Irritable Bowel Syndrome

General Illness Information


Medical Term:

IRRITABLE BOWEL SYNDROME

Common Name: SPASTIC COLON, MUCOUS COLITIS

Description: A disorder of the motility pattern of the bowels, characterized by abdominal pain, gaseousness, constipation or diarrhea, usually after meals or stress and in the absence of organic pathology. It is divided into 4  categories: 1.Alternating diarrhea with constipation; 2. Diarrhea predominant; 3. Constipation predominant; 4. Upper abdominal bloating and discomfort Irritable bowel syndrome affects women three times more often than males. It is not contagious, not cancerous, nor inherited. Predominant age group is late 20’s, it is rarely seen in teens. Affects about 15% of the population.

Causes:

Unknown. May be related to stress and emotional conflict that results in anxiety or depression. Situations that often precede an attack include: worry about everyday problems; marital tension; fear of loss of a beloved one or object; death of a loved one, financial difficulties.

Symptoms may also be triggered by eating, though no specific food has been identified as responsible.

Prevention: Reduce stress or try to modify your response to it. Pay attention to good diet habits. See diet.

Signs & Symptoms

  • The following symptoms usually begin in early adult life. Episodes may last for days, weeks, months;
  • Cramp-like pain in the middle or to one side of the lower abdomen. Pain is usually relieved with bowel movements;
  • Nausea;
  • Bloating and gas;
  • Headaches;
  • Rectal pain;
  • Mucus in stools;
  • Backache;
  • Occasional appetite loss that may lead to weight loss;
  • Diarrhea or constipation, usually alternating;
  • Fatigue;
  • Depression;
  • Anxiety;
  • Concentration difficulty;
  • Nausea, vomiting (rarely).

Risk Factors

  • Other members of the family with the same or similar gastrointestinal disorder;
  • History of childhood sexual abuse;
  • Sexual or domestic abuse in women;
  • Fatigue or overwork;
  • Poor physical fitness;
  • Excess alcohol consumption;
  • Smoking;
  • Improper diet.

Diagnosis & Treatment

Most people with irritable bowel syndrome appear to to be healthy and physical examination may not reveal much except for tenderness over the large intestine.

Diagnostic tests may include laboratory studies, including stool studies, to exclude other disorders such as lactose intolerance, ulcers, parasites, enzyme deficiency and ulcerative colitis; X-ray of the colon (barium enema); and sigmoidoscopy (examination of the sigmoid with a flexible viewing tube) – which may cause spasms and pain but the tests results are otherwise normal.

General Measures:

  • Warm heat to the abdomen (compresses, hot-water bottle, or heating pad) may help ease discomfort;
  • Reduce stress in your life. Try various techniques that can help you relax (meditation, self-hypnosis, or biofeedback). Keep a stress diary so you know who or what may bring on symptoms;
  • Medication may help, but it will not cure this disorder.

Medications:

  • Antispasmodics to relieve severe abdominal cramps may be prescribed;
  • Short-term use of tranquilizers to reduce anxiety.

Other possibilities include bulk-producing agents, constipating agents, anticholinergics, antiflatulents. Below is the list  of agents to be used depending on the symptoms:

  • Bulk producing agents – psyllium containing products (Metamucil) 1 tbsp 2 to 3 times per day;
  • Constipating agents (if diarrhea is significant) – loperamide (Imodium) 4 mg initial dose, then 2 mg after each unformed stool or Diphenoxylate-atropine (Lomotil) 2.5-5.0 mg (1-2 tablets) after each unformed stool;
  • Antispasmodics/anticholinergics – dicyclomine (Bentyl) 10-20 mg 2 to 4 times per day or lactase (Lactaid) 1-3 caplets with or before meals for lactose intolerance;
  • Anticholinergics/sedatives – chlordiazepoxide-clidinium (Librax) 1 or 2 before meals and at bedtime, phenobarbital-hyoscyamine-atropine-hyoscine (Donnatal) 1 or 2 tablets before meals and at bedtime; amitriptyline HCL (Elavil) 25-50 mg at bedtime;
  • Antiflatulents – simethicone (Mylicon) 2 or 4 tablets before meals and at night;
  • For milk intolerance – lactase capsules or tablets; 1-2 tablets prior to ingesting milk products.

Activity:

No restrictions. Good physical fitness improves bowel functions and helps reduce stress.

Diet:

  • Increase fiber in the diet to promote good bowel function. Add fiber to your diet slowly to give the body time to adjust;
  • Don’t eat foods or drinks that aggravate symptoms. Coffee or milk may be a major cause of symptoms in some people. Keep a food diary so you can find out which foods aggravate symptoms;
  • Avoid gas-producing and spicy foods;
  • Avoid large meals, but eat regularly;
  • Limit alcohol consumption.

Possible Complications:

Psychological fixation on bowel functions, leading to psychological disability.

Prognosis

The condition is usually recurrent throughout life. Symptoms decrease or may disappear for periods of time. It is not life-threatening and doesn’t progress to cancer or inflammatory bowel disease. Treatment usually controls the symptoms.

Other

Nothing Specified.

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