Irritable Bowel Syndrome(IBS)

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Irritable bowel syndrome is a chronic, functional disorder that affects the large intestine. It is not contagious, or inherited.  
As it is a long-term condition of the digestive system, it will be a lifelong problem having a large impact on everyday life.
IBS does not affect life expectancy or lead to other serious diseases such as cancer or conditions such as rectal bleeding.
It affects twice as many women as men and typically occurs before age 45. IBS can be developed at any age but its first symptoms appear when the person is between 20 and 30.
In some people, IBS can be developed after periods of gastroenteritis. In some others it is caused by dietary allergies or food sensitivities, but this has not been proven. In some people, IBS is completely unrelated to diet and brought on by periods of stress.

IBS can be classified as IBS-A (alternating stool pattern), IBS-C (constipation-predominant), IBS-D (diarrhoea-predominant), IBS-PI (post infectious) depending upon common occurrence of diarrhoea or constipation.
Post infectious IBS disorder is caused due to acute gastroenteritis infection and it is characterized by fever, vomiting, and diarrhoea.

Symptoms

Irritable bowel syndrome (IBS) is a group of symptoms such as abdominal pain and discomfort, excess gas and bloating, nausea, backache problems, food Intolerance, incontinence, fatigue and difficulty in sleeping, changes in bowel movements causing diarrhoea, or constipation,
Loose, thin, stringy and frequent stools, a feeling of being unable to empty bowels in the case of IBS- D patients.
Hard, lumpy, infrequent stools, straining during bowel movements in the case of IBS-C patients.
These symptoms may remain over a long time, often years also.
The symptoms are more severe in only a few people. Some people can control their symptoms by managing diet, lifestyle and stress. People with more-severe symptoms can be treated with medication and counselling.
Progressive relaxation exercises help muscles to relax, one by one to ease symptoms.
Long-lasting reduction of symptoms can be done by psychotherapy.

Causes:

The exact cause of irritable bowel syndrome is unknown. It may be due to

  • Abnormal gastrointestinal (GI) tract movements due to the disruption in the communication between the brain and the GI tract,
  • Increased awareness of bodily functions,
  • Hypersensitive nerves of gut,
  • Stress,
  • Severe bacterial or viral infection of the gut,
  • Stronger and long lasting intestinal muscle contractions in the intestine causing diarrhoea,
  • Weak intestinal muscle contractions leading to slow food passage, hard and dry stools causing constipation
  • Vitamin D deficiency,
  • High fibre breakfast cereals containing Bran
  • Gas producing indigestible and partially digestible fibrous foods such as pulses (peas, beans and lentils)
  • Consuming certain foods and beverages, such as wheat, dairy products especially cheese, citrus fruits, cabbage, milk and carbonated drinks.
  • Processed foods such as chips and cookies
  • Breads and cereals made with refined (not whole) grains
  • High intake of the sugar substitute sorbitol
  • Intolerance to lactose
  • Hormones – in many women the symptoms become worse during or around their menstrual periods due to the effect of hormones
  • Changes in “good" bacterial composition of the gut

Diet:

Diet triggers for IBS constipation
Digestible fibrous food intake has to be increased by taking whole-grain bread and cereals, beans, fruits, and vegetables. The daily diet should include 18g of fibre obtained from ordinary foods in soluble form such as apples, pears, dates and other fruits and vegetables, oats, barley and rye.
Foods that are rich in the sugar substitute sorbitol, such as dried plums and prune juice are to be eaten moderately.
Plenty of plain water at least 1.7 litres every day has to be taken.
Ground flaxseeds are to be taken by sprinkling on salads and cooked vegetables.
Live yoghurt has to be eaten and intake of plenty of live yoghurt will maintain a healthy balance of bacteria in the gut.

Photo by Julian Hochgesang / Unsplash

Precautions and care

By controlling stress disorders, IBS can be prevented.
Stress-reduction technique helps in the letting out of worries and distractions.
Foods that trigger symptoms are to be avoided.
Digestible fibre containing food intake is recommended.
Drinking plenty of fluids, doing exercise regularly, and getting enough sleep can prevent IBS.