What is it
Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by pain and alteration of the frequency of evacuation and consistency of the stool.
It affects 10-20% of the adult population and is more frequent in women than men. In about half of the cases it occurs before 35 years of age.
It consists in the alteration of the normal motility of the intestine: it can be absent, slowed down or exaggerated, causing painful spasms, constipation or diarrhea.
Causes
The cause of irritable bowel is not known, but several factors have been identified that may contribute to the appearance of the syndrome.
Alongside a genetic predisposition there also seems to be a particular sensitivity and reactivity of the colon to normally harmless stimuli.
Certain foods and stress are among the triggers, but the immune system could also be involved.
In a variable percentage depending on the studies, the disease appears as a result of infectious gastroenteritis: in this case we speak of post-infectious irritable bowel syndrome.
Common symptoms
The most frequent symptom is abdominal pain, more or less intense, often associated with nausea and discomfort.
It is usually accompanied by an alteration of evacuations, with too soft or too hard stools. These alterations define three clinical forms of irritable bowel: predominantly diarrhea, prevalent constipation or alternating (when periods of constipation and periods of diarrhea alternate).
Often the symptoms are accentuated in the morning or immediately after eating, with abdominal pain and urgent evacuation (which can lead to incontinence) of a modest amount of loose stools (liquid or semi-liquid). These symptoms then disappear quickly, but involve considerable physical discomfort and difficulties in social relationships.
Abdominal swelling and mucus in the stool may also appear.
Heavy meals, gas buildup in the colon, certain medications, intake of wheat, barley, rye, chocolate, milk and dairy products or alcohol, caffeinated beverages, and situations of stress or emotional upset can also worsen symptoms.
Complications
No correlation has been shown between irritable bowel syndrome and chronic inflammatory bowel disease, such as Crohn’s disease and ulcerative colitis, nor with the onset of tumors.
However, the symptoms can significantly reduce the quality of life. Depression and anxiety often appear that can make symptoms even worse.
Treatment
Even today there is no specific therapy for irritable bowel. There are, however, several options to treat symptoms, and treatment depends on their severity.
In mild forms, a proper diet associated with a lifestyle change (regular meals and in a quiet environment, moderate physical activity and ingestion of soluble fiber) may be sufficient.
Some antispasmodics may be useful against pain, but they do not act on diarrhea or constipation, for which suitable drugs may possibly be prescribed depending on the prevailing form.
The use of probiotics can mitigate abdominal pain, bloating and frequency of bowel movements. Cognitive-behavioral psychotherapy and hypnosis can also be effective in the short term.
In moderate and severe forms, tricyclic antidepressants or selective serotonin reuptake inhibitors (SSRIs) can be used for pain control.
There is no single diet that works for everyone who suffers from irritable bowel.
However, as a general rule, it would be advisable to pay attention to these foods.
| Dairy products | Milk, cheese, ice cream |
| Vegetables | Cabbage, artichokes, onions, arugula, cucumbers, potatoes |
| Fruit | Peaches, pears, plums, grapes |
| Beverages | Coffee, tea, soft drinks |
| Other | Legumes, canned meat, preserved meats, sweeteners |
When to consult your doctor
Irritable bowel could easily be confused with a food allergy or intolerance. Therefore, whenever abdominal pain occurs, even immediately after meals, bloating, diarrhea or stubborn or recurrent constipation it is best to consult your doctor.
The presence of blood in the stool, fever, weight loss and strong and continuous pain are not common symptoms of irritable bowel, and could indicate more serious problems. In this case it is good to contact your doctor immediately.
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
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