Irritable bowel syndrome:Causes and treatment

Irritable bowel|stress|diet

Irritable bowel syndrome is a group of symptoms affecting your gastrointestinal system.It is characterised by recurrent abdominal pain associated with abnormal stool form or frequency.It can be constipation predominant IBS or diarrhoea predominant IBS
Symptoms of IBS

  • Abdominal pain and bloating often relieved by a bowel movement
  • Increased frequency of bowel movement
  • Excess gas
  • Mucus in stool

Causes of IBS

  • Impaired motility of the intestine
  • Poor coordination of the brain and intestine causing the nerves lining gastrointestinal tract to overreact to changes that normally occur during digestion resulting in a feeling of bloating or pain.
  • Small intestinal bacterial overgrowth (SIBO)
Risk factors for IBS
  • Previous intestinal infections
  • Females
  • Stress
  • Family history
Complications of IBS
  • Impaired social life
  • Depression and anxiety
Diagnosis
Irritable bowel syndrome is a condition diagnosed by excluding other diseases.Doctors may use a set of investigations such as blood tests, breath tests,stool tests, colonoscopy and CT scan.
Treatment

Mild disease can be managed by:

  • Reducing stress
  • Eliminating trigger foods
  • Adopting low FODMAP diet- fermentable oligosaccharides, disaccharides, monosaccharides and polyols.
An IBS flare up is usually managed by medicatons such as:
  • Fibre supplements eg. psyllium for constipation
  • Anticholinergic medications
  • Antispasmodics – Cimetropium
  • Tricyclic antidepressants- to regulate brain- gut axis. eg. Imipramine
  • SSRI antidepressants – eg.fluoxetine
  • Pain medication- pregabalin
  • Rifaximin- for SIBO
  • Probiotics
Newer drugs
  • Alosteron
  • Eluxadoline
  • Lubiprostone
  • Linaclotide
Psychotherapy
  • Cognitive behavioural therapy or hypnotherapy
Future directions
  • Faecal microbiota transplantation- transfer of stool from healthy person to IBS affected person to restore healthy bacteria.Although current studies show inconsistent results, more research is already underway.

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