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What is Irritable Bowel Syndrome (IBS)?

Irritable bowel syndrome (IBS) is one of the most common ailments of the bowel (intestines) and affects an estimated 15% of persons in the US. The term, irritable bowel, is not a particularly good one since it implies that the bowel is responding irritably to normal stimuli, and this may or may not be the case. The several names for IBS, including spastic colon, spastic colitis, and mucous colitis, attest to the difficulty of getting a descriptive handle on the ailment. Moreover, each of the other names is itself as problematic as the term IBS.


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Most individuals are surprised to learn they are not alone with symptoms of IBS. In fact, irritable bowel syndrome (IBS) affects approximately 10-20% of the general population. It is the most common disease diagnosed by gastroenterologists (doctors who specialize in medical treatment of disorders of the stomach and intestines) and one of the most common disorders seen by primary care physicians.

Irritable bowel syndrome (IBS) is one of the most common ailments of the bowel (intestines) and affects an estimated 15% of persons in the US. The term, irritable bowel, is not a particularly good one since it implies that the bowel is responding irritably to normal stimuli, and this may or may not be the case. The several names for IBS, including spastic colon, spastic colitis, and mucous colitis, attest to the difficulty of getting a descriptive handle on the ailment. Moreover, each of the other names is itself as problematic as the term IBS.

Treatment options are available to manage Irritable Bowel Syndrome - whether symptoms are mild, moderate, or severe. These treatments for IBS can include dietary adjustments, medication and psychological interventions, and as for any physiological condition, works best when it successfully addresses the cause of the condition.

The distinction between functional disease and non-functional disease may, in fact, be blurry. Thus, even functional diseases probably have associated biochemical or molecular abnormalities that ultimately will be able to be measured. For example, functional diseases of the stomach and intestines may be shown ultimately to be caused by reduced levels of normal chemicals within the gastrointestinal organs, the spinal cord, or the brain. Should a disease that is demonstrated to be due to a reduced chemical still be considered a functional disease? I think not. In this theoretical situation, we can't see the abnormality with the naked eye or the microscope, but we can measure it. If we can measure an associated or causative abnormality, the disease probably should no longer be considered functional.

There has been a great deal of controversy over the role that poor digestion and/or absorption of dietary sugars may play in aggravating the symptoms of IBS. Poor digestion of lactose, the sugar in milk, is very common as is poor absorption of fructose, a sweetener found in many processed foods. Poor digestion or absorption of these sugars could aggravate the symptoms of IBS since unabsorbed sugars often cause increased formation of gas.

Most individuals are surprised to learn they are not alone with symptoms of IBS. In fact, irritable bowel syndrome (IBS) affects approximately 10-20% of the general population. It is the most common disease diagnosed by gastroenterologists (doctors who specialize in medical treatment of disorders of the stomach and intestines) and one of the most common disorders seen by primary care physicians.

Irritable bowel syndrome is understood as a multi-faceted disorder. In people with IBS, symptoms result from what appears to be a disturbance in the interaction between the gut or intestines, the brain, and the autonomic nervous system that alters regulation of bowel motility (motor function) or sensory function.

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Because there are many causes of diarrhea and IBS-like symptoms, the American Gastroenterological Association has published a set of guidelines for tests to be performed to diagnose other conditions which may have symptoms similar to IBS. Once other causes have been excluded, the diagnosis of Irritable Bowel Syndrome is performed using a diagnostic algorithm. The algorithm may include additional tests to guard against mis-diagnosis of other diseases like IBS. However, researchers have noted that red flag conditions may not always contribute to accuracy in diagnosis ??? for instance, as many as 31% of IBS patients have blood in their stool. Published research has demonstrated that some poor patient outcomes are due to treatable causes of diarrhea being mis-diagnosed as IBS. As mentioned earlier Coeliac disease in particular is often misdiagnosed as IBS.

Occasionally, diseases that are thought to be functional are ultimately found to be associated with abnormalities that can be seen. Then, the disease moves out of the functional category. An example of this would be Helicobacter pylori infection of the stomach. Many patients with mild upper intestinal symptoms who were thought to have abnormal function of the stomach or intestines have been found to have an infection of the stomach with Helicobacter pylori. This infection can be diagnosed by seeing the bacterium and the inflammation (gastritis) it causes under the microscope. When the patients are treated with antibiotics, the Helicobacter, gastritis, and symptoms disappear. Thus, recognition of Helicobacter pylori infection removed some patients' diseases from the functional category.

High rates of success in resolving IBS symptoms have been reported when treatment is specifically tailored to the underlying causes revealed through proper testing for the range of known causes of IBS symptoms. The multi-herbal extract Iberogast was found to be significantly superior to placebo via both an abdominal pain scale and an IBS symptom score after four weeks of treatment. Gut-directed or gut-specific hypnotherapy or self-hypnosis is one of the most promising areas of IBS treatment, also Traditional Chinese Medicine approaches IBS on an individual symptom-by-symptom basis, rather than recognizing a standard "IBS" diagnosis, which then warrants a blanket "IBS" treatment.

Treatment options are available to manage IBS???whether symptoms are mild, moderate, or severe.

For more information visit: Irritable Bowel Syndrome Treatment

While IBS is a major functional disease, it is important to mention a second major functional disease referred to as dyspepsia, or functional dyspepsia. The symptoms of dyspepsia are thought to originate from the upper gastrointestinal tract; the esophagus, stomach, and the first part of the small intestine. The symptoms include upper abdominal discomfort, bloating (the subjective sense of abdominal fullness without objective distension), or objective distension (swelling, or enlargement). The symptoms may or may not be related to meals. There may be nausea with or without vomiting and early satiety (a sense of fullness after eating only a small amount of food).

Other researchers argue that the cause of functional diseases is abnormalities in the function of the motor nerves. For example, abnormal commands through the motor nerves might produce a painful spasm (contraction) of the muscles. Still others argue that abnormally functioning processing centers are responsible for functional diseases because they misinterpret normal sensations or send abnormal commands to the organ. In fact, some functional diseases may be due to sensory dysfunction, motor dysfunction, or both sensory and motor dysfunction. Still others may be due to abnormalities within the processing centers One area that is receiving a great deal of scientific attention is the potential role of gas produced by intestinal bacteria in patients with IBS. Studies have demonstrated that patients with IBS produce larger amounts of gas than individuals without IBS, and the gas may be retained longer in the small intestine. Among patients with IBS, abdominal size increases over the day, reaching a maximum in the evening and returning to baseline by the following morning. In individuals without IBS, there is no increase in abdominal size during the day.

Some gastrointestinal diseases can be seen and diagnosed with the naked eye, such as ulcers of the stomach. Thus, ulcers can be seen at surgery, on x-rays, and at endoscopies. Other diseases cannot be seen with the naked eye but can be seen and diagnosed with the microscope. For example, celiac disease and collagenous colitis are diagnosed by microscopic examination of biopsies of the small bowel and colon, respectively. In contrast, gastrointestinal functional diseases cannot be seen with the naked eye or with the microscope. In some instances, the abnormal function can be demonstrated by tests, for example, gastric emptying studies or antro-duodenal motility studies. However, these tests often are complex, are not widely available, and do not reliably detect the functional abnormalities. Accordingly, by default, functional gastrointestinal diseases are those involving the abnormal function of gastrointestinal organs in which abnormalities cannot be seen in the organs with either the naked eye or the microscope.

Irritable bowel syndrome is believed to be due to the abnormal function (dysfunction) of the muscles of the organs of the gastrointestinal tract or the nerves controlling the organs. The nervous control of the gastrointestinal tract, however, is complex. A system of nerves runs the entire length of the gastrointestinal tract from the esophagus to the anus in the muscular walls of the organs. These nerves communicate with other nerves that travel to and from the spinal cord. Nerves within the spinal cord, in turn, travel to and from the brain. (The gastrointestinal tract is exceeded in the numbers of nerves it contains only by the spinal cord and brain.) Thus, the abnormal function of the nervous system in IBS may occur in a gastrointestinal muscular organ, the spinal cord, or the brain.

Treatment options are available to manage IBS???whether symptoms are mild, moderate, or severe.

For more information visit: Irritable Bowel Syndrome Treatment

As IBS is a chronic condition, with an ongoing fluctuating course, these treatments may help the individual to develop skills for managing the condition over the long haul. Irritable Bowel Syndrome does not lead to more serious conditions in most patients. Most individuals are surprised to learn they are not alone with the symptoms of Irritable Bowel Syndrome.

Although these abnormalities in production and transport of gas could give rise to some of the symptoms of IBS, much more work will need to be done before the role of intestinal gas in IBS is clear.

 
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As already mentioned, abnormal function of the nerves of the gastrointestinal organs, at least theoretically, might occur in the organ, spinal cord, or brain. Moreover, the abnormalities might occur in the sensory nerves, the motor nerves, or at processing centers in the intestine, spinal cord, or brain. Some researchers argue that the cause of functional diseases is abnormalities in the function of the sensory nerves. For example, normal activities, such as stretching of the small intestine by food, may give rise to abnormal sensory signals that are sent to the spinal cord and brain, where they are perceived as pain.

Irritable bowel syndrome is characterized by a group of symptoms in which abdominal pain or discomfort is associated with a change in bowel pattern, such as loose or more frequent bowel movements, diarrhea, and/or constipation.

The distinction between functional disease and non-functional disease may, in fact, be blurry. Thus, even functional diseases probably have associated biochemical or molecular abnormalities that ultimately will be able to be measured. For example, functional diseases of the stomach and intestines may be shown ultimately to be caused by reduced levels of normal chemicals within the gastrointestinal organs, the spinal cord, or the brain. Should a disease that is demonstrated to be due to a reduced chemical still be considered a functional disease? I think not. In this theoretical situation, we can't see the abnormality with the naked eye or the microscope, but we can measure it. If we can measure an associated or causative abnormality, the disease probably should no longer be considered functional.

Irritable bowel syndrome is characterized by a group of symptoms in which abdominal pain or discomfort is associated with a change in bowel pattern, such as loose or more frequent bowel movements, diarrhea, and/or constipation.

Dietary fat in healthy individuals causes food as well as gas to move more slowly through the stomach and small intestine. Some patients with IBS may even respond to dietary fat in an exaggerated fashion with greater slowing. Thus, dietary fat could and probably does aggravate the symptoms of IBS.

Sometimes irritable bowel syndrome is referred to as spastic colon, mucous colitis, spastic colitis, nervous stomach, or irritable colon. Irritable bowel syndrome, or IBS, is generally classified as a "functional" disorder. A functional disorder refers to a disorder or disease where the primary abnormality is an altered physiological function (the way the body works), rather than an identifiable structural or biochemical cause. It characterizes a disorder that generally can not be diagnosed in a traditional way; that is, as an inflammatory, infectious, or structural abnormality that can be seen by commonly used examination, x-ray, or blood test.

IBS is best described as a functional disease. The concept of functional disease is particularly useful when discussing diseases of the gastrointestinal tract. The concept applies to the muscular organs of the gastrointestinal tract; the esophagus, stomach, small intestine, gallbladder, and colon. What is meant by the term, functional, is that both the muscles of the organs or the nerves that control the organs are not working normally, and, as a result, the organs do not function normally. The nerves that control the organs include not only the nerves that lie within the muscles of the organs but also the nerves of the spinal cord and brain.

Evidence that food allergies (other than celiac disease) and other immune system challenges can cause IBS symptoms are reported in various published research. People with IBS more commonly than others have gastroesophageal reflux, symptoms relating to the genitourinary system, psychological symptoms, fibromyalgia, headache and backache. In some individuals, IBS may have an acute onset and develop after an infectious illness characterised by two or more of the following: fever, vomiting, diarrhea, or positive stool culture. Diagnosis of Irritable Bowel Syndrome involves excluding conditions which produce IBS-like symptoms, and then following a procedure to categorize the patient's symptoms.

Sometimes irritable bowel syndrome is referred to as spastic colon, mucous colitis, spastic colitis, nervous stomach, or irritable colon. Irritable bowel syndrome, or IBS, is generally classified as a "functional" disorder. A functional disorder refers to a disorder or disease where the primary abnormality is an altered physiological function (the way the body works), rather than an identifiable structural or biochemical cause. It characterizes a disorder that generally can not be diagnosed in a traditional way; that is, as an inflammatory, infectious, or structural abnormality that can be seen by commonly used examination, x-ray, or blood test.

Despite the shortcomings of the term, functional, the concept of a functional abnormality is useful for approaching many of the symptoms originating from the muscular organs of the gastrointestinal tract. This concept applies particularly to those symptoms for which there are no associated abnormalities that can be seen with the naked eye or the microscope.

Irritable Bowel syndrome is the most common disease diagnosed by gastroenterologists (doctors who specialize in medical treatment of disorders of the stomach and intestines) and one of the most common disorders seen by primary care physicians. In gastroenterology, irritable bowel syndrome (IBS) is a functional bowel disorder characterized by abdominal pain, discomfort or bloating relieved by defecation and alteration of bowel habits. Irritable Bowel Syndrome may begin after an infection (post-infectious, IBS-PI) or a stressful life event. IBS can be classified as either diarrhea-predominant (IBS-D), constipation-predominant (IBS-C) or IBS with alternating stool pattern (IBS-A or pain-predominant[6]). Other functional or pain disorders and certain psychological conditions are more common in those with IBS. In fact, irritable bowel syndrome (IBS) affects approximately 10-20%??of the general population.

While IBS is a major functional disease, it is important to mention a second major functional disease referred to as dyspepsia, or functional dyspepsia. The symptoms of dyspepsia are thought to originate from the upper gastrointestinal tract; the esophagus, stomach, and the first part of the small intestine. The symptoms include upper abdominal discomfort, bloating (the subjective sense of abdominal fullness without objective distension), or objective distension (swelling, or enlargement). The symptoms may or may not be related to meals. There may be nausea with or without vomiting and early satiety (a sense of fullness after eating only a small amount of food).

Occasionally, diseases that are thought to be functional are ultimately found to be associated with abnormalities that can be seen. Then, the disease moves out of the functional category. An example of this would be Helicobacter pylori infection of the stomach. Many patients with mild upper intestinal symptoms who were thought to have abnormal function of the stomach or intestines have been found to have an infection of the stomach with Helicobacter pylori. This infection can be diagnosed by seeing the bacterium and the inflammation (gastritis) it causes under the microscope. When the patients are treated with antibiotics, the Helicobacter, gastritis, and symptoms disappear. Thus, recognition of Helicobacter pylori infection removed some patients' diseases from the functional category.

Some gastrointestinal diseases can be seen and diagnosed with the naked eye, such as ulcers of the stomach. Thus, ulcers can be seen at surgery, on x-rays, and at endoscopies. Other diseases cannot be seen with the naked eye but can be seen and diagnosed with the microscope. For example, celiac disease and collagenous colitis are diagnosed by microscopic examination of biopsies of the small bowel and colon, respectively. In contrast, gastrointestinal functional diseases cannot be seen with the naked eye or with the microscope. In some instances, the abnormal function can be demonstrated by tests, for example, gastric emptying studies or antro-duodenal motility studies. However, these tests often are complex, are not widely available, and do not reliably detect the functional abnormalities. Accordingly, by default, functional gastrointestinal diseases are those involving the abnormal function of gastrointestinal organs in which abnormalities cannot be seen in the organs with either the naked eye or the microscope.

IBS is best described as a functional disease. The concept of functional disease is particularly useful when discussing diseases of the gastrointestinal tract. The concept applies to the muscular organs of the gastrointestinal tract; the esophagus, stomach, small intestine, gallbladder, and colon. What is meant by the term, functional, is that both the muscles of the organs or the nerves that control the organs are not working normally, and, as a result, the organs do not function normally. The nerves that control the organs include not only the nerves that lie within the muscles of the organs but also the nerves of the spinal cord and brain.

In people with Irritable Bowel Syndrome, symptoms result from what appears to be a disturbance in the interaction between the gut or intestines, the brain, and the autonomic nervous system that alters regulation of bowel motility (motor function) or sensory function. Several conditions may present itself as IBS including celiac disease, mild infections, several inflammatory bowel diseases, functional chronic constipation and chronic functional abdominal pain. Some other causes of IBS are unknown.

For more information visit: Irritable Bowel Syndrome Treatment


 
 
     
 
 





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