Irritable Bowel Syndrome (IBS) Symptoms Treatment

Irritable Bowel Syndrome (IBS)

Irritable Bowel Syndrome (IBs) is a gastrointes­tinal disorder without any structural pathology, characterized by pain in abdomen, and consti­pation and diarrhea.

• Irritable bowel syndrome (IBS) is a gastrointestinal syndrome characterized by chronic abdominal pain and altered bowel habits in the absence of any organic cause.
• May be characterized as diarrhea-predominant or constipation-predominant; or may alternate between diarrhea and constipation.
• Synonym(s): Spastic colon; Irritable colon
• A condition marked by abdominal pain (often relieved by the passage of stool or gas); disturbances of evacuation (constipation, diarrhea, or alternating episodes of both); bloating and abdominal distention; and the passage of mucus in stools.

Rome II Criteria for Diagnosis of IBS

• Patient should have 12 weeks of abdominal pain in the past 12 months.
• Pain is relieved by defecation (passing stools). Onset of disease (pain) is with decrease in stool frequency and form.
• May be characterized as diarrhea-predominant or constipation-predominant;
• or may alternate between diarrhea and constipation.
• Synonym(s): Spastic colon; Irritable colon

Clinical Features Symptoms OF IBS —

• · Occurs in’ young patients <45 years. May occur in middle aged and elderly.
• · More common,in women.
• · There is abdominal pain and constipation, diar­rhea, or both.
• · Diarrhea is usually painless.
• · Pain occurs in hypogastrium, right side, left side, or in the epigastrium.
• · It may be cramp-like or mild.
• Mucus in stools
• Constipation
• Bloating
• Diarrhea
• Abdominal distention
• May be characterized as diarrhea-predominant or constipation-predominant;
• or may alternate between diarrhea and constipation.
• Synonym(s): Spastic colon; Irritable colon
• · There is no malnutrition.
• · Pain occurs during waking hours.
• · Pain is increased by eating and emotional stress.
• · Pain is relieved by passage of stools.
• · Pain may be related with menstruation in women.
• · Constipation may be continuous and painful.

Other Symptoms of IBS —

• Feelings of incomplete evacuation
• Abnormal stool form
• Nausea, vomiting (rarely)
• · Stools are hard.
• · In patients with diarrhea, stool is small in quan­tity.
• There may be mucus in stools so it is also called mucus colitis.
• There is no bleeding or malabsorption.
• There is abdominal distension and flatulence due to gas.
• There is belching, heart burn, nausea, vomiting, dyspepsia.
• IBS exists with other functional disorders like non-cardiac chest pain.
• IBS has a strong relationship with stress and emotional upsets.

Risk Factors

• Other family members with similar GI disorder
• History of childhood sexual abuse
• Sexual or domestic abuse in women
• Depression
• Can occur after an infectious colitis

Imaging

• Abdominal CT scan or abdominal ultrasound to evaluate pain is generally normal.
• Small-bowel series or video capsule endoscopy to rule out Crohn disease of small intestine may be considered, and will also be normal.
• Sitzmarker study may be used to evaluate colon transit in patients with constipation.

Lab Findings

• Diarrhea-predominant: ESR, CBC, tissue transglutaminase, TSH, and stool for ova and parasites
• Constipation-predominant: CBC, TSH, electrolytes
• Abdominal pain: LFTs and amylase

IBS Treatment

• Reassurance
• Irritable Bowel Syndrome (IBS) TREATMENT
• Avoid coffee, legumes (peas), cabbage and any food which causes symptoms.
• High-fiber diet like bran is good for both consti­pation and diarrhea.
• Fiber is given as psyllium.
• Antispasmodics – anticholinergic drugs to relieve pain is given 30 minutes before meals.
• Belladonna alkaloids, dicyclomine, are used as antispasmodics.
• Antidiarrheal agents – codine, diphenoxylate. Antidepressants – paroxetine, citalopram, tricy­die antidrepressants like desipramine.
• Antiflatulents – Simethicone, antacids, activated charcoal.
• Avoid chewing gum? carbonated drinks, artificial sweeteners, cabbage, peas.
• Serotonin-receptor antagonists.

List of drugs used in IBS for various abdominal disorders —