Irritable bowel syndrome (IBS) facts.

• Irritable bowel syndrome (IBS) is a type of gastrointestinal disorder. IBS symptoms and signs include
• abdominal pain,
• altered bowel habits,
• increased gas,
• bloating (distention),
• cramping,
• food intolerance.
• The exact cause of irritable bowel syndrome (IBS) is unknown and may be due to multiple factors.
• A diagnosis of IBS is based on the duration (at least six months) and frequency of signs and symptoms (at least three times a month).
• There is no known cure for IBS, but there are many treatment options to reduce or eliminate symptoms. Treatment includes dietary modifications, lifestyle changes, and prescription medications.
• It is best to talk to a primary-care physician or a gastroenterologist about the best way to manage IBS symptoms and signs.

Irritable bowel syndrome (IBS) definition

          Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by the presence of a cluster of symptoms and signs that include cramping, abdominal pain, increased gas, altered bowel habits, food intolerance, and bloating (distention).
Irritable bowel syndrome is a "functional" disorder. This term refers to the changes in the functioning of the digestive system that results in the collection of symptoms referred to as IBS, meaning that it is a problem with the movement (motility) rather than any damage to the tissues of the digestive system.
In the past, irritable bowel syndrome was also called spastic colon or bowel, functional bowel disease, mucous colitis, or nervous colon. IBS is not the same as colitis, which is a group of separate conditions also referred to as inflammatory bowel disease (IBD).

What causes irritable bowel syndrome (IBS)?

          The exact cause of irritable bowel syndrome (IBS) is unknown. It is believed to be due to a number of factors including alteration in the gastrointestinal (GI) tract motility, abnormal nervous system signals, increased sensitivity to pain, and food intolerances. The following are some risk factors believed to cause IBS:

1. Abnormal movements of the colon and small intestines (too fast or slow, or too strong)
2. Hypersensitivity to pain from a full bowel or gas
3. Food sensitivities, possibly caused by poor absorption of sugars or acids in food
4. Gastroenteritis, a viral or bacterial infection of the stomach and intestines, may trigger IBS symptoms
5. Psychological conditions such as anxiety or depression are observed in many people with IBS, though they have not been found to be a direct cause of IBS.
6. Reproductive hormones or neurotransmitters may be off-balance in people with IBS.
7. Small intestinal bacterial overgrowth (SIBO)
8. Genetics is thought to be a possible cause of IBS, but so far this hereditary link has not been proven.

• What are irritable bowel syndrome (IBS) symptoms and signs?

  is characterized mostly by abdominal pain and cramping. Other IBS symptoms and signs include

  1. diarrhea or constipation;
  2. increased gas;
  3. abdominal swelling or bloating;
  4. cramping pain after eating certain foods;
  5. nausea;
  6. mucousy or foamy stool;
  7. symptoms are often relieved by bowel movements;
  8. women with IBS may have more symptoms during their menstrual periods;
  9. unexplained weight loss.
  
  

  How do physicians make the diagnosis of irritable bowel syndrome (IBS)?

            Irritable bowel syndrome is diagnosed by excluding other GI disorders that can cause similar symptoms. A complete history and physical is taken to determine the duration and frequency of symptoms. To be diagnosed with IBS, the duration of symptoms should be at least six months, and should occur at least three times a month.
  A doctor may order tests, including blood tests, stool tests, X-rays, or CT scans. There is no specific finding on these tests that can confirm the diagnosis of IBS, however, other problems can be ruled out by performing them.
  A doctor may also send the patient to a gastroenterologist (a specialist for the digestive system). Depending on the symptoms, an upper endoscopy and/or colonoscopy may be performed.

  What are irritable bowel syndrome (IBS) treatments and medications?

            Dietary modifications are the first treatment that should be tried to treat IBS. There are several types of foods in particular that often trigger IBS symptoms and signs (read IBS diet).
  If dietary modifications and lifestyle changes do not adequately treat IBS symptoms and signs, a doctor may recommend medical therapies.
  

  IBS medications

  1. Over-the-counter laxatives help relieve constipation and keep bowel movements regular.
  2. Antidiarrheal medications such as loperamide (Imodium), attapulgite (Kaopectate), and diphenoxylate and atropine (Lomotil) can be helpful if loose stool is one of the main symptoms.
  3. Antispasmodics, such as metoclopramide (Reglan), dicyclomine (Bentyl) and hyoscyamine (Levsin), decrease symptoms of pain and cramping.
  4. Antidepressants in low doses, such as tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs), may help relieve symptoms associated with IBS.
  5. Two drugs specifically used to treat IBS are lubiprostone (Amitiza), a laxative, and linaclotide (Linzess), a constipation medication.
  6. For females with IBS who experience severe diarrhea, alosetron (Lotronex) has been used.
  7. Antibiotics may be used when small intestinal bacterial overgrowth (SIBO) is suspected.

  Is there an irritable bowel syndrome (IBS) diet? Are there IBS home remedies?

  What one eats and how one eats can affect the symptoms of irritable bowel syndrome. While it may not be possible to completely prevent IBS symptoms, one may find that certain foods trigger IBS symptoms. To help figure out which foods cause symptoms, a doctor may suggest keeping a food diary.
  

  Foods to avoid or limit with IBS:

  1. Dairy products, including milk and cheese: Lactose intolerance symptoms can be similar to IBS symptoms.
  2. Certain vegetables that increase gas (such as cauliflower, broccoli, cabbage, Brussels sprouts), and legumes (such as beans).
  3. Fatty or fried foods
  4. Alcohol, caffeine, or soda
  5. Foods high in sugars
  6. Artificial sweeteners
  7. Chewing gum

  Some foods can help in the prevention of symptoms.
  

  Foods to eat with IBS:

  1. Dietary fiber supplements
  2. Water
  3. Low-fat foods
  4. High-carbohydrate foods (such as whole wheat pasta, brown rice, and whole grain breads)
  5. Probiotics
  6. Some people report kefir or aloe vera juice helps symptoms. Talk to a doctor about these home remedies.

  Some lifestyle changes can also help relieve symptoms, including
  

  1. eating smaller, more frequent meals;
  2. smoking cessation;
  3. exercising regularly;
  4. employing stress management and relaxation techniques.

  
  

  Is irritable bowel syndrome (IBS) related to small intestinal bacterial overgrowth (SIBO)?

            Small intestinal bacterial overgrowth (SIBO) is considered one of the factors that may produce signs and symptoms of irritable bowel syndrome (IBS). The medical data from studies done on SIBO are conflicting.
  Some studies show an increase in gas production by intestinal bacteria as a cause of the pain and bloating associated with IBS. However, other studies done to determine if SIBO is the cause of IBS and if antibiotic treatment of SIBO is helpful in reducing or eliminating IBS symptoms have not been conclusive.

  What is the prognosis for irritable bowel syndrome (IBS)?

            Irritable bowel syndrome is a chronic disease with symptoms that tend to come and go. The overall prognosis for patients with IBS depends on the severity and frequency of symptoms, and the patient's ability to control these symptoms, whether by diet, lifestyle changes, or medications.
  In general, there are few complications associated with IBS other than the symptoms of the disease itself. If someone has hemorrhoids, the diarrhea and constipation associated with IBS may irritate them. Also, too strict a diet that limits nutrients could cause problems related to lack of proper nutrition.
  IBS does not lead to colon cancer, rectal bleeding, or inflammatory bowel diseases such as ulcerative colitis.
  
  

  REFERENCES:
  
  Arvanitis, Michael. "Irritable Bowel Syndrome." American Society of Colon and Rectal Surgeons. <https://www.fascrs.org/patients/disease-condition/irritable-bowel-syndrome-0>.
  
  El-Salhy, M. "Irritable Bowel Syndrome: Diagnosis and Pathogenesis." World J Gastroenterol 18.37 Oct. 7, 2012: 5151-5163.
  
  International Foundation for Functional Gastrointestinal Disorders. "IBS Diet."
  
  "Irritable Bowel Syndrome." Medscape.com.
  
  "Irritable Bowel Syndrome (IBS)." PubMed Health.
  
  National Digestive Diseases Information Clearinghouse. Irritable Bowel Syndrome.
  
  Owens, D.M., et al. "The Irritable Bowel Syndrome: Long-Term Prognosis and the Physician-Patient Interaction." Ann Intern Med. 122.2 Jan. 1995: 107-112.
  
  "Pathophysiology of Irritable Bowel Syndrome." UpToDate.com.
  
  United States. National Institute of Diabetes and Digestive and Kidney Diseases. "Symptoms and Causes of Irritable Bowel Syndrome." <http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/irritable-bowel-syndrome/Pages/symptoms-causes.aspx>.