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Know About Irritable Bowel Syndrome

By Dr. Vikas Singla in Gastroenterology, Hepatology & Endoscopy

Apr 17 , 2023 | 2 min read

IBS (Irritable Bowel Syndrome) is a disorder involving the small intestine and large intestine, responsible for many gastrointestinal symptoms. IBS is responsible for significant morbidity among patients. It has a significant impact on the quality of life due to physical suffering, psychosocial issues and economic non-productivity.

According to some studies, the global prevalence of IBS has been estimated to be 11.2%. Based on epidemiological studies on IBS, the reported prevalence of IBS varies from 4.2% - 7.5% of the population. The actual numbers may be much higher.

Symptoms of IBS vary from patient to patient and may change over time. The most common symptoms of IBS include abdominal pain and distress, bloating, cramping, changes in the frequency (diarrhoea or constipation) and the nature of stool (liquid or hard). Based on the predominant symptoms, IBS has been subtyped into IBS-D (diarrhoea predominant), IBS-C (constipation-predominant) or IBS-M (mixed). Other symptoms include the feeling of incomplete evacuation, gastric issues and mucus in the stool.

The diagnosis of IBS (Irritable Bowel Syndrome) is mainly based on clinical evaluation and diagnostic criteria. Diagnostic tests are generally prescribed and used to rule out other diseases. IBS is usually diagnosed when all other disorders with similar symptoms have been excluded.

There are several myths associated with IBS. Many people believe that IBS is associated with cancer or it may give rise to inflammatory bowel disease. However, IBS is not an autoimmune disorder and will not give rise to colon cancer or IBD.

The exact cause of IBS is unknown, but some common factors that appear to play a role include severe gastrointestinal infection, irregular muscle contractions,

changes in gut microbiota and poor coordination between the intestine and the nervous system may cause IBS.

The bidirectional communication along the gut-brain axis is being extensively studied. The complex interaction between the gut and the brain plays a role in IBS and the aggravation of symptoms. Several psychosocial aspects of IBS are poorly understood. The association of certain disorders like depression and anxiety may be noted in some patients with IBS.

The initial treatment plan should include patient education and reassurance. The benign nature of the disease should be conveyed to the patient. Though there is no one-time cure for IBS, the symptoms can be effectively managed. The choice of treatment depends mainly on the predominant symptom.

First-line pharmacological treatments include fibre and osmotic laxatives for constipation, opioids for diarrhoea, and antispasmodics for pain. Management of associated psychological disorders also forms an important aspect. Adequate management of IBS requires a multidisciplinary team approach involving the physician, dietician and psychologist.

In clinical settings, dietary restriction of short-chain fermentable carbohydrates (the low fermentable oligosaccharide, disaccharide, monosaccharide and polyol (FODMAP diet) is gaining popularity in managing the symptoms of IBS.