Irritable Bowel Syndrome IBS
Uploaded by gurlyguy on Oct 21, 2007
Managing Irritable Bowel Syndrome
Irritable bowel syndrome (IBS)--also called irritable or spastic colon--is a common functional intestinal disorder characterized by recurrent abdominal discomfort and abnormal bowel function. The discomfort often begins after eating and goes away after a bowel movement. The symptoms can include cramps, bloating, constipation, diarrhea, and a feeling of incomplete emptying.
IBS occurs in about one in five Americans, more commonly in women, and more often at times of emotional stress. It usually begins in late adolescence or early adult life and rarely starts after the age of fifty. In severe cases, it can result in missed work days and curtailment of social activities. Although effective help is available, many people with IBS are too embarrassed, pessimistic, or afraid to seek medical care. Even worse, some people who consult a doctor receive insufficient guidance and conclude that nothing further can be done for them.
Why Symptoms Occur
During normal digestion, foods are broken down in the stomach and small intestine so that their nutrients can be absorbed into the body. Undigested or partially digested portions--mostly in liquid form--then enter the large intestine (colon), where most of the water is reabsorbed. Movement through the intestines results from peristalsis, a wavelike contraction of muscles in the intestinal walls that propel their contents forward. When all is well, the end result is stool that is solid but soft enough to be excreted easily.
Diet, eating habits, stress, and various environmental factors can disrupt the normal function of the intestines. If the intestines squeeze too hard or not enough, the partially digested food can travel too rapidly or too slowly through the digestive system. Movement that is too fast will result in diarrhea, because not enough water is reabsorbed. Movement that is too slow can result in constipation, because too much water is absorbed. Overly hard squeezing (spasm) can result in cramps. However, the diarrhea of IBS can also occur without pain.
IBS symptoms occur after eating because of the gastrocolic reflex--increased movement of the intestinal contents in response to food entering the stomach. The strength of this reflex can be influenced by the volume and temperature of the food and the number of calories it contains. Large meals (particularly high-fat meals) and large numbers of cold beverages can trigger IBS attacks.
Medical Evaluation
A thorough history and physical examination should be obtained. The extent of further evaluation depends on the patient's age, general health, and symptoms. If symptoms...