Irritable Bowel Syndrome, often abbreviated IBS and sometimes referred to as “spastic colon” or “nervous stomach”, is a functional gastrointestinal disorder were altered gastrointestinal function leads to symptoms. The implication is that the gastrointestinal system in not damaged but altered in such a way that patients begin to have symptoms. It is believed that aberrant signals between the brain and gut result in abnormal motility and sensation leading to abdominal symptoms. This brain-gut axis is also modified by psychological stressors, prior acute bacterial gastroenteritis, imbalances in good versus bad gut bacterial flora and changes in reproductive hormones.
Patients are given a diagnosis of IBS when they have had cramping abdominal pain at least three times a month in the last three months with accompanying change in bowel frequency and/or consistency (diarrhea or constipation) and a characteristic improvement in pain following a bowel movement. A diagnosis of IBS is one of exclusion in that no other gastrointestinal disorders are present to explain these symptoms. Patients sometimes have other additional symptoms including the passage of mucus, bloating, distension and indigestion.
It is estimated that up to 20% of the adult population has experienced Irritable Bowel Syndrome. IBS appears to affect women more than men and occurs more commonly in our young adult population. A family history of IBS also increases one’s risk, however the exact genetics behind this relationship is unclear.
Irritable Bowel Syndrome is typically diagnosed clinically based on history and physical examination. If there are complicating, alarming or atypical features then you should visit Dr. Mantas for further evaluation and exploration of other more serious gastrointestinal conditions that can mimic IBS. Sometimes additionally testing is needed including blood/stool tests, imaging and endoscopy/colonoscopy. Dr. Mantas has specialty training in each of these modalities.
Some people may have IBS-like symptoms but have another disorder entirely. Ruling these conditions out is imperative. Common disorders include Celiac Disease, chronic pancreatitis, Inflammatory Bowel Disease and food intolerance/allergy.
People with IBS also tend to have other functional disorders including migraine headaches, insomnia, chronic fatigue syndrome, chronic pelvic pain, TMJ disorder and depression or anxiety. Recognition and treatment of these accompanying disorders is important for one’s overall health and management of IBS.
Rarely patients with IBS are at higher risk of developing additional gastrointestinal complications including ischemic colitis. It is important to have a gastroenterologist such as Dr. Mantas follow you and watch for complications.
Though IBS does not have a cure the symptoms of IBS can be treated. It is important to first rule out other serious gastrointestinal disorders that mimic IBS before starting treatment. The mainstay of IBS treatment rests on modifying the brain gut axis through the use of medications that alter neurotransmitter levels. In addition, various bowel modifying agents can be helpful including fibers, laxatives, anti-diarrheals, anti-spasmotics and upper pro-kinetic agents.
As we all know stress can affect your gastrointestinal system and cause and/or exacerbated IBS symptoms. Studies show that treatment of underlying psychological disorders can provide relief. Specifically, the use of medications like anti-depressants, anxiolytics and mood stabilizers and various therapies like hypnotherapy and cognitive behavioral therapy can be helpful. Also measures to reduce stress in your life including meditation, yoga, exercise and restful sleep will help alleviate your IBS. Lastly, because bacteria can interact with the brain gut axis modification of one’s flora through the use of prebiotics, probiotics and antibiotics may be of help in patients suffering from IBS.
A variety of other disorders can affect the intestine. Suggestive symptoms include abdominal pain, nausea, vomiting, diarrhea, constipation, bleeding and weight loss. Please visit Dr. Mantas if you feel that you have an intestinal disorder. Other common intestinal disorders include infectious enteritis, short gut syndrome and intestinal cancer.