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Irritable bowel syndrome (IBS) is a common disorder that affects the functioning of the gastrointestinal (GI) tract. Irritable bowel syndrome has previously been referred to as spastic colon, colitis, mucous colitis, and spastic bowel. Experts have chosen the name irritable bowel syndrome to better encompass the many physical and mental aspects of the condition, and to accommodate a broad spectrum of symptoms that seem to be related. Unlike irritable bowel disorders such as ulcerative colitis and Crohn’s disease, IBS does not damage the GI tract. Patients with irritable bowel syndrome commonly experience cramping, abdominal pain, bloating, gas, diarrhea, and constipation, though their intestines typically remain free of erosion and scarring.
The National Institute of Health (NIH) categorizes IBS into four subtypes:
Because little is known about what causes the functional changes of irritable bowel syndrome, IBS remains a syndrome – a grouping of symptoms that occur without a known cause – rather than a disease. It is, however, the focus of many major research projects, and many are hopeful that a definite cause is on the horizon.
According to the National Institute of Health, as much as 20% of the American adult population is affected by IBS, though only 5% to 7% receive a diagnosis. Women are twice as likely to suffer from IBS than men, and individuals under the age of 45 are at the highest risk of developing the disease.
Very little is known about the causes of IBS. Researchers suspect the following:
In addition to the broad causes of IBS, there are a number of other conditions and diseases that can be underlying causes of IBS. These include:
Though the causes of IBS are largely unknown, there are several factors that can influence your risk of developing the disorder:
An IBS diagnosis is exclusionary, meaning that a diagnosis is made when all other conditions with similar symptoms have been ruled out.
Before arriving at an IBS diagnosis, doctors may need to rule out the following conditions, which can present similar symptoms:
Tests that may help a doctor arrive at an IBS diagnosis may include:
In order to be diagnosed with IBS, a patient must experience symptoms for at least six months in total, and must have experienced symptoms at least three times a month for he three months leading up to the diagnosis.
According to the National Institute of Health, diagnostic criteria for the different types of IBS are as follows:
IBS symptoms can vary from patient to patient in severity and symptom type. The wide variety of possible IBS symptoms means that it is possible for the condition to present itself in entirely different ways in different patients.
Symptoms of IBS include:
Because IBS encompasses such a large group of symptoms and patient experiences, prognosis varies from case to case. Some people find complete relief by changing their diet or making other small lifestyle changes, while others chronically suffer from symptoms. The overall prognosis for patients with IBS depends on the severity and frequency of symptoms, as well as the patient’s ability to control these symptoms, whether by diet, lifestyle changes, or medications. Since IBS does not cause physical damage to the intestine, individuals with IBS are not at a heightened risk of colon cancer.
Many people report a significant improvement in symptoms by making lifestyle changes.
The following are tips to help you live more comfortably with IBS:
Because of the broad spectrum of cases within the scope of IBD, screening methods are not used to diagnose IBS in standard practices. If you are exhibiting any of the symptoms of IBS or feel that you may have IBS, your doctor will be able to perform diagnostic tests to help determine the cause of your symptoms.
The exact causes of these conditions aren’t known so there is no absolute prevention. However, it does appear that IBS development is correlated to stress levels and diet. Dealing with stress through methods such as meditation, biofeedback, deep breathing and yoga, may help prevent flare-ups. Maintaining a life-long balanced diet and taking regular probiotics may also help promote a healthy gut biome and digestive process.
Because little is known about the causes of IBS, most medications are directed at managing the symptoms of IBS. However, the FDA has recently approved a few medications to treat the causes behind specific cases of IBS.
The first line of treatment for IBS patients is most often symptom management through lifestyle and dietary changes. These include:
Restricted diet. Patients may be asked to cut out inflammatory food groups or change the balance of their diet.
Exercise regimen. Exercise can help minimize stress and promote regular digestion. If you do not already exercise regularly, your doctor may suggest implementing a routine that is manageable for you.
Nutritional Supplements. If the bowels are moving too quickly, proper nutrient absorption may be disrupted, leading to critical nutrient deficiencies such as iron deficiency and vitamin B deficiency. Ask your doctor or a registered dietitian about what supplements are best for you.
Medications. Medications are also available to help manage IBS symptoms. These include:
If symptoms worsen while taking any of these medications, or thoughts of suicide develop, stop taking the medication immediately. If you are experiencing thoughts of suicide, call the suicide hotline at 1-800-273-TALK (8255)
The following are the FDA approved medications for the treatment of IBS:
Alosetron (Lotronex). Alosetron has been linked to serious side effects, and prescription of the medication is therefore limited to female patients suffering from IBS with diarrhea who have not responded to other treatments. Alosetron works by relaxing the colon and lengthening the time it takes stool to pass through the colon.
Common side effects of Alosteron include:
More serious side effects include:
Do NOT take Alosteron if you:
Lubiprostone (Amitiza). Lubiprostone is also connected to serious side effects, and is therefore limited to female patients 18 years and older suffering from IBS with constipation who have not responded to other treatments. Lubiprostone works by increasing the secretion of fluids in the small intestine to help ease the passing of stool.
Common side effects of Lubiprostone include:
More serious side effects include:
Do NOT take Lubiprostone if you:
Lubiprostone may cause fetal harm, though studies are inconclusive. If you are pregnant or are thinking about getting pregnant, consult with your doctors about before taking Lubiprostone.
Linaclotide (Linzess). Linaclotide was approved for the treatment of IBS with constipation for both men and women in 2012. Linaclotide works by increasing the movement of food and waste through the gastrointestinal tract and by blocking problematic nerve signals in the colon.
Common side effects include:
More serious side effects include:
Most naturopathic approaches to healing IBS are focused on rebuilding the gut biome. According to Dr. Michael Hyman, medical doctor and best-selling author of the books The UltraSimple Diet and The Daniel Plan: 40 Days to a Healthier Life, there are almost 3 pounds of bacteria (more than 500 species) in your gut that help along your digestive process. When this massive population of microorganisms is disrupted, it can cause severe digestive upset.
Dr. Hyman recommends the following 5 steps to cure your IBS:
Many alternative health practitioners recommend certain mind-body practices that have been shown to reduce stress. These include:
Additionally, acupuncture may be able to effectively treat IBS symptoms and IBS-linked stress. Acupuncture to specific points is thought to release the energy and redirect its flow. In some cases electrical stimuli are given to the acupuncture needles to increase the effect (electro-acupuncture).Two very small trials examining acupuncture for the treatment of IBS have been performed with contradictory results. Despite this lack of data, many patients pursue acupuncture for abdominal pain, bloating, and nausea.
If you suffer from IBS, call your doctor if you experience:
If your doctor has diagnosed you with IBS, you may want to ask him or her the following questions:
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