcohol, red meat, and any drinks that contain artificial
sweeteners, so particularly diet soda is bad news for IBS
sufferers.
Patients with irritable bowel syndrome should not have any
difficulty in digesting food, or getting the nutrients from
the food that they eat, but it is more a case of the process
of eating and digesting food putting strain on the digestive
system, and particularly the colon, and therefore aggravating
symptoms. This is often due to an increased visceral sensitivity
causing an overreactive gastrocolic response, which leads
directly to the traditional symptoms of IBS, including pain,
bloating, diarrhea and/or constipation.
Medicinal treatments for irritable bowel syndrome often
come in the form of either laxatives (in the case of constipation
and associated pain) or antidiarrheals (in the case of diarrhea
and associated pain and discomfort). Antidiarrheal medication
is usually in the form of opiates like loperamide (Imodium)
or diphenoxylate (Lomotil), or codeine preparations.
In the case of constipation causing pain and discomfort
to sufferers of irritable bowel syndrome who do not respond
to simple dietary fiber supplementation, the next course of
action is usually osmotic agents used as laxatives, such as
sorbitol or lactulose. These agents are less likely than more
potent stimulant laxatives to cause complications such as
cathartic colon.
Patients who experience cramping pain or diarrhea as a result
of their IBS may benefit from a course of antispasmodic drugs,
such as dicyclomine or hyoscyamine. These drugs can be combined
with barbiturates and tranquilizers for a further relieving
effect, such as in the case of Librax or Donnetal.
Serotonin is a hormone occurring naturally in the brain
which stimulates, amongst other things, the motility of the
gut. Therefore serotonin agonists may be useful in relieving
irritable bowel sufferers with constipation, while serotonin
antagonists can have the reverse effect, relieving symptoms
of diarrhea.
Serotonin agonists include tedaserod, which is used to relieve
constipation in both men and woman, and various selective
serotonin re-uptake inhibitors, known as SSRIs.
Serotonin antagonists include alosetron, whose use is restricted
due to possible side-effects in some patients, and cilansetron,
currently undergoing clinical trials.
Some antidepressants may help sufferers of irritable bowel
syndrome in terms of psychological and physiological benefit.
These include selective serotonin re-uptake inhibitors, SSRIs,
which ted to be more effective in IBS patients with constipation,
and tricyclic antidepressants, TCAs, which are theoretically
more effective to treat patients whose symptoms include diarrhea.
Rifaximin, an antibiotic recently used in treatment for
IBS, suggests that there may be a problem with excess bacterial
action in some IBS sufferers, which targeted antibiotics might
relieve.
Iberogast, a supplement containing a variety of different
herbal extracts, has been found to have a beneficial effect
in most patients and on most different kinds of irritable
bowl syndrome.
In cases of more serious inflammatory bowel disease, potent
opioids may be employed to relieve pain and discomfort, and
possibly relax the bowel. This is a last resort treatment
ideally, because of the risks associated with opioid use and
the possibility of addiction developing.
Cannabis, where it is available, is sometimes prescribed
to help sufferers of IBD in terms of pain relief and appetite
stimulation, as well as helping them to fall asleep.
Probiotics, such as those available over-the-counter and
in various popular foodstuffs, are generally agreed to have
a beneficial effect in patients who suffer from intestinal
disorders.
They work by supplementing the body’s natural defenses.
Saccharomyces boulardii, which is a probiotic yeast, has been
shown to have significant benefit for patients with histories
of IBS, particularly diarrhetic forms of the disease. The
yeast lessened the frequency and improved the consistency
of bowel movements for many patients.
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